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According to NICE guideline NG198 on acne management, first-line options include fixed-combination topical treatments such as adapalene with benzoyl peroxide or benzoyl peroxide with clindamycin

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Also, after weight loss surgery, patients are on a very restricted diet and adjusting to a reduction in stomach capacity making it difficult to ingest all the nutritional supplements required

Theoretical concerns include excessive NAD+ elevation in individuals with preexisting metabolic disorders or mitochondrial dysfunction