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Herein, we reviewed and discussed the underlying pathways of androgen biosynthesis and metabolism, non\u2010genomic regulation of androgen receptor expression and function, posttranslational regulation of androgen excess in acne and acne\u2010associated syndromes, such as polycystic ovary syndrome, and congenital adrenal hyperplasia. We provide insights into the involvement of sex hormones, particularly androgens, in skin homeostasis and acne pathogenesis, including comedogenesis, lipogenesis, microbiota, and inflammation. 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