Acne vulgaris is often a sign of underlying metabolic disturbance – a web woven of blood sugar, insulin, and sex hormone imbalance and often also a signal of microbiome disturbance. Classically, insulin resistance leads to direct stimulation of androgens from the ovaries in females. Overproduction of testosterone may lead to excessive sebum production, which, in turn, may increase the risk of inflamed sebaceous glands. This can trigger acne outbreaks.
But what about cases where objective tests measurements all appear to be normal?
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