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If the presence of an initial stressor is prolonged, the HPA axis will become chronically activated and trigger the overproduction of cortisol which, over time, will result in a reduction in cortisol levels (427)

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Certain medications: Some medications, such as corticosteroids, androgens, or lithium, can cause acne as a side effect

Vinayagam R, Kandati S, Murugesan G, Goveas LC, Baliga A, Pai S, Varadavenkatesan T, Kaviyarasu K, Selvaraj R (2023) Bioinspiration synthesis of hydroxyapatite nanoparticles using eggshells as a calcium source: evaluation of Congo red dye adsorption potential