Though it might be commonly experienced in your teenage years, acne doesn’t always stop once you’re an adult—many people over 20 deal with pimples, too, and they can happen for a variety of reasons.
Many factors can contribute to acne breakouts. One type of acne is steroid acne, which is closely related to specific medications such as corticosteroids.¹ Here we’ll cover the basics of steroid acne, its causes, prevention strategies, and possible treatments.
Steroid acne is a type of drug-induced acne that occurs as a side effect of taking specific medications. Most notably, these include oral or topical corticosteroids—a type of steroid that treats respiratory, inflammatory, and autoimmune disorders. Yet, other compounds can also cause acne, such as testosterone, anabolic steroids, and vitamin B12.²
Steroid acne is similar to “common” acne (acne vulgaris), causing multiple eruptions on the face and certain areas of the body. The lesions of steroid acne usually concentrate on the chest, back, and shoulders, but some people may also get facial acne.³
Acne is a known side effect of corticosteroids. There are also other possible side effects, which include:⁴
Unexpected weight gain
It’s important to keep in mind that anyone taking these medications can get steroid-induced acne, no matter their age.⁵ While the straightforward treatment for steroid acne is to stop taking steroids, sometimes you’ll have to keep going with your current treatment because of medical conditions and your medical provider’s recommendations. Luckily, there are other options for treating steroid acne.
Steroid acne is caused by a specific type of medication called corticosteroids. Prescription corticosteroids are used for treating asthma, inflammatory bowel disease, multiple sclerosis, and other conditions.⁶
Researchers recently discovered that corticosteroids could affect a specific type of skin cell receptor called “TLR2” (Toll-like receptor 2). TLRs are crucial to your immune response to external—and harmful—microorganisms. One of these is a bacteria, Propionibacterium acnes (P. acnes), and it plays a role in the formation of acne vulgaris. Experts suggest that P. acnes could promote TLR2 activation, causing skin inflammation.⁷
Corticosteroids could impact TLR2 in a similar way, promoting its activation by increasing gene expression. Combined with the natural presence of P. acnes in your skin, this could be one of the main causes of steroid-induced acne.⁸
Yet, not all steroid acne lesions come from corticosteroids. Anabolic-androgenic steroids (AAS), used for bodybuilding, also contributes to acne. Research shows that about 50% of AAS users get acne as a side effect.⁹
Usually, the main prevention strategy for steroid acne involves suspending the medication. This may be an option if you have a condition that medical providers can treat with other non-steroid medications. Steroid acne usually resolves itself over a period of weeks and months once you discontinue your corticosteroid treatment.¹⁰
However, many people need to take corticosteroids, and stopping treatment may not be an option. In that case, your medical provider may recommend specific acne management strategies. Although steroid acne may seem persistent, several treatments are possible, ranging from topical therapy to oral antibiotics.
Steroid acne treatment is similar to common acne treatment, and may involve several different treatment options. These may include topical preparations, oral medications, skincare routines, and diet and lifestyle changes. The exact treatment for your skin will depend on several factors, so be sure to check with a medical provider before starting any treatment on your own.
Topical preparations work by helping to prevent the plugging of hair follicles, stopping the growth of bacteria, and reducing the area’s inflammation. The most common topical medications for acne include:¹¹
Retinoids (such as tretinoin, adapalene, and tazarotene)
Antibiotics (such as clindamycin and erythromycin)
On the other hand, oral medications take a more systemic approach to treating acne. Your medical provider may recommend using one of these along with a topical application. Oral medications for steroid acne include:¹²
Oral antibiotics (such as doxycycline)
Oral contraceptives (in women)
Anti-androgen medications (such as spironolactone)
While these treatment options will keep steroid acne under control, you should try to implement healthy skincare routines and diet changes into your life. A personalized skincare routine is one of the best steps you can take to treat skin conditions such as acne.
Curology helps you get your hands on everything you need to treat acne. From consultations with licensed dermatology providers to personalized skincare formulas, we’ve got you covered. The best part? We offer a 30-day trial*—sign up now and enjoy the convenience of having all of your skincare needs handled right from your home.
Steroid acne usually looks like common acne, mostly affecting your chest, back, neck, and shoulders. The pimples are often between 1-3 millimeters, with the color ranging from pink to red. They usually develop several weeks after starting your corticosteroid treatment.¹³
Steroid acne may not fully clear with antibiotics, topical preparations, and other treatment options. Instead, it goes away after a period of weeks and months after discontinuing your use of corticosteroids.¹⁴ Always follow your medical provider’s specific advice on medications that have been prescribed to you.
Zinc pyrithione is a great ingredient for fighting steroid acne, thanks to its antimicrobial properties. Its anti-inflammatory properties also help to reduce inflammation and redness from acne.¹⁵
Choi, J.K. Steroid Acne. Inpatient Dermatology. (2018, November 3).
Kazandjieva, J., and Tsankov, N. Drug-induced acne. Clinics in Dermatology. (March-April 2017).
Choi, J.K. Steroid Acne. Inpatient Dermatology. Ibid.
Hodgens, A. and Sharman, T. Corticosteroids. StatPearls. (2022, July 26).
Kazandjieva, J. and Tsankov, N. Drug-induced acne. Clinics in Dermatology. Ibid.
Hodgens, A. and Sharman, T. Corticosteroids. StatPearls. Ibid.
Shibata, M. et al. Glucocorticoids Enhance Toll-Like Receptor 2 Expression in Human Keratinocytes Stimulated with Propionibacterium acnes or Proinflammatory Cytokines. Journal of Investigative Dermatology. (February 2009).
Shibata, M. et al. Glucocorticoids Enhance Toll-Like Receptor 2 Expression in Human Keratinocytes Stimulated with Propionibacterium acnes or Proinflammatory Cytokines. Journal of Investigative Dermatology. Ibid.
Melnik, B. et al. Abuse of anabolic-androgenic steroids and bodybuilding acne: an underestimated health problem. Journal of the German Society of Dermatology. (February 2007).
Fitzpatrick, J.E., et al. Drug-Induced Acneiform Reactions. Urgent Care Dermatology: Symptom-Based Diagnosis. (2018, n.d.).
Zaenglein, A.L., et al. Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology. (May 2016).
Zaenglein, A.L., et al. Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology. Ibid.
Choi, J.K. Steroid Acne. Inpatient Dermatology. Ibid.
Fitzpatrick, J.E., et al. Drug-Induced Acneiform Reactions. Urgent Care Dermatology: Symptom-Based Diagnosis. Ibid.
Gupta, M., et al. Zinc Therapy in Dermatology. Dermatol Res Pract. (2014, July 10).
Donna McIntyre is a board-certified nurse practitioner at Curology. She obtained her Master of Science in Nursing at MGH Institute of Health Professions in Boston, MA.
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Donna McIntyre, NP-BC