All items are brand new and unused. Includes the shower head body and 8 cartridges. I subscribed to this, but it didn't fit my shower type, so I couldn't use it. I kept it unused without canceling the subscription. All instructions, etc., are included. It was only taken out of the box for the photos and is in beautiful condition. Thank you. #ShowerHead #Galeido #AtopicSkin #VitaminC