TNF and acne: Simultaneously, pro-inflammatory cytokines like IL-1β and TNF-α can also induce excessive production of proteolytic enzymes (e.g., matrix metalloproteinases), leading to collagen fiber degradation, impaired recombination, and subsequent alterations in local skin tissue structure during the reparative phase of post-acne erythema, ultimately resulting in scar formation (122, 123).