CXCL8 and acne: Given that the FemmeBalance formulation contains N-acetylcysteine (NAC), which has demonstrated efficacy in acne treatment through its anti-inflammatory properties, including inhibition of inflammatory cytokines (TNF-α, IL-8, IL-6, IL-1β) and antimicrobial activity against acne-associated bacteria [21], dermatological assessment was included as a secondary exploratory outcome to evaluate potential skin benefits.