Anabolic steroids can trigger or worsen acne by increasing oily skin and acne-related inflammation. The effect is common enough to be a meaningful risk, but it does not affect every user in the same way. Anabolic-androgenic steroids are testosterone-like substances used medically in limited settings and sometimes used nonmedically for bodybuilding or performance. Acne can appear on the face, chest, shoulders, and back, where oil glands are especially active.
Medical information disclaimer: This article is for general educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a physician or other qualified health professional about symptoms, medications, tests, or treatment decisions.
Table of Contents
- Why steroids can cause acne
- How strong is the link?
- Who is most likely to break out?
- What to do about steroid-related breakouts
- When to involve a clinician promptly
Why steroids can cause acne
Androgens are hormones that stimulate sebaceous glands, which make the skin's protective oil, or sebum. High-dose testosterone and anabolic-androgenic steroids can enlarge these glands, raise skin-surface lipids, and increase *C. acnes* populations—the bacteria involved in acne development—according to a 1992 *Cutis* report indexed by PubMed.
More sebum does not automatically produce acne. It can, however, create conditions that make clogged pores and inflamed breakouts more likely. Existing acne, sweat, tight training clothing, and pore-clogging skin products can make the problem harder to control.
How strong is the link?
The association is substantial in real-world research. In a Danish retrospective cohort of 545 men with positive anabolic-androgenic-steroid tests, acne affected more than 10% of users and occurred significantly more often than among 5,450 matched controls, according to the 2019 *Journal of Internal Medicine* study. The study population matters when applying that result.
It involved men identified through fitness-centre doping tests in Denmark, so it describes that group rather than every person using testosterone or another anabolic steroid. Evidence from testosterone treatment also supports an exposure relationship. In a 323-person prospective study of transgender men starting testosterone, moderate-to-severe acne increased from 11.8% before treatment to 39.1% after one year; testosterone levels above 10 nmol/L predicted greater risk in the 2024 study indexed by PubMed.
Who is most likely to break out?
A personal tendency toward acne still matters. The American Academy of Dermatology notes that hormones can increase sebum and inflammation, while genetics, stress, medicines, occlusive clothing, and pore-clogging products can also contribute to breakouts during testosterone therapy.
This means a new chest or back eruption after starting, increasing, or cycling an androgen is a useful clue, not a reason to assume that every blemish has one cause. A person with oily skin or prior acne may need a more deliberate prevention plan from the start.
What to do about steroid-related breakouts
Start with a simple routine that targets oil, clogged pores, and inflammation without adding friction or harsh scrubbing: Current American Academy of Dermatology guidance supports benzoyl peroxide and topical retinoids, recommends limiting antibiotic use, and reserves dermatologist-supervised isotretinoin for severe or treatment-resistant acne. The AAD's updated acne guidance supports combining effective treatments rather than relying on repeated antibiotic courses alone.
- Use a benzoyl peroxide wash or leave-on product as directed.
- Use a topical retinoid if it is appropriate for your skin and treatment plan.
- Shower after sweating and change out of tight, damp workout clothing.
- Choose non-comedogenic products for the face, chest, and back.
- Avoid picking, which can deepen inflammation and increase scarring risk.
When to involve a clinician promptly
Seek medical care for painful deep nodules, rapidly worsening acne, scarring, widespread chest or back involvement, or breakouts that do not improve with a consistent routine. These patterns often need prescription treatment and may require a discussion of the hormone or product exposure itself. Do not make an abrupt medication change without clinical guidance.
The FDA warns that some bodybuilding products sold as dietary supplements illegally contain anabolic steroids or steroid-like substances and advises people using these products to consult a clinician; it also lists severe acne among associated risks in its consumer update. A sudden ulcerative, painful eruption with systemic illness needs urgent assessment. Acne fulminans has been reported after anabolic-steroid injections, but the evidence for that extreme presentation comes mainly from case reports, including this 2011 report.