I have seen far too many obese women put on antibiotics and retinoids and tacrolimus before checking them for pcos. In this age this is almost malpractice
Thank you for your comprehensive approach to understanding acne as more than just a skin issue. Viewing it as an early marker of systemic metabolic stress and inflammatory imbalance was insightful. The way you connected the mTORC1/FoxO1 axis and the gut-microbiome relationship really highlights how integrative this condition is.
Building on your excellent framework, two complementary factors fit into this systemic model. The HPA axis and chronic stress response is fascinating here—elevated cortisol and adrenal androgens like DHEA can directly stimulate sebaceous glands, while also promoting neurogenic inflammation through neuropeptides like Substance P. This adds another layer to the inflammatory pathways you described.
The exposome is another piece worth considering that there are environmental toxins and endocrine-disrupting chemicals that can interfere with hormonal balance, alter sebum regulation, and amplify oxidative stress, which feeds right back into that inflammatory cycle you outlined.
These elements complement your explanation and reinforce that whole-body perspective you have taken. It is this multifactorial thinking that makes the integrative approach to acne so compelling, recognising how internal physiology and external environment continuously interact in ways that show up on our skin.
Great read! Your skin is an external reflection of your internal health
I have seen far too many obese women put on antibiotics and retinoids and tacrolimus before checking them for pcos. In this age this is almost malpractice
Thank you for your comprehensive approach to understanding acne as more than just a skin issue. Viewing it as an early marker of systemic metabolic stress and inflammatory imbalance was insightful. The way you connected the mTORC1/FoxO1 axis and the gut-microbiome relationship really highlights how integrative this condition is.
Building on your excellent framework, two complementary factors fit into this systemic model. The HPA axis and chronic stress response is fascinating here—elevated cortisol and adrenal androgens like DHEA can directly stimulate sebaceous glands, while also promoting neurogenic inflammation through neuropeptides like Substance P. This adds another layer to the inflammatory pathways you described.
The exposome is another piece worth considering that there are environmental toxins and endocrine-disrupting chemicals that can interfere with hormonal balance, alter sebum regulation, and amplify oxidative stress, which feeds right back into that inflammatory cycle you outlined.
These elements complement your explanation and reinforce that whole-body perspective you have taken. It is this multifactorial thinking that makes the integrative approach to acne so compelling, recognising how internal physiology and external environment continuously interact in ways that show up on our skin.