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Smoking: Tobacco use lowers HDL (good cholesterol), which helps remove LDL from the bloodstream [1][2][4]

8 An increasing number of GPs and patients advocate for changes to policy and practice that enables self-management of the disorder, including self-injection

It's worth noting that skin whitening is the subject of extensive research and training in some Asian countries for dermatologists, which doesn't seem to be a real concern for dermatologists, who focus on so-called "uncomfortable" treatments, even though many perform Botox injections frequently