From the Guidelines
Anabolic steroids can change skin flora, leading to an overgrowth of certain bacteria such as Propionibacterium acnes and Staphylococcus aureus, which can manifest as acne, particularly on the back, shoulders, and chest. The mechanism involves steroids stimulating sebaceous glands to produce more sebum, which serves as food for these bacteria, as well as suppressing immune function, further compromising the skin's ability to maintain a healthy microbial balance 1.
The severity of skin flora disruption generally correlates with the dose and duration of steroid use, with higher doses and longer periods of use causing more significant alterations to the skin's microbial ecosystem. Some key points to consider include:
- The use of anabolic steroids can lead to changes in skin flora, which can result in acne and other skin issues 1
- Topical corticosteroids, which are sometimes used to treat skin conditions, can also have adverse effects, including skin atrophy and allergic contact dermatitis 1
- The risk of adverse effects from topical corticosteroids can be minimized by using lower potency steroids, avoiding occlusion, and limiting use on thinner and intertriginous skin 1
It's worth noting that the evidence on the effects of anabolic steroids on skin flora is not as extensive as it is for other topics, and more research is needed to fully understand the relationship between steroid use and skin health. However, based on the available evidence, it is clear that anabolic steroids can have a significant impact on skin flora, and users should be aware of the potential risks and take steps to minimize them. The most recent and highest quality study on this topic is from 2023, which provides guidance on the management of atopic dermatitis in adults with topical therapies, including the use of topical corticosteroids 1.
From the Research
Anabolic Steroids and Skin Flora
- There is no direct evidence to suggest that anabolic steroids change skin flora 2, 3, 4, 5, 6.
- However, anabolic steroid use has been linked to various skin problems, including acne, gynecomastia, prostatitis, and alopecia 2, 5, 6.
- Acne, in particular, is a common side effect of anabolic steroid use, with some cases being severe enough to be classified as acne fulminans 6.
- The exact mechanism by which anabolic steroids affect the skin is not fully understood, but it is thought to be related to the hormone's effect on sebaceous glands and oil production 5.
- Dermatologists play an important role in identifying and addressing anabolic steroid use in patients, as the skin manifestations can be an indicator of underlying steroid abuse 6.