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(PubMed) Chuengsamarn S, Rattanamongkolgul S, Luechapudiporn R, Phisalaphong C, Jirawatnotai S

Temporal increases in plasma markers of oxidized low-density lipoprotein strongly reflect the presence of acute coronary syndromes

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The concern is not that the anti-acne effects cancel out, they likely add up, but that pharmacodynamic overlap means the body is receiving redundant pressure on sebocytes and hepatic detoxification pathways simultaneously