There is no current research specific to drug use and acne in any peer reviewed medical journals or dermatology texts. However, research does exist attempting to relate marijuana, cocaine, and ecstasy (MDMA) with hormone production, both in animals and in humans. Since we know that changes in hormonal balance can affect acne, this research is potentially interesting.

Marijuana

 Marijuana and its active component THC affects multiple endocrine (hormone) systems...Many of these responses observed, however, are lost with chronic administration.

Journal of Clinical Pharmacology

In other words, marijuana seems to skew hormone balance in the short term, but the development of tolerance may play a part in mitigating marijuana's hormonal effects with regular use. The article goes on to state:

 Studies in humans have had inconsistent results...Long term effects on the various endocrine systems have not been clearly demonstrated...1

Journal of Clinical Pharmacology

While it remains unknown how much marijuana affects hormones and acne, one piece of evidence stands out. Men who regularly use marijuana have a lowered sperm count.1 Again, why this is the case, and whether it would relate to acne in some way is unknown.

Cocaine

Studies on cocaine show changes in testosterone and estrogen levels in humans and animals during and after administration of cocaine.2 Human trials have shown increased leuteinizing hormone (LH) in both male and female human subjects during cocaine administration.3-4 We also know that chronic cocaine use can disrupt the menstrual cycle in female primates.2 In rats, testosterone levels and testes size was markedly lower after four weeks of cocaine use.5

Ecstasy

In one study, scientists found lowered testosterone and GnRH mRNA levels in rats seven days after administration of ecstasy (MDMA).6 One small human sample showed a huge spike in cortisol (800%) during usage with testosterone increasing by 75%.7

Methamphetamines and other drugs

No research exists.

We do not have enough research to draw any conclusions about drugs, hormone levels, and acne, but an initial look at the research is intriguing.

acne and stress myth

Stress

Drug use can cause both mental and physical stress, and stress is intimately connected with acne symptoms in many people. Overuse of drugs can lead to paranoia, anxiety, and depression. Drug use can also put stress on the body. Bodily stress is an often overlooked factor in acne formation.
acne and regimen myth

Missing your daily regimen

Drug binges can sometimes lead to missing one's daily skin care regimen. Consistent application of a properly applied regimen is required to completely clear acne.
acne and irritation myth

Irritation

Some drugs, especially methamphetamines, can lead to the uncontrollable need to pick at one's skin. Picking, or any irritation for that matter, is one of the biggest factors in acne development, and should not be underestimated.

  1. Brown TT, Dobs AS. "Endocrine effects of marijuana." Journal of Clinical Pharmacology. 2002 Nov;42(11 Suppl):90S-96S.
  2. Mello NK, Mendelson JH, et al. "The effects of cocaine on gonadal steroid hormones and LH in male and female rhesus monkeys." Neuropsychopharmacology. 2004 Nov;29(11):2024-34.
  3. Mello NK, Mendelson JH, et al. "Effects of Intravenous Cocaine and Cigarette Smoking on Leutinizing Hormone, Testosterone, and Prolactin in Men." Journal of Pharmacology and Experimental Therapeutics. 2003 Oct;307(1):339-48.
  4. Mello NK, Mendelson JH, et al. "Effects of cocaine on luteinizing hormone in women during follicular and luteal phases of the menstrual cycle and in men." Journal of Pharmacology and Experimental Therapeutics. 2001 Mar;296(3):972-9.
  5. Jia XD, Zhou DX, Song TB. "The reproductive system impairment of adult male rats induced by cocaine." [Article in Chinese] Fa Yi Xue Za Zhi. 2008 Dec;24(6):411-3.
  6. Dickerson SM, Walker DM, et al. "The recreational drug ecstasy disrupts the hypothalamic-pituitary-gonadal reproductive axis in adult male rats." Neuroendocrinology. 2008;88(2):95-102.
  7. Parrott AC, Lock J, et al. "Dance clubbing on MDMA and during abstinence from Ecstasy/MDMA: prospective neuroendocrine and psychobiological changes." Neuropsychobiology. 2008;57(4):165-80.