Drugs and Acne

Looking at the Research and Possible Links Between Drugs and Acne

Drugs and Acne

Article Summary

There is very little evidence regarding the effects of drugs on acne. However, most drugs increase the stress hormone cortisol, and some drugs increase inflammation in the body. Since stress can aggravate acne, and since acne is at its core an inflammatory disease, it is possible that drugs may prove detrimental for acne. However, due to ethical limitations on researching people who are doing drugs, we simply do not know for sure how various drugs might affect acne.

Scientists have performed two recent studies on marijuana and acne, but no research specific to other drugs and their effects on acne exists in any peer-reviewed medical journals. However, we do have research attempting to relate cocaine, MDMA (ecstasy), and marijuana with androgen production, both in animals and in humans. Androgens are male hormones that are present in both males and females and are intricately connected with acne development. As a general rule, the higher the androgen level, the more acne we see.

In addition, marijuana, cocaine, MDMA, and methamphetamines have all been shown to increase cortisol levels. Cortisol is the main stress hormone in the body and has been linked with acne. Some drugs also stimulate inflammation in the body. Acne is at its core an inflammatory disease, so anything that increases inflammation could theoretically worsen acne. Here’s what the research tells us so far:


Studies that have tried to find a link between marijuana use and acne have obtained mixed results. One recent study found that people who regularly use marijuana are more likely to suffer from acne than non-users.1 On the other hand, another study found that one of the components of marijuana reduces the production of sebum and suppresses inflammation, which should theoretically reduce acne in marijuana users.2


Marijuana and its psychoactive cannabanoid THC affect multiple endocrine (hormone) systems. Changes in hormone levels, particularly increased androgen levels, can increase acne. However, human studies investigating the effects of cannabinoids on hormones have been conflicting, with some studies showing lowered levels of androgens, some showing no change, and still others showing increased levels.3,4

In summary, more research is needed before we draw any conclusions on how marijuana affects hormone levels, sebum production, or acne incidence or severity.


There are no studies that have looked at the direct link between cocaine and acne. However, cocaine can change hormone levels and increase inflammation, which could theoretically result in worsening of acne.

Studies on cocaine show changes in testosterone and estrogen levels in humans and animals during and after administration.Human trials have shown increases in the androgen hormone called leuteinizing hormone (LH) in both male and female human subjects during cocaine administration.6-7

Animal trials have shown conflicting results. Chronic cocaine use was shown to disrupt the menstrual cycle in female primates.How this would potentially affect acne is unknown. In one study on rats, testosterone levels and testes size was markedly lower after four weeks of cocaine use.Lower testosterone normally means lower acne symptoms, but this is just one study performed on rats so we cannot draw any conclusions.

Two additional studies in humans have found that cocaine might indirectly increase the amount of the stress hormone cortisol in the body and can also increase inflammation.9,10 Both of these effects of cocaine could theoretically contribute to making acne worse.

MDMA (Ecstasy)

There are no studies that have looked at the direct link between MDMA (ecstacy) and acne. However, some evidence points toward possible changes in androgen and stress hormone levels following MDMA administration in animals and humans. The studies are small and results conflict.

MDMA (Ecstasy)
In one study on rats, scientists found lowered amounts of testosterone and also lowered amounts of another reproductive hormone GnRH in rats seven days after administration of ecstasy (MDMA).11 One small human study showed a huge spike in cortisol (800%) during MDMA usage with testosterone also increasing by 75%.12 Another study published in 2014 measured hormone levels in sixteen healthy men and women after administration of MDMA and found that while cortisol levels increased by 166% twenty-four hours after taking MDMA, testosterone levels did not change.13

Since the evidence thus far on MDMA and hormones is mixed, and we cannot extrapolate results from animal studies to humans, we do not know at this point whether MDMA negatively or positively affects androgen production. However, considering that ecstasy may dramatically raise cortisol levels, this could possibly be a concern when it comes to acne development.


Although anecdotal evidence suggests that methamphetamine users tend to develop acne, no research has been done on this topic. Methamphetamine users are also known to pick at their skin uncontrollably. Picking can cause physical irritation, which can lead to acne development. Picking is also a major contributor to scarring.

A study published in 2010 found that methamphetamines also increase stress in the body, which is linked to acne.14

Other Considerations Regarding Drugs and Acne 


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.

Missing Your Daily Regimen

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.

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.

The Experts at Acne.org

Our team of medical doctors, biology & chemistry PhDs, and acne experts work hand-in-hand with Dan (Acne.org founder) to provide the most complete information on all things acne. If you find any errors in this article, kindly use this Feedback Form and let us know.


  1. Wolkenstein, P. et al. Smoking and dietary factors associated with moderate-to-severe acne in French adolescents and young adults: results of a survey using a representative sample. Dermatology 230, 34–39 (2015).
  2. Olah, A. et al. Cannabidiol exerts sebostatic and antiinflammatory effects on human sebocytes. J. Clin. Invest. 124, 3713–3724 (2014).
  3. Brown, T. T. & Dobs, A. S. Endocrine effects of marijuana. J. Clin. Pharmacol. 42, 90S–96S (2002).
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  8. Jia, X. D., Zhou, D. X. & Song, T. B. [The reproductive system impairment of adult male rats induced by cocaine]. Fa Yi Xue Za Zhi 24, 411–413 (2008).
  9. Manetti, L., Cavagnini, F., Martino, E. & Ambrogio, A. Effects of cocaine on the hypothalamic-pituitary-adrenal axis. J. Endocrinol. Invest. 37, 701–708 (2014).
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  11. Dickerson, S. M., Walker, D. M., Reveron, M. E., Duvauchelle, C. L. & Gore, A. C. The recreational drug ecstasy disrupts the hypothalamic-pituitary-gonadal reproductive axis in adult male rats. Neuroendocrinology 88, 95–102 (2008).
  12. Parrott, A. C., Lock, J., Conner, A. C., Kissling, C. & Thome, J. Dance clubbing on MDMA and during abstinence from Ecstasy/MDMA: prospective neuroendocrine and psychobiological changes. Neuropsychobiology 57, 165–180 (2008).
  13. Seibert, J. et al. Acute effects of 3,4-methylenedioxymethamphetamine and methylphenidate on circulating steroid levels in healthy subjects. Neuroendocrinology 100, 17–25 (2014).
  14. King, G., Alicata, D., Cloak, C. & Chang, L. Psychiatric symptoms and HPA axis function in adolescent methamphetamine users. J. Neuroimmune Pharmacol. 5, 582–591 (2010).
  15. Alexopoulos, A. & Chrousos, G. P. Stress-related skin disorders. Rev. Endocr. Metab. Disord. 17, 295-304 (2016).
See More References

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