Clear skin
Pilosebaceous inflammation↓
Also searched as Acne · Pilosebaceous inflammation.
Four mechanisms must coincide for a lesion to form, which is why single-target approaches disappoint. Androgen drive sits upstream of sebum, which is why it responds to hormonal state as much as to topical treatment.
In depth
Follicular inflammation at the pilosebaceous unit. The conventional model is local, not systemic — and the direction may run backwards: acne can be a marker of hormonal abnormality rather than its consequence.
What drives it
Blocks the hormone that shrinks follicles increases it.
10.1007/s00403-009-1019-6 — Drawn from reviews of neighboring outcomes rather than from studies of this outcome itself, which is weaker evidence, and the map marks it so. doi 10.1007/s00403-009-1019-6
Testosterone increases it.
C. acnes promotes inflammation via TLR2 and TLR4; TLR signals induce NF-kB-dependent expression of NLRP3, pro-IL-18 and pro-IL-1beta. Androgens raise sebum secretion, triggering acne. doi 10.21037/atm-22-1362 · PMC2904443
Hormone-binding protein reduces it.
All nine included studies reported a negative correlation between vitamin D level and chronic rhinosinusitis; vitamin D deficiency also causes airway hyperresponsiveness. doi 10.7759/cureus.55955 · PMC4002254
Skin reduces it.
10.12659/MSM.945336 — Drawn from reviews of neighboring outcomes rather than from studies of this outcome itself, which is weaker evidence, and the map marks it so. doi 10.12659/MSM.945336
Cell migration switch increases it.
Drawn from reviews of neighboring outcomes rather than from studies of this outcome itself, which is weaker evidence, and the map marks it so. Sources: doi 10.3389/fmed.2025.1582946; PMC11897119; PMC11007107. doi 10.3389/fmed.2025.1582946 · PMC11897119
Pathogen tripwire increases it.
10.7717/peerj.13553 — Drawn from reviews of neighboring outcomes rather than from studies of this outcome itself, which is weaker evidence, and the map marks it so. doi 10.7717/peerj.13553
Innate immune sensor increases it.
C. acnes promotes inflammation via TLR2 and TLR4; TLR signals induce NF-kB-dependent expression of NLRP3, pro-IL-18 and pro-IL-1beta. Androgens raise sebum secretion, triggering acne. doi 10.21037/atm-22-1362 · PMC2904443
Inflammatory signaling increases it.
C. acnes promotes inflammation via TLR2 and TLR4; TLR signals induce NF-kB-dependent expression of NLRP3, pro-IL-18 and pro-IL-1beta. Androgens raise sebum secretion, triggering acne. doi 10.21037/atm-22-1362 · PMC2904443
Inflammation signal (IL-6) increases it.
10.1007/s00403-014-1519-x — Drawn from reviews of neighboring outcomes rather than from studies of this outcome itself, which is weaker evidence, and the map marks it so. Verbatim: “IL-6 and IL-8 are also implicated in the pathogenesis of acne”. doi 10.1007/s00403-014-1519-x · PMC8322376
Inflammation signal (TNF-α) increases it.
10.1111/ced.12757 — Drawn from reviews of neighboring outcomes rather than from studies of this outcome itself, which is weaker evidence, and the map marks it so. doi 10.1111/ced.12757
Calms inflammation increases it.
10.3390/ph18010071 — Drawn from reviews of neighboring outcomes rather than from studies of this outcome itself, which is weaker evidence, and the map marks it so. doi 10.3390/ph18010071
Inflammatory alarm increases it.
C. acnes promotes inflammation via TLR2 and TLR4; TLR signals induce NF-kB-dependent expression of NLRP3, pro-IL-18 and pro-IL-1beta. Androgens raise sebum secretion, triggering acne. doi 10.21037/atm-22-1362 · PMC2904443
Calms body-wide inflammation increases it.
Drawn from reviews of neighboring outcomes rather than from studies of this outcome itself, which is weaker evidence, and the map marks it so. Sources: doi 10.3389/fmed.2025.1582946; PMC11897119; PMC11007107. doi 10.3389/fmed.2025.1582946 · PMC11897119
Oxidative stress increases it.
34466486 — Drawn from reviews of neighboring outcomes rather than from studies of this outcome itself, which is weaker evidence, and the map marks it so. Sources: doi 10.3389/fmed.2025.1582946; PMC11897119; PMC11007107. doi 10.3389/fmed.2025.1582946 · PMC11897119
What it drives
It reduces Skin.
PMC11537166 — 10.1371/journal.pone.0285648 — Supported by the reviews of this outcome as a whole. No separable effect size has been reported for this arm. doi 10.1371/journal.pone.0285648 · PMC11537166
It reduces Mood.
Supported by the reviews of this outcome as a whole. No separable effect size has been reported for this arm. This link rests on the reviews of this outcome as a whole, and no effect size specific to it has been reported. Sources:. PMC10831867
It increases Calm under stress.
Significant association of acne vulgaris with depression (r=0.22) and anxiety (r=0.25, 95% CI 0.19-0.31, P<.00001) across 42 studies; global anxiety prevalence in acne patients approximately 29%. doi 10.1016/j.jaad.2020.02.040 · PMC11893195
It increases Calms body-wide inflammation.
Supported by the reviews of this outcome as a whole. No separable effect size has been reported for this arm.
It reduces Wound healing.
https://www.merckmanuals.com/professional/dermatologic-disorders/acne-and-related-disorders/acne-vulgaris — Supported by the reviews of this outcome as a whole. No separable effect size has been reported for this arm.
Blends that modulate it
Each blend page names this pathway and carries the study behind its claim.
See it on the map
Open the causal map to follow this pathway upstream and downstream, arrow by arrow, each with its study.