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Larger prospective studies are needed to better understand the risks of polycythemia and thromboembolism in this patient population as well as to develop evidence-based treatment strategies

Inflammation causes mood changes through alterations in subgenual cingulate activity and mesolimbic connectivity

23 Psychological stress can activate the hypothalamic-pituitary-adrenal axis, promoting the release of inflammatory factors such as interleukin-1 and tumor necrosis factor, thereby intensifying the facial erythema symptoms in patients

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That is not inherently a problem for maintenance, but for patients dealing with active acne, resistant hyperpigmentation, or post-inflammatory scarring, those concentrations often fall short of what the skin needs