Steroid Acne Treatment

Although most people associate acne with teenagers and oily skin, there is one form of the skin condition that's related to steroid use, whether you're an athlete looking to improve performance or a patient with a serious illness. "Steroid acne," or "body-builder's acne" as it is sometimes known, shares some of the same symptoms and treatments as the more common form of acne, but there are also differences.

Cause

Both testosterone and stanozolol contained in oral anabolic steroids have been shown to increase sebum, or skin oil, that can lead to clogged pores and the formation of acne. A study from 1972 in the "Archives of Dermatological Research" also found that topical application of corticosteroid solutions caused this type of acne but will be more common if you're younger than age 30, are Caucasian or have a history or signs of acne. Steroid acne can also occur if you have Cushing's syndrome, an endocrine disorder caused by high levels of cortisol that is sometimes--but not always--brought on by the use of oral corticosteroid medication. In addition, steroid acne has become more common since the advent of organ transplant surgery and cancer treatment regimens, although the exact reason for this is unknown.

Identification

At first, steroid acne looks similar to the common acne vulgaris, but it actually shows more similarities to a skin condition called malassezia folliculitis caused by yeasts. It most often occurs on your chest but can also develop on your face, neck, back and arms, appearing as small skin bumps that may itch or be pustular. Unlike acne vulgaris, most of these lesions are the same size, and elevated nodules are rare. In instances of high doses of corticosteroids, you may also have a wave-like progression of numerous whiteheads that eventually transform into blackheads.

Considerations

The same steroids such as prednisone that can cause acne may also lead to other skin problems. You may find you have a tendency to bruise more easily even with only slight trauma, have slow wound healing, redness of the face, stretch marks and increased facial hair. Doctors such as Pennsylvania internist Dr. Robert D. Fusco recommend that if you're on a medical steroid like prednisone you should keep your skin clean and protected and avoid skin trauma, including sunburn, to minimize these potential side effects.

Treatment

The first step in treatment is to stop taking the steroids, if that's possible, although in the case of medical use, you may need to continue taking it with a different type or at a different dose. A University of Pennsylvania Department of Dermatology study from the 1970s found that using a topical application of a 0.05 percent solution of tretinoin, once to twice daily, resulted in a complete clearing of steroid acne within two to three months, despite continued therapy with high doses of steroids. Doctors also may prescribe topical antimicrobials such as benzoyl peroxide or azelaic acid or an oral antibiotic medication.

Warnings

Since 2002, a very dangerous class of synthetic anabolic-androgenic steroids, called "designer steroids," have been illegally created and used primarily by athletes. They haven't been tested or approved by the Food and Drug Administration, and their long-term effects are unknown. All anabolic-androgenic steroids may not only cause acne, but liver and kidney abnormalities and tumors, high cholesterol, aggressive behavior, birth defects, prolonged bleeding time, infertility and baldness.