Today, many men and women in the bodybuilding industry are finding that with the use of anabolic steroids and high doses of testosterone required to build the perfect physique comes with it a blast from the past in the form of hormonal acne.
While you can treat acne caused by hormonal imbalances (or an overabundance of certain types of androgens), it should be kept in mind that any treatment cream will only be effective once the use of steroids has ceased.
Forget Bro Science, We Have Acne Science
Acne is a chronic inflammatory medical skin condition that can range from small clogged pores called comedones, that are open (blackheads) or closed (whiteheads), papules (small red bumps on the skin), and pustules (papules filled with pus) to large, painful, swollen cysts that lie deep beneath the skin.
When you are on the way to crafting a body that is the height of perfection for either amateaur or professional bodybuilding competitions, having an unsightly breakout of acne isn’t going to do much for your confidence.
Acne, the resulting scarring and those dark marks it often leaves behind (post-inflammatory hyperpigmentation or PIH) can be stressful, so seek treatment as early as possible so you can feel confident in your body. Remember that there is no such thing as ‘mild acne’ – all acne should be treated to avoid it progressing and spreading.
Acne And Steroids
The most common cause of acne is hormonal. Hormones are powerful and they have a tendency to go haywire when your body is struggling with something else, like dieting, working out or stress.
If you’re an adult male, your acne might be hormonal. Hormonal acne causes pimples to form on the face, chest, neck and back. The hormones responsible for this are testosterone and DHEA-S. High levels of these hormones can lead to spiking the body’s sebum production. What is sebum? It is a natural oil that lubricates our skin and hair. If there is an excessive amount of sebum present in the pores it can clog them, leading to a breakout!
Androgens are hormones that play a vital role in human reproduction, like testosterone which is responsible for male sexual development and reproduction. Adult males and females produce androgens naturally; however, the levels differ between men and women.
Steroid-related acne presents in about 50% of people who use anabolic steroids in large doses for bodybuilding. The steroid known as sustanon (sometimes called “Sus” and “Deca”) is a common cause of steroid acne in bodybuilders. High-doses of injected testosterone may also contribute to acne outbreaks.
Anabolic steroids that are used for bulking cycles also produce testosterone, which as we learnt earlier ramps up the production of sebum, a leading cause of severe acne.
Aside from the use of anabolic steroids there is a more insidious way for your skin to suddenly freak out while sculpting your body. Whey protein, the popular workout supplement and meal replacement choice has been known to be linked with acne. This is because whey protein stimulates muscle growth, which in turn increases the levels of the insulin-like growth factor, or IGF-1. This hormone increases sebum production and skin cell growth. More oil being pumped out of your sebaceous glands and more skin cells come together to form the perfect scenario for acne.
If whey is making you break out, there are non-dairy alternatives like egg white protein and pea protein (which are great options if you also find you bloat after consuming a whey protein shake).
From over-the-counter (OTC) remedies to custom formulated prescription treatments, there are various ways to treat acne and prevent it from returning. The clinically formulated treatments can be found through telehealth providers, like Qr8 MediSkin, whose doctors can customise the best acne cream or serum treatment product for you – one that targets the acne-causing pathways to help you manage acne (and PIH at the same time). Let’s take a look at the types of acne and their treatments.
Whiteheads or closed comedones, are pores that have been blocked along their entire length. The head of the pore is closed, leaving a small white bump on the skin. Don’t pick or squeeze these little guys, you may be left with scars.
Treating whiteheads is easy enough with a bog-standard OTC treatment geared at unclogging pores: benzoyl peroxide, salicylic acid, and retinoids. Retinoids help clear acne by unclogging pores full of oil and dead skin cells.
These are open comedones, where the head of the pore is open while the rest is clogged. Blackheads can be squeezed, although again you shouldn’t in case you end up with scarring.
Acne treatment options for blackheads are the same as those used for whiteheads. While they may be tempting for some, pore strips are in fact an abrasive, temporary fix that can damage the top layer of your skin. Which can make your breakout worse!
Papules are small red bumps without any pus. They form when oil and excess dead skin cells clog pores and mix with bacteria called Cutibacterium acnes.
OTC benzoyl peroxide treatments can be effective when treating papules and other forms of inflammatory acne because of its antibacterial properties. Dermatologists may prescribe a topical retinoid acne cream, antibiotics, or birth control pills (for women) to help combat inflammatory acne. Birth control pills can reduce oil production by decreasing androgen (the male sex hormones that are found in both men and women) levels.
These small bumps usually have a white centre, are filled with pus, and are surrounded by inflamed skin. They like to pop up the chest, face, and back. Pustules are blocked pores that have become infected, but they can be caused by changes in hormones.
The same OTC and prescription treatment options used for papules work on pustules. Antibiotics are sometimes recommended to get rid of the bacteria-filled pus.
Nodules are skin-coloured or red bumps under the skin’s surface. Nodular acne is usually a result of the C. acnes bacteria causing a deep, sometimes painful, infection within the pore. Salicylic acid and benzoyl peroxide are both effective against nodules. Salicylic acid is keratolytic, it exfoliates dead skin to help reduce clogging. Benzoyl peroxide reduces inflammation, kills P. acnes bacteria and reduces oil production.
A dermatologist can help you clear acne nodules with prescription-strength benzoyl peroxide or salicylic acid, antibiotics, retinoids, or birth control pills (for women).
Acne cysts are large, red, inflamed, painful, and pus-filled. Cysts are softer than nodules and often burst, resulting in the spread of infection.
Treat cystic acne with medications like isotretinoin (an oral retinoid), antibiotics, topical retinoids, birth control pills (for women), or spironolactone. A breakout of cysts may require multiple medications, and some medical professionals may suggest injecting cysts with steroids to directly reduce inflammation.