TNF and acne: The literature supports that an increase in weight loss leads to an increase in IGF-1.19 The results from one study suggest that IGF-1 may lead to the induction of acne or worsen preexisting acne through upregulating inflammatory biomarkers in sebaceous genes.20 After treating cultured sebocytes with IGF-1, a study performed polymerase chain reaction and enzyme-linked immunosorbent assay to evaluate changes in the expression of inflammatory markers such as interleukin (IL) 1β, IL-6, IL-8, tumor necrosis factor α, and nuclear factor kappa-light-chain-enhancer of activated B cells.