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
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
Benzoyl peroxide
Salicylic acid
Antibiotics
Topical antifungals
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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