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Excess glucocorticoid exposure suppresses GH secretion mainly through the increase in hypothalamic somatostatin tone, whereas low cortisol levels causes relative GHD that is reversible by glucocorticoid therapy (Giustinas effect) ( Figure 5 ) (104)

Many commercial formulations contain higher concentrations

Users stopping retinoids frequently report rapid regression of benefits within 4-8 weeks including increased breakouts sometimes exceeding pre-treatment levels (retinoid rebound), accelerated fine line reappearance approaching or surpassing baseline, skin texture deterioration returning to pre-treatment roughness, and psychological dependency from dramatic visible decline creating pressure for continuous use despite side effect burden

Inflammatory pathways of importance for management of inflammatory bowel disease

In reconstituted form, store in fridge and use in 4-8 weeks