Acne of any type, at any age, can be frustrating and, at times, embarrassing. It can occur on your face, chest, back, or other areas of the body, although those are the most common.

While many factors contribute to acne issues, steroid use, whether as a prescribed corticosteroid (oral or topical), testosterone hormone replacement therapy, or anabolic steroid use, the result is the same – unwanted acne.

Common acne, such as the type seen in puberty, is called acne vulgaris. It is most often seen on the face and certain body areas. With steroid acne, unwanted lesions appear more frequently on the back, shoulders, and chest. Steroid acne can still appear on the face.

Steroid acne has two types:

Acne vulgaris
Fungal acne

While most steroid acne cases come from acne vulgaris, fungal acne, also called Malassezia folliculitis, can occur due to a yeast infection in hair follicles that can happen with injected or oral steroid use.

Acne vulgaris spots associated with steroids are more uniform in nature than no-steroid acne. With fungal acne, the spots are similar in size, and there is an absence of whiteheads and blackheads.

Causes

Because it is called steroid acne, the first thought that comes to mind is illegal steroid use, a contributing factor in many cases. However, other things can cause steroid acne, as we see below.

Prescription corticosteroids

Prescribed corticosteroids are beneficial for many health conditions, including inflammatory bowel disease flare-ups, to prevent organ rejection, multiple sclerosis, asthma, and other medical conditions. However, corticosteroids, such as prednisone, can cause acne outbreaks a few weeks after starting treatment. Inhalation corticosteroid therapy that uses a mask is more likely to cause facial acne outbreaks.

While the exact mechanism behind corticosteroids causing acne is unknown, recentresearch shows that corticosteroids increase toll-like receptors (TLRs), with TLR2 being stimulated by Propionibacterium acnes (P.acnes), which exacerbates acne vulgaris and steroid acne.

The following factors can dictate if a person is more likely to develop acne during corticosteroid use:

Dosage – higher dosages increase risk
Susceptibility to acne – those who experienced acne during puberty or other times may have a higher risk
Skin tone – lighter skin has a higher risk
Length of treatment – the longer the use of corticosteroids, the greater the risk
Age – more common under thirty

Bodybuilding

It is not the act of lifting weights that causes acne breakouts, but the steroids used by some bodybuilders and athletes can lead to steroid acne. One of the leading formulations contributing to this problem is sustanon. Others use testosterone in extremely high doses, which can also lead to acne and oil skin. Acne is one of the side effects of testosterone use in too high a dosage.

Steroids, such as prednisone or other corticosteroids, are usually prescribed to tamp down inflammation by limiting the immune system response. These medications serve critical functions. Steroids are the best option in special cases like inflammatory conditions or the rejection of organ transplants. Maintaining a strong immune system is crucial to optimizing health.

Another good option to strengthen the immune system is HGH when growth hormone levels are low and causing problems. Find out the essential differences between HGH vs. steroids to determine if there are benefits for you.

Treatment

Steroid acne can appear as whiteheads, blackheads, cyst-like swellings, small or large red bumps, or yellow or white spots. Scratching or picking at acne can cause scarring, red, or dark marks. The recommended treatment will differ based on the acne's type, location, and severity.

Here are the most likely options for treating steroid acne:

Retinoids

Often, the first recommended option is a topical retinoid that can be purchased over the counter, such as products containing adapalene, tretinoin, or tazarotene. Topical retinoids (vitamin A derivatives) come as creams, gels, or lotions, and when applied to the skin, they can help prevent acne, but they take a few months to have an effect. These products reduce inflammation and help promote healthy skin cell production. *Do not use it if you are pregnant or breastfeeding.

Benzoyl peroxide

A non-prescription option to try is benzoyl peroxide, an antiseptic that kills bacteria that can cause acne. It also reduces inflammation and may work in combination with oral antibiotics. Try this if retinoids do not work. When applying it to your face, cover the entire area, not just the spots, and be gentle, as rubbing or scrubbing the skin can aggravate the outbreak.

Salicylic acid

Another non-prescription option, this treatment, helps exfoliate the skin and break down acne lesions. Do not use this with benzoyl peroxide, as that can irritate the skin, unless in a combination product.

Antibiotics

Topical and oral (off-label) antibiotics (tetracycline, minocycline, doxycycline) may help treat steroid acne. Oral antibiotics are not generally used for this treatment, which is why prescribing them for this purpose is off-label. Antibiotics help kill bacteria and may provide anti-inflammatory benefits.

It is a short-term solution that can take several weeks to a few months but should not be used in the long term. Ask your doctor about probiotic use when taking antibiotics to restore beneficial gut flora. Topical antibiotics are prescribed less due to the risk of antibiotic resistance.

Topical antifungals

Due to the fungal nature of this type of acne, a topical antifungal shampoo, such as ketoconazole, or an oral version, such as itraconazole, may be the prescribed treatment.

Additional recommendations include avoiding oil-containing skin products that clog pores. Look for products marked as non-comedogenic, and whatever you do, do not pick, scratch, or rub any acne lesions, as that can lead to infection or scarring.

Changing your diet and eliminating dairy, oily and fried foods, and sugar may help reduce acne breakouts.

Phytotherapy, which uses blue and blue-red light to help reduce acne, may help in some cases.

Conclusion

Prevention is the best course of action, which means avoiding steroid use whenever possible. Prescribed corticosteroids are for a reason, so discussing the risks of stopping treatment is crucial. Do not stop any prescribed medication without speaking first with your doctor.

Anyone taking anabolic steroids without a prescription should consider stopping, as that can reverse any acne and prevent more serious side effects. Look at steroid acne as a precursor warning that the body is not accepting the treatment well.

If you are using testosterone replacement therapy, you should immediately tell your doctor about any adverse reactions, including steroid acne. Lowering the dosage may help reduce acne flare-ups.

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Steroid Acne: Type, Causes, Treatment Guest Blog News