PRL and acne: There was also evidence of dysregulated blood metabolites and elevated levels of prolactin in over half of this sample, which is common in people with SMI.26 Hyperprolactinaemia can have serious consequences, such as hormonal disturbances causing sexual dysfunction, facial hair and acne, disruption to usual pubertal development in young people and increased risk of developing cancers such as breast cancer.26–28 This is addressed appropriately within the service and monitoring of bloods is conducted routinely.