Acne and Performace Enhancing Drugs: Understanding the Connection and How to Manage Breakouts

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Acne is a common yet frustrating side effect of using performance-enhancing drugs (PEDs), especially anabolic steroids and corticosteroids. These drugs can trigger breakouts that range from mild to severe, affecting not only the skin but also the confidence and mental well-being of athletes.

While PEDs enhance physical performance and muscle growth, their impact on hormonal balance often disrupts skin health. Understanding this connection is the first step in addressing acne effectively.

The Connection Between PEDs and Acne​

Many PEDs, particularly anabolic steroids, increase androgen levels, such as testosterone. These hormonal surges stimulate sebaceous glands, producing excess sebum—a key contributor to acne.

Corticosteroids, on the other hand, can disrupt hormonal balance and cause inflammatory responses in the skin. These changes create a perfect storm for clogged pores and acne breakouts, especially in athletes with a genetic predisposition to acne.

Steroid acne is a distinct type characterized by small red papules, pustules, and, in severe cases, painful nodules. These lesions often develop on areas rich in sebaceous glands, such as the chest, back, and face.

Dermatological and Physiological Factors​

Excess sebum production caused by hormonal shifts creates an oily environment that clogs hair follicles. This blockage traps bacteria, particularly Propionibacterium acnes (now known as Cutibacterium acnes), which thrive in oxygen-deprived conditions.

As bacteria multiply, the immune response triggers inflammation, resulting in red, swollen acne lesions. These mechanisms highlight the importance of addressing oil control and bacterial overgrowth in acne management.

Acne isn’t just a physical concern—it can significantly affect mental health. Athletes may struggle with self-esteem issues, social anxiety, and stress related to their appearance.

Effective Management and Treatment Strategies​

Topical treatments like benzoyl peroxide, salicylic acid, and azelaic acid are effective for mild to moderate acne. These agents reduce oil production, exfoliate dead skin cells, and combat bacterial growth.

Systemic treatments such as isotretinoin (Accutane) may be necessary for severe or resistant cases. This potent medication reduces sebum production and can yield long-term results but requires careful monitoring due to potential side effects.

Since hormonal imbalances are central to PED-induced acne, regulating hormones through medical interventions can help. Anti-androgens or other hormone-modulating treatments may be prescribed under professional supervision.

Preventive Measures and Lifestyle Adjustments​

Diet plays a significant role in skin health. High-glycemic foods and dairy have been linked to acne flare-ups. Athletes should focus on a diet rich in whole grains, lean proteins, and anti-inflammatory foods like fruits, vegetables, and omega-3 fatty acids.


Self-management can only go so far—consulting a dermatologist is essential for creating a tailored treatment plan. Dermatologists can assess the severity of acne, recommend suitable therapies, and monitor progress over time.

For athletes using PEDs, healthcare professionals play a crucial role in balancing treatment for both performance and skin health. Regular check-ins ensure that acne management strategies are optimized for long-term success.

Frequently Asked Questions​

Why do performance-enhancing drugs cause acne?

PEDs often increase androgen levels, which stimulate oil glands and disrupt hormonal balance. This leads to clogged pores and acne breakouts, especially in predisposed individuals.

Is steroid acne different from regular acne?

Yes, steroid acne typically involves small, uniform papules and pustules and is often concentrated on the chest, back, and shoulders. It develops due to hormonal fluctuations caused by steroid use.

Can acne from performance-enhancing drugs be prevented?

While it may not be entirely preventable, managing oil production, maintaining a balanced diet, and practicing good skincare can significantly reduce breakouts. Hormone modulation can also help.