Introduction
Anabolic steroids. They’re great for building muscle mass but they do have a plethora of side effects. One of which is acne, which can be quite severe in steroid users.
Causes
Why is it that steroids can cause more acne? It’s been shown that up to 50% of misusers develop acne [1]. This is because the majority of anabolic steroids mimic the chemical structure of male hormones like testosterone, DHT or nandrolone. As we know these male hormones give rise to oilier skin and this sebum/skin oil can attach to the dead skin cells and block pores causing acne. Naturally, these steroids can cause other health issues such as gynecomastia (due to elevated aromatisation of testosterone into oestrogen), balding (due to DHT), excessive body hair growth and premature ageing.
When dead skin cells and excess skin oil block a pore, this skin oil cannot find a way out onto the surface of the skin, this pore then becomes enlarged. Acne bacteria can then thrive and this causes inflammation.
Scientists are now quite confident about how much male androgens like testosterone cause acne. One study has shown that castrated men who have a lack of male androgen hormones “do not develop” acne [2, 3]
Prevention/Treatment
What is the best way to treat this acne? Firstly, prevention is always the best treatment but without advising you not to use steroids in the first place which would be the best solution. I believe that firstly it’s the large fluctuations in hormones that cause the biggest issues. So, a long ester steroid that absorbs slower would cause fewer fluctuations which would be better. Also, more frequent administration would do the same.
But, in terms of treatments dermatologists would normally recommend, a cream like benzoyl peroxide which works well but has a few side effects like bleaching hair and clothes, antibiotics that work mildly well on body acne but can kill good bacteria in the gut and stop working after time. Isotretinoin is the strongest treatment with the best results but horrendous side effects and should only be used on real scarring acne. But if you want a treatment with minimal side effects, I would use a natural one like the Aqneeq Solution and ensure I’m showering twice a day and following the recommended routine.
[1] https://pubmed.ncbi.nlm.nih.gov/17274777/