AI made acne worse!

[ngolo28999]

I've struggled with acne for years, especially during cycles and cruises. Nothing has seemed to work, so I've decided to start Accutane in a few weeks.

Currently, I'm on 450 mg of Test E per week, injecting daily to maintain stable levels. Last week, I began taking Arimidex due to symptoms of high estrogen—1 mg per week, split into two doses, which I take on Mondays and Fridays. However, things took a turn for the worse at the end of last week, and especially this week. My bacne has flared up, and I’m now getting acne on my shoulders, which hasn’t happened in a while. It feels like there are literally zits all over my back.

What could be causing this? Is it because I’ve introduced a new hormone into my body, or could there be another reason?

 

[Ghoul]

It's because changes in Testosterone levels cause acne.

Sebaceous glands produce skin oils and waxes (sebum). Sebum collects inside sebacytes(specialized cells) within your pores. As new cells are produced, they push existing oil filled sebacytes to the surface of your skin(called "turnover") where they break open and spill their contents, moisturizing skin.

A sudden increase in Testosterone stimulates sebaceous glands to produce more sebum, but cell turnover doesn't immediately speed up, so pores become clogged with oil filed cells, they break open and decompose within the pore, causing an infection.

When Testosterone levels drop, cell turnover slows before oil production does, so the same problem happens.

The way to minimize this is to keep things stable. Eventually cell turnover speeds up enough to match increased oil production.

Knowing you're prone to this, whenever doing anything that can impact your hormone levels, be extra diligent cleansing your skin with salicylic acid body wash for the first couple of weeks. If it's really bad, 100mg doxycycline taken daily for a couple weeks at the same time you make the change can prevent it.

 

[ngolo28999]

How does my testosterone drop when I take an AI? Isn’t an AI supposed to lower estrogen? I’ve been on testosterone for a while without experiencing such severe outbreaks, but after introducing the AI, things got significantly worse. Could this be due to fluctuations in estrogen levels?

 

[Ghoul]

How does my testosterone drop when I take an AI? Isn’t an AI supposed to lower estrogen? I’ve been on testosterone for a while without experiencing such severe outbreaks, but after introducing the AI, things got significantly worse. Could this be due to fluctuations in estrogen levels?

The test that was getting aromatized into estrogen became available to stimulate sebaceous glands. If you keep using the AI for a while it'll settle down, stopping and starting will make it worse.

 

[Ghoul]

 

[Eddie.]

How much was your e2 before starting the arimidex and where it sits now? I hope you're tracking your hormones and not just guessing.

 

[bighunanballs]

It's because changes in Testosterone levels cause acne.

Sebaceous glands produce skin oils and waxes (sebum). Sebum collects inside sebacytes(specialized cells) within your pores. As new cells are produced, they push existing oil filled sebacytes to the surface of your skin(called "turnover") where they break open and spill their contents, moisturizing skin.

A sudden increase in Testosterone stimulates sebaceous glands to produce more sebum, but cell turnover doesn't immediately speed up, so pores become clogged with oil filed cells, they break open and decompose within the pore, causing an infection.

When Testosterone levels drop, cell turnover slows before oil production does, so the same problem happens.

The way to minimize this is to keep things stable. Eventually cell turnover speeds up enough to match increased oil production.

Knowing you're prone to this, whenever doing anything that can impact your hormone levels, be extra diligent cleansing your skin with salicylic acid body wash for the first couple of weeks. If it's really bad, 100mg doxycycline taken daily for a couple weeks at the same time you make the change can prevent it.

Indeed it's the titration steps usually or the change of hormone that seems to trigger it.

I like chase irons thoughts/approach to blast/cruising. You start at trt dose to shut down hpta and get your body used to exogenous AAS. While traing and clean bulking or recomping you titrate up 50mg/wk when you stall or every 6 weeks or so. Your body multiplies androgen receptors and gets used to the current dose and you step up very incrementally over a long period of time. This keeps the large jump or titrations from shocking the system downstream as it aromatizes. I think if a person has heavy sides using this method at a given test dose then they're taking too much for their body to properly use for muscle protein synthesis and instead too much is aromatized into non ideal metabolites.

 

[ngolo28999]

How much was your e2 before starting the arimidex and where it sits now? I hope you're tracking your hormones and not just guessing.

I was a bloated mess, bloodwork came back and showed 131.2 pg/mL.

 

[ngolo28999]

The test that was getting aromatized into estrogen became available to stimulate sebaceous glands. If you keep using the AI for a while it'll settle down, stopping and starting will make it worse.

i'll continue with it, and hope it will settle down.

 

[Ghoul]

i'll continue with it, and hope it will settle down.

For a while I was sloppy with my TRT, dose +\- 20%, missing the occasional dose, etc. Acne flared up and was non stop. So bad I was bleeding through my shirt.

Once I became more disciplined, it massively improved. Of course, this is mostly an issue for those who had acne when they were young because of genetic susceptibility. One reason accutane can provide a permanent cure is because it genetically "resets" sebacytes, making cell turnover happen much more quickly, so even an increase in sebum production doesn't cause acne.

 

[Eddie.]

I was a bloated mess, bloodwork came back and showed 131.2 pg/mL.

Yeah that's very high especially if you're proned to acne. Huge mistake to let it climb that high. I let mine once go 106 by mistake of high HCG but i had zero sides.

2 things come to my mind. First like ghoul said by reducing conversion to e2 you're having more test available and second maybe your e2 reduction was somewhat aggressive and thus it lead to a sudden hormonal fluctuation. I had something similar when i added primo when i had that 106 estradiol and the reduction was pretty aggressive, in just one month e2 went to 34 and for the first time i was seeing some weird zits in my arms that after a month stopped coming back.

Worst thing you can do when there's already a genetic predisposition towards acne and similar sides is the sudden hormonal imbalance. Either is higher or lower test, either it's DHT or estrogen.

 

[Liter O' Test]

I started accutane recently but before this, dutasteride would reduce my acne overnight.

I think this would help control your sebum during your hormone fluctuation in addition to oral antibiotics.

prior to dutasteride i would have never dared go above 1 gram even with e2 in range. I think bodybuilders can benefit from short term usage of dutasteride and maybe even finasteride to control acne.

This isnt a perfect solution as reducing DHT does increase the likelihood of gyno, and seems to lower the threshold of e2 levels that gyno tissue would form

(although I read something about finasteride not affecting dht receptors in the skin etc, i think it still helps as I tried it a few years ago and had clear skin but didnt make the connection at the time)

but i think if anyone is having a wicked breakout, if you can get a 5-ar inhibitor , you can get results almost immediately, even dave palumbo speaks about finasteride and acne.

 

[Ghoul]

I started accutane recently but before this, dutasteride would reduce my acne overnight.

I think this would help control your sebum during your hormone fluctuation in addition to oral antibiotics.

prior to dutasteride i would have never dared go above 1 gram even with e2 in range. I think bodybuilders can benefit from short term usage of dutasteride and maybe even finasteride to control acne.

This isnt a perfect solution as reducing DHT does increase the likelihood of gyno, and seems to lower the threshold of e2 levels that gyno tissue would form

(although I read something about finasteride not affecting dht receptors in the skin etc, i think it still helps as I tried it a few years ago and had clear skin but didnt make the connection at the time)

but i think if anyone is having a wicked breakout, if you can get a 5-ar inhibitor , you can get results almost immediately, even dave palumbo speaks about finasteride and acne.

DHT will attach to sebaceous gland androgen receptors even more strongly, so it does make sense. And the hairline benefit along with keeping your prostate size in check are a bonus. Use caution in case you're a hyper responder and start with .25mg, quarter pilll, to avoid sides. If no sides you can work up to 1mg / day for full benefit, but so wouldn't. start at 1mg. For the small minority (like me) who experienced sides, it's enough to frighten you off it forever. Meanwhile at .25mg I have no sides and still enjoy most of the benefits.

 

[Liter O' Test]

DHT will attach to sebaceous gland androgen receptors even more strongly, so it does make sense. And the hairline benefit along with keeping your prostate size in check are a bonus. Use caution in case you're a hyper responder and start with .25mg, quarter pilll, to avoid sides. If no sides you can work up to 1mg / day for full benefit, but so wouldn't. start at 1mg. For the small minority (like me) who experienced sides, it's enough to frighten you off it forever. Meanwhile at .25mg I have no sides and still enjoy most of the benefits.

you ever going to try dutasteride? or no point cause you get what you want from that dose of fin with no sides?

 

[Ghoul]

you ever going to try dutasteride? or no point cause you get what you want from that dose of fin with no sides?

I may, because dutasteride and oral minoxidil combined have the best clinically proven outcome for hair of any treatment.