PIK3CA and acne: Recent studies show that androgens, insulin, and IGF-1 promote sebum secretion and acne development by activating the PI3K-Akt pathway (33) This pathway suppresses FOXO1 (34)upregulates mTORC1/SREBP-1 signaling, and triggers sebocyte proliferation, inflammation, and adipogenesis, ultimately contributing to acne pathogenesis (35).