The use of anabolic steroids, especially testosterone, is highly correlated with acne development. In other words, if you take anabolic steroids, your chances of developing acne, including severe acne, go up dramatically.
Why is this the case? Anabolic steroids increase the amount of skin oil produced in pores, and people with more skin oil tend to have more acne and more severe cases of acne.
Additionally, abuse of steroids can cause other serious conditions, including hormonal imbalances, liver damage, and heart problems. They also can cause less serious, but still troubling problems, such as gynecomastia (breast growth in men), thickened skin, and premature aging.
Because anabolic steroids can be damaging to the body and skin, they should be taken only under strict guidance from a medical professional, and only when absolutely necessary.
Steroid hormones naturally exist in the human body. They are responsible for important body processes that include the development of sex organs, as well as the formation of the immune and stress response.
Anabolic steroids, also called anabolic-androgenic steroids (AAS) are a subtype of steroid hormones called androgen steroids. Steroids of this type grow the skeletal muscles (anabolic function) and promote the sex development of both sexes (androgenic function). One common and familiar anabolic steroid is testosterone, which is present in both males and females.
While AAS naturally exist, they can also be man-made and supplemented through either injecting into muscle tissue or swallowed orally.
Although doctors use AAS to treat a variety of health conditions, including delayed puberty, reduced sex drive, and the wasting of the body due to severe diseases like HIV/AIDS and cancer, AAS treatment can cause severe side effects, including, but not limited to, hormonal imbalances, hypertension, liver damage, heart problems, hair loss, excessive hair growth, and skin problems like acne. In fact, anabolic steroid abusers are likely to experience acne not only on the face but also on the shoulders and back.1
Anabolic Steroids Increase Sebum (Skin Oil) Production
Anabolic steroids trigger acne by increasing the production of sebum in the pores of the skin. Research shows us that increased sebum production normally leads to more acne.2
Adding evidence to the connection between androgens and acne, other studies that have focused on castrated men who do not have androgen hormones have found that due to a lack of androgens, castrated men “do not develop acne.” However, scientists can observe acne in castrated men who receive testosterone replacement.2,3
Therefore, it is safe to conclude that an increase in the level of androgens leads to an increase in sebum and potentially in acne. Since AAS are part of the larger class of androgens, they also result in increased sebum production.
Anabolic Steroids Are Correlated with Acne Development
One independent study found that people with naturally high levels of testosterone tend to notice more acne. And five more studies show that externally administered anabolic steroids also cause increased acne.
A 1986 study published in the journal of Clinical and Experimental Dermatology examined the blood steroid levels of 17 male and 42 female patients with and without acne. The researchers found that testosterone levels were 22.4% higher in acne patients compared to those of healthy individuals.4
A 1994 study published in The Journal of Clinical Endocrinology and Metabolism examined how a high dose of testosterone impacts behavior and physiology of healthy men. To perform this study, healthy men were injected with an abundance of testosterone once a week for 20 weeks. The researchers found that half of the 19 participants who took a high dose of testosterone developed acne, and the majority of the men who developed acne were younger and had a previous medical history of it.5
A 1996 study published in The New England Journal of Medicine examined how testosterone injections affected muscle growth and strength in men. For 10 weeks, 43 men received weekly injections of testosterone or a placebo. After study completion the researchers found that 3 of the 21 participants who received testosterone developed acne during the study. The occurrence of acne was only 14%, which is the lowest incidence found among these studies.6
A 1997 study published in the British Journal of Sports Medicine examined the side effects reported by 100 male anabolic steroid abusers. They found that the most common side effect was acne—54% of the study-participants experiencing the skin condition. 7
A 2007 study published in the JDDG examined the side effects reported by the 4339 anabolic steroid abusers who called an anti-doping hotline run by Huddinge University Hospital in Stockholm, Sweden. AAS abusers reported acne as the third most common side effect after aggression and depression, with an incidence rate of 18%.8
Side Effects of Anabolic Steroids
The following are the most common side effects from anabolic steroid use:
And here we can see what side effects anabolic steroid users report:
The Bottom Line
Anabolic steroids, especially testosterone, are highly correlated with acne development. Additionally, abuse of steroids can cause other undesirable side effects like reduced testicular volume and breast growth in men. They can also cause serious conditions, including liver damage and heart problems. Anabolic steroids can be damaging to the body and skin and should be taken only under strict guidance from a medical professional.
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- Kuhn, C. Anabolic steroids. Recent Prog. Horm. Res. 57, 411–434 (2002).
- Degitz, K., Placzek, M., Borelli, C. & Plewig, G. Pathophysiology of acne. J. Dtsch. Dermatol. Ges. 5, 316–323 (2007).
- Leyden, J. et al. A systemic type I 5 α-reductase inhibitor is ineffective in the treatment of acne vulgaris. J. Am. Acad. Dermatol. 50, 443–447 (2004).
- Lawrence, D. Shaw, M. & Katz, M. Elevated free testosterone concentration in men and women with acne vulgaris. Clin. Exp. Dermatol. 11, 263–273 (1986).
- Bagatell, C., Heiman, J. R., Matsumodo, A. M., Rivier, J. E. & Bremner, W. J. Metabolic and behavioral effects of high-dose, exogenous testosterone in healthy men. J. Clin. Endocrinol. Metabol. 79, 561–567 (1994).
- Bhasin, S. et al. The effects of supraphysiologic doses of testosterone on muscle size and strength in normal men. New Eng. J. Med. 335, 1–7 (1996).
- Evans, N. Gym and tonic: a profile of 100 male steroid users. Br. J. Sports Med. 31, 53–58 (1997).
- Melnik, B. Jansen, T. & Grabbe, S. Abuse of anabolic-androgenic steroids and bodybuilding acne: an underestimated health problem. J. Dtsch. Dermatol. Ges. 5, 110–117 (2007).
- Hartgens, F. & Kuipers, H. Effects of androgenic-anabolic steroids in athletes. Sports Med. 34, 513–554 (2014).