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When circulation is compromised, oxygenation is low, or collagen is depleted, the result is visible: dilated blood vessels, pooled blood, and increased pigmentation all show up more easily here than anywhere else on the face

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Atrophic gastritis Loss of stomach acid, usually seen in older adults, can result in a condition called atrophic gastritis, says Miller

Consider this study from 2019

The researchers compare these in people with normal clear skin and people with skin that is prone to acne