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The difference is what reaches the dermis

In autism and TD groups, ACC D1 receptor radioligand binding was negatively correlated with ACC glutamine levels (r = 0.55, p = 0.022

doi:10.4088/PCC.23m03514

Welsh JL, Wagner BA, vant Erve TJ, et al

The data revealed the intense molecular anti-inflammatory and antioxidant OLC activities, which determine ROS level reduction in the intracellular compartment and a decrease in COX-2, NO, and PGE2 levels augmented via exposure to LPS in THP-1-derived macrophages

Additional findings suggest that DSIP may influence withdrawal responses in cases where subjects are dependent on traditional pain medications, potentially reducing rebound pain symptoms that arise during discontinuation