Steroid Acne in Men: Causes, Treatment, and Prevention

               Naturally, about everyone has some form of acne, some small, some big. Steroid acne is a result of using anabolic steroids for a long. Or it could be your body is just sensitive to a particular compound present in anabolic steroids. First, it is important to note that this kind of acne is very normal, only that it may appear bigger than normal. Also, keep in mind that it is no disease, just a reaction.

Steroid Acne

             Normally, acne is caused by a change in hormones which triggers the production of fat. The fat clogs the pores on the skin, resulting in a lump which is referred to as acne. It is not clear what causes steroid acne but it is believed to be a result of individual compounds found in a particular steroid. Whether the steroids are prescribed or those used in bodybuilding, steroid acne affects the skin in a way that makes someone feel uncomfortable.

Steroid acne is a skin condition that is seen in people with high levels of corticosteroids circulating in their system. Anabolic steroids are known to cause severe acne which causes inflammation and swelling of an area of the skin. While there is a high chance that acne appearing on a bodybuilder’s skin is caused by steroid use, it is also worth noting that some acnes are very normal and natural. Steroid acne may be of two types.

• Acne vulgaris – this particular type of acne affects specific sites prone to acne, and the location varies from one person to the next. But the most common regions are the back, chest, and face.
• Malassezia folliculitis – this is a kind of steroid acne that is caused by yeast and bacteria found on the skin. The condition is triggered by the use of corticosteroids, more so those that are injected, ingested, or applied on the surface.

Steroid acne can be managed by applying special cream with anti-inflammatory characteristics. Alternatively, one can halt the use of steroids temporarily until the concentration of acne on the skin goes down. However, in most cases, steroid acne does not prevent bodybuilder from doing normal exercises. It only becomes a problem when they are exposed to hot temperatures which increases itchiness.

Types of Steroid Acne

             Steroid acne occurs in two main kinds. The most dominant is fungal acne. Also known as Malassezia folliculitis, this kind of acne is due to infection of the hair follicles. Acne Vulgaris is another type of steroid acne that affects most steroid users. It occurs whenever one uses an injected steroid, although it also occurs naturally. Steroid acne is mostly seen in adolescence but can also occur in other groups of people. It is important to note that most chemicals found in steroids are naturally occurring, and that’s why steroid acne is seen in people who don’t use steroids as well.

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How to Identify Steroid Acne?

            A bodybuilder may blame steroids for acne on their skin, yet it could just be any natural kind of acne. As mentioned earlier, steroid acne is not very different from normal acne. However, there are a few details that make steroid acne a bit different. Some outstanding features include:

• Open and closed blackheads that are normally bigger and darker than normal acne.
• Small red lumps. The lumps may increase in size, become redder, and more painful as one continues using the drug
• Lumps that look like a cyst. They may be painless in the beginning but becomes very painful when scratched or when pressure is applied.
• Inflammation of oil glands on the skin and around the hair gland area.

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What Causes Steroid Acne?

              It is known what causes steroid acne for sure, but theories have been advanced to try and explain its origin. Fungal acne is caused by the proliferation of Malassezia yeast. It is normally experienced by the bodybuilder around the chest and upper back area. Steroid acne presents itself as some itchy papules on the skin surface. Malassezia acne induced by steroids is of the same size and appearance. All kinds of steroid acne are a result of inhalation, ingestion, or injection of steroids into one’s system. The main cause of steroid acne is the use of certain types of steroids which increase the likelihood of developing the condition.

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Corticosteroids

            Corticosteroids such as prednisone are prescription steroids that are normally given to people who are undergoing organ transplants. The objective is to prevent organ rejection by the person’s system. However, corticosteroids can also be used for fitness purposes, specifically for bodybuilding.

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         The drug has been found to aggravate the occurrence of acne to a higher degree. However, acne caused by this drug does not occur immediately. It is normally seen long after someone starts using it. It also doesn’t affect people who have not used the drug for long. Steroid acne in corticosteroid users is prevalent in people under the age of 30 but is generally found among all age groups that use it.

              How does acne occur on steroid users exactly? Research, though not conclusive, shows that steroids trigger the production of immune system receptors. The receptors are known as TLR2 and together with bacteria residing in the human body cause acne in specific parts of the body. They do this by creating more oils than normal in the body which cause clogging of pores in the back and chest regions. It is the closest researchers have gotten to finding the cause of steroid acne, but more studies are still ongoing.

            It has also revealed that acne has some inheritance characteristics. Men whose fathers have had close acne will likely have it as well. It is more of a hormonal trait and not necessarily caused by steroid use. Steroid. acne is made worse by sweating. That means breakouts normally happen when the weather is hot and when someone is doing regular anabolic exercises. When mixed with sweat, the acne becomes very itchy and painful. Steroid acne is harder to control, unlike the one that appears on your face.

Treating Steroid Acne

First, steroid acne affects different parts of the body, namely:

• The face
• Upper back
• Chest region

           Treatment sometimes depends on the part of the body with the most outbreak. Treatment is also dependent on the kind of acne. Sometimes the acne becomes very stubborn and defies several treatment measures. Such kind of acne will require more complicated medical procedures to get rid of completely. But you don’t need to go through all that trouble as the condition is not fatal.

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            Steroid acne, like any other kind of acne, can be treated at home if it is not causing you extreme discomfort. Medical attention becomes necessary when the condition starts becoming a serious health issue. That normally happens when you scratch or press the spot hard and leave an open won’t. The wound can get infected when you apply skin creams or when it comes into contact with any other foreign substance. While most people prefer to treat acne with antibodies, it is always a good idea to treat it with Topicals. The following treatment strategies have been found to reduce steroid acne significantly. Sometimes the condition even disappears completely.

Related Article:: How Do You Get Rid of Steroid Acne?

Ingested Antibiotics

             Severe and moderate cases of steroid acne by taking tetracycline antibiotics orally. Oral antibiotics of this group have been found to contain chemicals that kill the bacteria that causes acne. Even if the acne doesn’t go away completely, the drugs will cure you of all inflammation. Children normally have a different prescription of oral antibiotics for the treatment of acne.

          Be informed that oral antibiotics don’t cure steroid acne overnight. It takes up to ten weeks of regularly using the drugs to see positive results. The good part is it is unlikely that the condition will come back after treatment. Your body sort of develops immunity to the condition even as you continue using steroids.

           Antibiotics as a treatment method for steroid acne is most preferred by people of color due to its effectiveness in eliminating acne scars. The reason is that that group of people are more susceptible to acne outbreak than the rest of the population.

Apple Cider Vinegar

           Made by fermenting apple cider, this compound can be applied to the area where steroid acne has broken out. It kills the bacteria or fungi that are causing the condition faster than you think.

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         Apply the mixture once or twice a day for better results. The technique is purely natural and can be done at the comfort of your home. Applying apple cider vinegar may only treat mild cases of steroid acne. Seek a stronger treatment if the condition is severe.

Benzoyl Peroxide

            Studies have shown that Benzoyl Peroxide is the most effective antiseptic to get rid of steroid acne. The compound kills the bacteria that causes acne through oxidation. It is the bacteria that is responsible for inflammation and reddening of the affected area. The effectiveness of Benzoyl Peroxide can be enhanced by combining it with oral antibiotics. The treatment method works best for mild cases.

          Steroid acne treatment with Benzoyl Peroxide is most popular because the compound is easily accessible. You only need to pay a visit to a regular chemist or pharmacy to get it. Most manufacturers mix it with salicylic acid to make it safer to use.

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            You should practice caution when using the product to treat acne as it may aggravate the outbreak. There is bound to be some irritation when Benzoyl Peroxide comes into contact with the wound. You should not scratch the spot no matter how much it gets itchy. The itchy feeling will go away after some time, paving way for the acne to heal and disappear. Acnes are not only the ones you can see. Some are too small to notice with the naked eye. Always apply the mixture to your entire, not to spots you can see only.

Phototherapy

              Although this treatment method is still being studied, some people have been healed of steroid acne through phototherapy. The treatment involves directing light at the spot of acne. Blue and red-blue light is mostly used for this purpose.

      The technique is not very popular among bodybuilders due to the long process of treatment. It is also expensive compared to other treatment methods. Besides, there may be severe side effects if the procedure is not carried out properly.

Home Treatment

            Not every case of steroid acne requires the attention of the doctor. You can manage the condition just fine with a few tips. You can learn how to prepare some kinds of Topicals to use them at home. A topical that goes by the name retinoid has been found to treat mild cases. The compound is found in specific creams, gels, and lotions. It is made from vitamins and does not have any side effects.

Steroid Acne Prevention

              Steroid acne is difficult to prevent unless you’re planning to halt the use of steroids entirely. But this is not an option if you’re a bodybuilder who has developed a dependence on steroids. All hope is not lost, though. We have prepared strategies for you that have a high likelihood of preventing steroid acne as well as reducing the severity of the symptoms.

Avoid Misusing Steroids

               You wonder why steroid acne does not affect everyone that is using steroids. Well, the condition is a direct result of misusing steroids. What constitutes steroid misuse? Prescribed steroids must not have treated differently from any other medication. Only take the required doses at the given intervals. Overdosing steroids will cause your body to react, steroid acne is one such reaction.

Stop using Steroids Altogether

            This is not a viable option but you have no other choice if the condition is very severe and is life-threatening. It is up to you to decide whether to stop using a particular steroid altogether for the sake of your health. Stopping the use of steroids comes with a lot of sacrifices, especially if it can potentially lead to career loss.

Use Topicals

            Topicals retinoids are not used to treat steroid acne only. They can also be used to prevent their appearance. The compound works best when combined with other dermatological products. Topicals should also be used regularly if you want to prevent acne completely.

Avoid Fatty Foods

          Acne would not form if there was no fat clogging your pores. It has been discovered that acne inflammation is a result of pressure put on the skin tissue by clogged fat on the pores. Reducing the intake of foods with a lot of fat and oil reduces the likelihood of steroid acne appearing. Or at least it will not make them big and painful. There is an anti-acne diet that you can take to reduce the likelihood of developing acne. An anti-acne diet is low in fat and rich in vitamins and minerals.

Common Skin Disorders Caused by Steroids in Men

              Steroids work well in treating skin disorders. But the drugs may cause additional skin conditions if used for long or wrongly. Many bodybuilders have not mastered how to strike the balance to avoid exposing themselves to severe skin conditions. However, it is important to note that skin conditions could still arise even when the bodybuilder doesn’t misuse the steroids or use them for long. It all depends on how your body responds to the steroids in the first place. Besides, people have underlying conditions that may also contribute to skin disorders. Sometimes the bodybuilder gets so much affected by the condition psychologically that it starts interfering with their career. Luckily for you, we are here to offer a little help.

            Steroid use is linked to several skin disorders, including cutaneous microbial proliferation. The drugs have been found to increase skin lipid levels and thus lead to clogging of pores. That is not the only disorder, though. Several studies are ongoing to determine the effect of steroids on the bacterial microflora invasion of the user’s skin. But first, let us see how steroids can be used to treat skin disorders.

Steroid Therapy for Skin Conditions

             The body naturally produces corticosteroid hormones in the adrenal gland. The hormones have anti-inflammatory characteristics and are used by the body to manage skin disorders such as dermatitis, rash, psoriasis, itching, eczema, and more. Topical steroids on the other hand are man-made and trigger the production of the same hormones. That means steroids can also be used to manage the same conditions.

             But as the saying goes, ‘too much of everything is poison’. The more one uses steroids, the more the negative impacts the drugs have on the user. However, side effects like skin disorders are not reason enough to quit your bodybuilding career. Unless the condition becomes life-threatening, of course.  Most of these conditions can be overcome easily, sometimes without needing to see a doctor. We are going to highlight common skin disorders to look out for as you continue using topical steroids. We will also provide some remedies for the conditions to help you continue using steroids without worrying about your health too much.

Red Skin Syndrome (RSS)

           Red Skin Syndrome is a condition of the skin caused by the use of steroids for a long time. The bodybuilder’s skin turns red, becomes itchy, and develops a burning sensation. Sometimes it swells and oozes. The condition normally worsens when one stops using steroids altogether. Bodybuilders who have become addicted to steroids are at a higher risk of RSS. A bodybuilder who is normally addicted to the drugs requires more and stronger dose than the previous one to get the same results. As the user keeps increasing the dosage and making it even stronger, their skin starts changing gradually. It reaches a point when the entire skin is affected and nothing else can be done other than seeing a doctor.

               Topical steroids cannot be used to treat RSS, for the simple reason that the condition is worsened by the drugs. If the user is addicted, counseling on stopping the addiction is the first kind of help they need. Some drugs may be used to treat individual symptoms such as antihistamines for itchiness. Most importantly, the patient’s condition may improve greatly when given appropriate psychological and emotional support. Immunosuppressants have also been found to work on some patients, so it is an option on the table.

Eczema and Perioral Dermatitis   

              The two conditions involve the inflammation of the skin which may cause itching or blistering of the skin. The only difference is that eczema is caused by substances originating within the body while dermatitis is caused by substances outside the body. Atopic eczema causes inflammation and a frequent flare-up of itching at various parts of the body from time to time. Contact dermatitis is caused when substances contained in topical steroids come into contact with the skin and cause inflammation.

             Eczema can be prevented by limiting the use of steroids, more so injected or ingested steroids. Since dermatitis is caused by topical steroids applied or sprayed on the skin, it goes away as soon as one stops using the drug.

Permanent stretch marks

         Highly potent corticosteroids have been found to cause permanent stretch marks on the body of the bodybuilder. The areas most affected by the stretch marks are:

• The underarms.
• Upper inner thighs.
• Elbow and knee creases.

           However, it is important to note that not all stretchmarks are caused by steroids. Most people and teens especially experience stretchmarks as a result of the thinning of the skin.  Under-treated eczema has also been found to contribute to stretchmarks in bodybuilders. The only remedy to stretchmarks caused by corticosteroids is to discontinue their use.

Bruising

             Prolonged use of steroids causes thinning and bruising of the bodybuilder’s skin around the upper arm. Bruising is usually caused by oral steroids taken for long periods spanning years. The condition becomes severe with age, meaning youthful bodybuilders don’t experience this disorder as often. And when they experience bruising, it is normally mild and disappears on its own. Exposing your arms to direct sunlight may also aggravate the condition. Bodybuilders with this condition are advised to wear long-sleeved shirts when outdoors to avoid exposing their skin to the sun.

              Bruising caused by steroid use can also be remedied by the use of skin moisturizers and applying special cream. Compounds such as CeraVe have been found to reduce the bruising considerably. Also, apply Arnica gel to the affected part and the bruising might just go away in a matter of days.

Discoloration

            Steroids can cause a change in skin color in some people. Whether it is a prescribed steroid or the one used in bodybuilding, there is always some sort of discoloration of the skin when used for long. Skin discoloration normally happens as a result of another skin disorder associated with steroid use such as eczema. Inflammation from dermatitis also changes the amount of pigmentation on the skin.

           The Center of Adverse Reactions Monitoring has been receiving reports of hyperpigmentation from steroid users. The condition has since been blamed on the prolonged use of potent topical corticosteroids. Adverse discoloration of the skin can lead to all other conditions already mentioned such as periorificial dermatitis.

           Skin discoloration from steroid use is reversed by discontinuing the drugs. However, you can try using low potent corticosteroids to manage the condition.

Steroid Rosacea

            Mid-face rosacea is caused by the long-term use of high potent steroids or withdrawal from their use. The condition is closely related to periorificial dermatitis, only that it is much similar to steroid-induced acne. A bodybuilder experiencing steroid rosacea will have inflammatory acne lesions that may consist of pustule papules and cysts. In more severe conditions, the patient may have motile Demodex mites from inflammatory cells.

         The face is a very sensitive part of the body, and only mild steroids should be applied to avoid conditions such as rosacea. Non-steroid anti-inflammatory drugs can be used to manage the condition as well.

Telangiectasias

           Telangiectasias is a skin disorder that is characterized by visible broken blood capillaries on the surface of the skin. The condition is due to the release of nitric oxide from endothelial cells. Telangiectasias induced by steroids first appear as red lines that get white when pressed. Many steroid users, however, don’t experience telangiectasias. There is no direct link between the use of steroids and telangiectasias. The condition is caused by long-term exposure to direct sunlight or high temperatures. What steroids do is aggravate the likelihood of developing the disease.

           There is no known cure for telangiectasias, but the condition can be managed by bodybuilders in certain ways. One of the preventive measures is obvious; discontinuing the use of the drug. If the symptoms are severe, it recommends that the patient sees the doctor as soon as possible. Diagnostic tests are normally conducted and the bodybuilder is treated based on the test results. Since telangiectasias can also be caused by underlying conditions such as eczema, the treatment may involve treating the underlying condition first.

Delayed Healing

             Delayed wound healing is another skin condition associated with the use of steroids. Some steroids have been found to inhibit keratinocytes thus delaying re-epithelialization. Long steroid use may also inhibit the connective tissue leading to other conditions like telangiectasias. the combined effect of these inhibitions and resulting conditions generally reduces the skin’s ability to heal faster. In such a case, the bodybuilder takes unusually long to recover from injuries.

          Delayed wound healing as a result of steroid use can be managed by reducing steroid intake and frequency. The bodybuilder can also choose to pause the use of steroids to avoid accumulating injuries that may interfere with their bodybuilding career.

Protecting Yourself from Steroid-related Skin Conditions

            The best way to prevent the appearance of common skin disorders from the use of steroids is to regulate steroid intake. That includes using for short periods as well as using products with appropriate potency. If you are not getting the results you want after using steroids for a long time, it is highly unlikely that you will get any results at all. It is even worse if the steroids are having a huge toll on you, more so your skin, yet you have nothing to show for it. If the latter is happening to you, stop their use immediately, because they aren’t doing you any good. But if they are helping your bodybuilding career, you can surely put up with discomfort or two of the skin. Either way, avoid prolonged use of steroids at all costs.

            Amidst all the misery caused by steroid skin conditions on bodybuilders, there is a ray of hope. Studies have been ongoing to develop selective glucocorticoid receptor agonists that will pave way for the development of steroids with few to no side effects on bodybuilders.

Final Word

            While most steroid-related skin conditions are not life-threatening, they may lead to more severe conditions if ignored. You know the condition is getting worse when you start experiencing unrelated symptoms. For instance, one may experience an intense headache and a fever when there are is an acne outbreak. That is the time to consult your doctor about it. But before it gets to that, monitor closely how your body responds to steroids after every cycle. If you are using different steroids, pay close attention to the effect each of them has on you. Monitoring them in this manner makes it easy to pinpoint the steroid that is responsible for a specific skin disorder, and you will then discontinue the use of that particular steroid only. All in all, remember that steroids are indeed used to treat skin conditions, so they are not bad for the skin entirely.

Conclusion

             Steroid acne is something you should learn to live with. The reason is simple; the benefits of using steroids, whether prescribed or for bodybuilding purposes are more than the downsides. However, your life is not something to gamble with. If steroid acne is bothering you physically or psychologically, don’t wait until it's too late. You can always start with home remedies, if they don’t work, consider seeing a doctor. Most importantly, find alternatives that do not cause acne. Steroid acne is one condition that is best treated with conventional techniques with no side effects. A little bit of irritation may be all you will experience.