brand new never used I only opened the outer cardboard box to remove the sticker with my name on it comes with all instructions inhibitor AND remover I bought it because I have PCOS and am undergoing electrolysis and thought this was an inhibitor alone. it is also a remover and I can't counteract my electrolysis with a remover they won't take it back it DOES get great reviews on efficacy (Google it, five stars) I'm NOT a doctor clearly and this IS Rx only (super easy to get an Rx) so I hold no responsibility for your purchase in that sense. recommended for those already familiar with the product who want it at a cheaper rate again it has never been opened / touched