What are the other Names for this Condition? (Also known as/Synonyms)

• Steroid Acne

What is Steroid-Induced Acne? (Definition/Background Information)

• Steroid-Induced Acne describes a skin condition presenting acne-like eruptions due to the adverse effects of corticosteroids in blood. The condition may develop as a side effect of steroid medication, or from abnormal levels of circulating corticosteroids in blood due to medical conditions such as Cushing disease
• Corticosteroids are steroid hormones that are produced in the human body by the adrenal glands. They help perform many physiological functions. These hormones may also be administered in the form of topical/oral/systemic medications to treat several diseases/disorders. Corticosteroids help lower body inflammation and decrease the immune system activity
• Steroid-Induced Acne may be managed by gradually discontinuing the use of the causative steroid medications, along-with administration of other topical and/or oral therapeutic medications. The outcomes of the condition are good with adequate treatment of the same

Who gets Steroid-Induced Acne? (Age and Sex Distribution)

• Steroid-Induced Acne is mostly observed in older children, teens, and adults
• Both males and females are affected
• Worldwide, individuals of all racial and ethnic background may be affected

What are the Risk Factors for Steroid-Induced Acne? (Predisposing Factors)

In general, some of the predisposing factors for Steroid-Induced Acne include:

• Treatment using steroid hormone medications, especially when moderate to high doses of systemic medications are taken for weeks to months
• Poorly-controlled diabetes
• Cushing disease
• HIV infection and AIDS
• Hodgkin’s disease

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Steroid-Induced Acne? (Etiology)

Increased levels of circulating corticosteroid hormones in blood due to endogenous or exogenous factors can result in the condition called Steroid-Induced Acne.

• The endogenous factors include abnormal hormone production in the body due to medical conditions such as Cushing disease
• The exogenous factors include medication therapy using oral corticosteroids for various underlying diseases/disorders such as systemic lupus erythematosus (SLE), arthritis, traumatic brain injury, and allergies

It is important to note that a variety of systemic signs and symptoms may be observed as side effects of steroid medications.

What are the Signs and Symptoms of Steroid-Induced Acne?

The signs and symptoms of Steroid-Induced Acne may vary from one individual to another. The presentations may resemble acne vulgaris or Malassezia folliculitis (a yeast infection of the hair follicles).

• Presence of inflammatory lesions that may include cysts, nodules, papules, and pustules
• The lesions are typically red-pink, small, firm, and numerous
• The face, neck, chest, back, and shoulders may present these acne-like skin lesions
• Unlike acne, a more uniform presentation of skin lesions is noted in Steroid-Induced Acne. This means that the acne is predominantly observed as small papules, without older lesions, open comedones, and so on

How is Steroid-Induced Acne Diagnosed?

A diagnosis of Steroid-Induced Acne may involve the following:

• Physical examination and a complete medical history, including history of corticosteroid use or other related medical conditions
• Blood tests, analysis of pus, culture of the fluid being drained, as needed
• Dermoscopy: Dermoscopy is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• Skin biopsy: A skin tissue biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

Tests and exams to diagnose an underlying causative condition, if any, may be necessary.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Steroid-Induced Acne?

Steroid-Induced Acne can cause the following complications:

• Emotional and psychological stress
• Cosmetic issues
• Secondary bacterial and fungal skin infections
• Scarring of the affected region leading to permanent scarring
• Treatment complications

How is Steroid-Induced Acne Treated?

The treatment of Steroid-Induced Acne depends on the cause and its severity. The treatments may involve:

• Discontinuation of the medication responsible for the side effect, which may result in a cure or in an improvement of the condition
• Undertaking treatment of the underlying causative condition is important
• Use of antiseptic topical applications
• Topical retinoids and benzoyl peroxide
• Administration of oral medications (isotretinoin), for severe cases
• Antibiotic regimens typically used in acne patients
• Antibiotic or antifungal therapy for secondary infections, if necessary

Self-care (home) remedies may include:

• Wash the lesions with mild soap (antibacterial)
• Apply warm compress
• Wash hands before applying topical applications
• Keep nails trimmed; do not pick at the lesions

How can Steroid-Induced Acne be Prevented?

The prevention of Steroid-Induced Acne may involve the following measures:

• Undertaking early diagnosis and prompt treatment of endogenous (intrinsic) factors responsible for Steroid-Induced Acne, such as Cushing disease, and other medical conditions
• Avoid self-medication, or bringing about any changes to one’s medications, or continuing to take medications beyond the prescribed period without consulting the healthcare provider, may help lower the risk for Steroid-Induced Acne from exogenous (extrinsic) factors
• Use corticosteroids as prescribed, only under medical supervision

What is the Prognosis of Steroid-Induced Acne? (Outcomes/Resolutions)

The prognosis of Steroid-Induced Acne depends on the severity of the condition but is generally good with early recognition of the condition followed by suitable treatment.

Additional and Relevant Useful Information for Steroid-Induced Acne:

Cleaning the skin too hard with strong chemicals or soaps may aggravate the skin condition. Care must be taken avoid strong soaps and chemicals that could potentially worsen the condition.