Androgens stimulate the sebaceous glands in the skin to secrete an oily substance called sebum, which is composed of fats and cell debris. Similar to steroid abuse, excessive stimulation can also lead to a significant increase in the size of the sebaceous glands. These glands are located at the base of hair follicles in all hair-bearing areas of the skin. If androgen levels become too high and the sebaceous glands become overly active, the follicles may begin to clog with sebum and dead skin cells, leading to acne. Acne vulgaris is commonly seen in steroid users, especially when drugs are taken at supratherapeutic levels. This usually includes acne lesions on the face, back, shoulders, and chest.

Treatment of Acne

Mild cases of acne vulgaris are typically managed with specialized over-the-counter medications. Acne medications and strict skin cleansing routines can help clear excess oil and dirt. More sensitive individuals may develop severe acne, including acne conglobata (severe acne with interconnected nodules under the skin) or acne fulminans (highly destructive inflammatory acne). These conditions may require medical treatment, often involving isotretinoin therapy. Specialized anti-androgen medications for the treatment of severe acne are also under investigation and have shown great promise in early trials. Acne usually resolves by discontinuing steroid use, although sebum production may remain excessive until the sebaceous glands shrink back to their original size. Severe acne can result in lasting scars.