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Additional factors which contribute to the formation of Meibomian gland obstructions include: -An accumulation, or buildup, of keratin (a protein) contributing to the narrowing or blocking of the Meibomian gland ducts -Dead skin (epithelial) cells or debris can accumulate and block the glands -Eye rubbing causing mechanical trauma and exacerbating inflammation

pH 5.5 Formulated at skin's natural pH unlike harsh soaps and most drugstore face washes that raise skin pH above 7, disrupting the acid mantle and compromising everything that follows 0 Sulfates, Parabens, or Harmful stripping agents 2 Daily cleansing without barrier compromise 100ml Per bottle 23 months of daily use

This is verified via HPLC and mass spectrometry, with complete results documented on the included Certificate of Analysis

It is a requirement straight from Eli Lilly, the manufacturer, and reinforced by the FDA prescribing information for both Mounjaro and Zepbound