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Acne

Discussion in 'Steroid Forum' started by Todd1234, Oct 11, 2011.

  1. Todd1234

    Todd1234 Junior Member

    Hello, I was referred to this site by a friend who recommended that I ask a general men’s health question here. I am 27 years old and not using any type of supplements or doing any kind of intense exercise program. However one side of my family has a history of acne and my whole life I have had moderate to severe acne on my upper body. When I was in my teens I went through two 6 month cycles of Accutane which seemed to lessen the acne but not resolve it. Since then studies have shown it not to be safe and I would prefer not to resort to it. I have also tried the topical cream treatments and I am currently on a 6 month oral antibiotic cycle. The antibiotics seem to hold the outbreak in check but not reverse or help the situation. I had a consultation with a dermatologist a couple months ago as well and they informed me they could try laser therapy or skin peels but nothing was guaranteed to work and those are costly treatments. Does anybody have any other suggestions or is anybody familiar with other remedies that I could try other than the typical perscriptions on here of topical creams, antibiotics, accutane? Thanks in advance for any help or advise.
     
    Last edited by a moderator: Dec 23, 2012
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  2. Michael Scally MD

    Michael Scally MD Doctor of Medicine

  3. hkuja

    hkuja Junior Member

    Hope this comes to right section. I have quite bad acne expecially on my face, no other place is as bad. I did pop some cefalexin for it. I dont have an idea does it help. Now I have purim tablets made by himalaya, i try those.

    Earlier I took course of roaccutane, but its so damn harsh I dont know do I want to take it again.. Any other herbal solutions or medical also?

    I eat purim for some days, if it wont help I go to dermatologist/doctor.
     
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  4. dfein

    dfein Junior Member

    Can you explain what was harsh about it? I do know it messes with lipids and possibly slows down the HPTA, but I've never heard of anyone explain why it's so harsh besides the fact that it dries skin out (but that's how it works).
     
  5. hkuja

    hkuja Junior Member

    Dries so fking bad. Lips and tongue, must drink all the time and even it wont help. Good thing is it kills acne but it also kills progress on gym.

    I would like to have some mid solution.
     
  6. dfein

    dfein Junior Member

    I've had dry lips with it, but nothing that a little petroleum jelly couldn't handle. Dry tongue? Are you sure you aren't using too high of a dose? I never had it affect my physical performance either. If your acne is really bad, there really is not a replacement for Roaccutane. I think actually that alot of the stuff out there irritates the acne worse and makes the inflammation worse.
     
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  7. Michael Scally MD

    Michael Scally MD Doctor of Medicine

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  8. hkuja

    hkuja Junior Member

    So roaccutane does not inhibit protein synthesis or affect anyhow on gym? I strongly feel it hindered back in 2000's my training.

    Reason why acne started again is propably due I started nebido injections on 2010 as TRT treatment and those made things to start and it has been worsening gradually. As to pictures in Dr. Scally's pdf, my acne is nowhere severe. Mild or moderate rather. But my pretty face is mashed now ;)

    I call doctor next week. Now is winter here so Roaccutane course is good way to start. I propably have to stop it for while on february (florida trip).

    Thanks for replies.
     
  9. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Acne Fulminans Induced By Anabolic Steroids

    [​IMG]

    Clinical images of the case patient. A and B, The patient at the time of his first consultation shows severe acne fulminans with inflammatory nodules, pustules, and deep hemorrhagic ulcerations in the chest area and back. C and D, The same patient 6 months after treatment with oral prednisolone and isotretinoin shows extensive scarring.


    A 22-year-old male amateur bodybuilder presented to our clinic with a 3-month history of severe acne lesions on his upper trunk and face, accompanied by arthralgia of several joints. He reported the use of anabolic androgenic steroids (AAS) (testosterone enanthate, trenbolone acetate, drostanolone propionate, and methandrostenolone) for 3 months to increase his muscle mass. Shortly after he discontinued AAS intake, he developed severe inflammatory acne with painful rupturing and draining inflammatory nodules, pustules, and hemorrhagic ulcerations on his upper trunk and face (Figure, A and B). Moreover, he described an immobilizing arthralgia of his right ankle and both shoulder joints, as well as general symptoms including fatigue and a 15-kg weight loss over the 6 weeks prior to presentation.

    Treatment with several antibiotics had been attempted, including erythromycin, clindamycin, doxycycline, and flucloxacillin, but his condition did not improve. Treatment with isotretinoin, 20 mg/d, was stopped after 4 weeks because of an aggravation of skin lesions. He presented to our clinic while being treated with oral doxycycline, 100 mg/d, and prednisolone, 40 mg/d, for 1 week. Enlarged lymph nodes were palpable in the groin; fever was absent.

    Laboratory examination showed leukocytosis (white blood cell count, 19 400/?L) and an elevated C-reactive protein concentration of 52.3 mg/L. (To convert white blood cells to number of cells × 109/L, multiply by 0.001; to convert C-reactive protein to nanomoles per liter, multiply by 9.524.) Magnetic resonance imaging of the patient's right ankle joint revealed soft-tissue edema and articular effusion. The diagnosis of AAS-induced acne fulminans was made, characterized by sudden onset, ulceration of lesions, fever, polyarthralgia, weight loss, and failure of usual antibiotic therapy.

    In our clinic, doxycycline and prednisolone treatment were discontinued. The patient was treated locally with debridements, antiseptic wound dressings, and benzoyl peroxide ointments. A new systemic therapy with isotretinoin, 60 mg/d, was started 3 days later. Arthralgia was controlled by treatment with oral diclofenac, 100 mg/d. A continuous improvement with reepithelialization of ulcerations and reduction of purulent lesions and nodules was noted. After 3 months, the isotretinoin dose was reduced, after 6 months, isotretinoin therapy was discontinued. However, the formation of extensive and partly hypertrophic scars could not be prevented (Figure, C and D).

    The illegal use of AAS is increasingly common even among leisure sports athletes. Doping prevalence among college athletes in the United States reportedly is 17% to 20%; among male amateur bodybuilders it is even as high as 80%. In addition to cardiovascular, hepatocellular, and psychological adverse effects, 43% of patients who abuse AAS develop androgen-induced acne. As derivatives of the hormone testosterone, AAS lead to hypertrophy of the sebaceous glands, increased sebum production, and increased density of the Propionibacterium acnes population.

    Our patient developed AAS-induced acne fulminans with the typical unresponsiveness to systemic antibiotics. After initial therapy with oral prednisolone, 0.5 mg/kg, and debridements, a clinical response was achieved with isotretinoin, 0.75 mg/kg.

    In conclusion, it is important for health care providers to keep in mind that androgen-induced acne is one of the most frequent symptoms of AAS abuse. The most important measure is the immediate termination of AAS administration. Increased public education is needed to curb AAS abuse and associated health risks.


    Kraus SL, Emmert S, Schon MP, Haenssle HA. The dark side of beauty: acne fulminans induced by anabolic steroids in a male bodybuilder. Arch Dermatol 2012;148(10):1210-2. JAMA Network | Archives of Dermatology | The Dark Side of Beauty: Acne Fulminans Induced by Anabolic Steroids in a Male Bodybuilder
     

    Attached Files:

  10. Re: Acne Fulminans Induced By Anabolic Steroids

    one of the best articles i have seen on here in years on acne and steroids at a young age and non-pct correctly / - acne is my #1 problem with gear and i always get acne on my back after cycles so i use isotetinion which helps and stay away from most all gear that has any estrogen sides / great article and great warning to people looking to get into steroids before knowing you can really mess your skin up !!!!

    iso tretinion, sun tan and showering right after workouts have helped the most personally always / but the best thing of all is to just not do steroids to begin with or have isotretinion and a good pct on hand with non-estrogen converting steroids
     
  11. Cartwright

    Cartwright Junior Member

    Re: Acne Fulminans Induced By Anabolic Steroids

    Wow, that’s really bad. I would imagine that kid had a predisposition to acne and the steroids just added fuel. I haven’t run a cycle yet but acne is a big concern of mine because it was the scourge of my youth. I didn’t develop it until I was around 21 (I’m 40 now) and thought I was too old to get it because everyone I knew had it already in high school. Two tours of Accutane prevented any permanent scarring and in that respect I love that drug but it’s not pleasant to be on. Really dried out my skin and I had to get blood drawn monthly at the dermatologist to monitor my triglyceride levels. The only way I’d ever go on it again would be to prevent scarring but I’d live with the acne if it’s just a nuisance. Clearly in the case of the kid in the article it was much more than that.
     
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  12. kobefan

    kobefan Member

    Re: Acne Fulminans Induced By Anabolic Steroids

    does not look like AAS user :confused::confused::confused:
     
  13. Dr JIM

    Dr JIM Member

    Re: Acne Fulminans Induced By Anabolic Steroids

    Fantastic Dr S, probably because I've never seen a case of A.F. and was unaware of the inclusion criteria.
    But LAB FLOUNDER please give me a break "one of the best ACNE articles I've seen since I've been here", really? Well just why is that? Perhaps it justifies your therapy for ELEVATED E-2 as the etiology. What? Every adolescent KNOWS acne occurs alongside the physical changes associated wit puberty, and that has NOTHING to do with estrogen in males, lol! Perhaps you were referring to females? NOT! Acne Fulminans is a very rare condition with roughly ONE HUNDRED cases reported in the literature! This condition is thought to be immune mediated, (at least in part) with the antigen being an unknown bacterial cell wall protein. Interestingly the "responsible" bacteria Propionbacterium Acnes is cultured from many other patients with garden variety acne (acne vulgaris) but something triggers an immune mediated "over reaction" to it's presence. That sentinel event in the majority of those afflicted is increased testosterone (not E-2) LEVELS! Moreover, the majority of A.F. folks have a history of acne vulgaris (most common form) which predates it's onset. For our mates this condition should be considered when you have or someone informs you 1) I've got a real bad case of acne 2) I also noticed a fever last night 3) Been having some joint pains fella ----- AND STOP THERE -----SAY----GO SE YOUR DOC! ------but for those purists on Meso, lastly
    4) DOC Jim is a bone head caus give me some those hear acnebiotics butt there not worth a hoot (know I didn't fill em) just not helping mate, lol! (ah, a little levity soothes the heavy heart, IMO) Finally a word of caution, let this be a warning for those looking into steroids, since YOU could be the 101st patient whom develops this condition and be mindful that benzodiazepines , narcotic analgesics, methamphetamines are cocaine "won't mess up your skin", necessitating isotretinion be "on hand" right flounder?. Astute observation KBF, goodness it appears this novice "leisure sports athelete" has all the precursors necessary for the development of bitch tits, lol. FYI -CW, the frequency of acne especially facial, falls precipitously with age, such that for you to develop a condition even remotely similar to A.F., in spite of this patients thorasic location, at age 40!!!, would be exclusive (and reportable IMO) indeed!
    Best
    :)
     
  14. Cartwright

    Cartwright Junior Member

    Re: Acne Fulminans Induced By Anabolic Steroids

    Thanks for clarifying Dr. J. I realized after my last post that I had never heard of Acne Fulminans and read up on it a little. I guess there’s an indefinite number of ways the immune system can screw you up. Has to be pretty long odds of someone with that condition being an AAS user, which is probably what led to it being documented in JAMA.

    My concern with acne is probably irrational given my age but it was a huge nightmare for me for a long time and doing something willingly that has a chance of bringing back there gave me pause. Aaaaannnd I’m over it :)

    Kobe: My guess is this was the first time the guy in the article had used AAS. He’s pretty young but it looks like he didn’t even do any significant natural training prior to using. Again, I have zero experience in this, but it looks like he even had some gyno, which indicates he probably wasn’t using them responsibly either. Starting too young and not following responsible protocol are two of the things I’ve noticed the vets really pound home and also seem to be two of the major issues leading to negative experiences that contribute to the stigma of AAS.
     
  15. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Saleh BO. Role of growth hormone and insulin-like growth factor-I in hyperandrogenism and the severity of acne vulgaris in young males. Saudi Med J 2012;33(11):1196-200. SAUDI MEDICAL JOURNAL

    OBJECTIVE: To evaluate the association of growth hormone (GH), and insulin-like growth factor-1(igf-1) in the production of male sex hormones and the severity of acne in Iraqi male patients, and to assess their role in development of secondary hyperlipidemia in such patients.

    METHODS: We conducted this case-control study and single-center measurement of hormones and selected biochemical parameters in a cohort of volunteer males in the Department of Biochemistry College of Medicine, Baghdad University, and in the Dermatology Department, Baghdad Teaching Hospital, Iraq, from January 2010 to November 2010.

    RESULTS: The mean serum levels of GH and IGF-1 of severe acne patients were significantly increased when compared with mild-, moderate acne patients, and healthy controls (p=0.0001). Also, the mean serum total testosterone, androstenedione, and dehydroepiandrosterone sulfate (DHEAS) levels were significantly increased in severe acne compared with those of mild- (p=0.0001), moderate acne patients (p=0.005), and healthy males (p=0.0001). The mean values of lipid parameters significantly differed in severe acne patients in comparison with other acne groups and controls (p=0.004). The results also revealed a significant correlation between the studied parameters.

    CONCLUSION: The study showed a significant elevation of serum GH and IGF-1, which enhanced androgen hormone production and the development of severe acne. These patients may develop hyperlipidemia secondary to their hyperandrogenism.
     
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  16. whitegato777

    whitegato777 Member

    From all the things ive messed with and being on thyroid hormones permanently i really think body acne is from high cortisol. The body increases 5 alpha reductase enzyme to reduce cortisol in the body. And results in higher dht
     
  17. Dr JIM

    Dr JIM Member

    The studies have been done and there's NO correlation separate from endogenous androgens.
    :)
     
  18. Dr JIM

    Dr JIM Member

    You believe a science blog discussing kido's with per-pimples whom are "under stress" is evidence of a cortisol link, because cortisol increases as the "stress hormone" LMAO!

    Cortisol levels are often elevated in those with systemic infections does that mean cortisol causes infections also?

    Well then why don't adults, who are "under stress" and have cortisol elevations, DON'T develop zits, especially compared to teens?
    Because there IS a direct correlation between the development of acne androgen levels, and not cortisol.
     
  19. Michael Scally MD

    Michael Scally MD Doctor of Medicine