Steroid acne is a result of certain medications. However, before possibly switching medications, it is wise to weigh medical costs and benefits.
What is steroid acne?
Steroid acne is a form of acne, i.e. an inflammatory disease that can be observed in the hair follicles, among other places. Steroid acne owes its name to the fact that the acne form is usually the result of a certain medication. Although the term steroid acne is occasionally used in everyday usage for acne that follows abuse of steroids (such as the male sex hormone testosterone), this is not medically correct. Steroid acne is usually manifested by the appearance of red papules (nodules of the skin). Less frequently, so-called papulopustules can also form; these are purulent papules. If steroid acne has been present for several months, blackheads may also form as part of the disease. The skin changes caused by steroid acne are mainly seen on the shoulders and back.
Causes
Steroid acne can originate both from medications applied locally (for example, in the form of ointments) and from those applied systemically (for example, in the form of tablets; that is, with an effect on the entire organism). However, steroid acne caused by local drug administration occurs comparatively rarely. The drugs that can cause steroid acne include glucocorticoids (also known as cortisone). The latter are used, among other things, to treat asthma or autoimmune diseases; glucocorticoids are also occasionally used in organ transplants. In addition to cortisone, various antibiotics or sleeping pills, among others, can also lead to steroid acne.
Symptoms, complaints, and signs
Steroid acne is primarily manifested by skin changes such as pustules and papules. After two to three months, so-called comedones may form, extensive, usually very painful skin changes that are typically localized in the area of the back and shoulders. The skin changes develop gradually and do not cause any noticeable symptoms at the beginning. Only in the course of the disease itching, redness and pain occur. As the disease progresses, sensory disturbances and even partial paralysis may develop. The symptom picture often represents a considerable burden for those affected. For example, the constant itching can lead to sleep disturbances and malaise, which can result in further problems. Some patients also suffer psychologically from the skin changes. Social anxiety, inferiority complexes or depressive moods may then develop. The psychological complaints usually subside as soon as the steroid acne has been cleared up. If the acne persists over a longer period of time, the psychological suffering can become entrenched. In addition, scars, pigment disorders and other permanent skin changes may occur. In addition, steroid acne causes the typical symptoms of steroid abuse. These can include gastrointestinal complaints, cardiovascular problems and a variety of hormonal disorders.
Diagnosis and course
Steroid acne can be diagnosed based on the presence of symptoms and a patient interview: if a patient has typical symptoms (such as papules) of a form of acne and it turns out that the patient is currently being treated with medications that can cause steroid acne, the appropriate diagnosis is usually made. The course of steroid acne is related, among other things, to the particular patient and to the treatment measures that are taken. If it is possible to discontinue the medication that is believed to have triggered the steroid acne, the condition often resolves on its own after a few weeks. Long-term consequences of steroid acne can be scars that appear on the areas of the skin that were affected by skin lesions.
Complications
In steroid acne, the affected person suffers from the usual symptoms of acne. As a rule, it comes to the formation of pimples or blackheads. These complaints can be very unpleasant, especially on the face or other visible areas and have a very negative impact on the quality of life and aesthetics of the affected person.Most patients feel uncomfortable with the symptoms and suffer from inferiority complexes or significantly lowered self-esteem. Bullying or teasing may also occur. Steroid acne can also lead to pustules or papules. If steroid acne occurs over a longer period of time, it can also lead to scars on the face. In many cases, these can no longer be treated directly and thus remain on the face. In the treatment of steroid acne, the triggering substance must first be discontinued. In many cases, the symptoms then disappear on their own. Complications usually do not occur. Only in rare cases is treatment with ointments or creams necessary. Steroid acne does not negatively affect the patient’s life expectancy.
When should you go to the doctor?
A doctor should always be consulted in case of steroid acne. This disease must be treated by a doctor, as it cannot heal itself in the process. If steroid acne is not treated, the symptoms usually worsen. A doctor should be consulted if the affected person suffers from the formation of papules and pustules. In most cases, these appear on the face of the affected person, but can also cover the entire body. Especially after taking steroids, these symptoms should be checked by a doctor. Most patients also show redness or severe itching, and there may also be sleep disturbances or disturbances in sensitivity. If these complaints do not disappear again on their own, a doctor must be consulted in any case. Steroid acne can be treated well by a dermatologist or by a general practitioner. The further course depends on the exact cause. Since steroid acne can also lead to depression or psychological upset, psychological help should also be sought. As a rule, steroid acne does not reduce the life expectancy of the affected person.
Treatment and therapy
The therapy of steroid acne is initially related to factors such as the severity of occurring symptoms and the cause of corresponding skin changes. To the extent possible, a first-line therapeutic step is to stop (or at least limit) the drug treatment that has led to steroid acne. Before taking this step, however, a detailed discussion with the treating physician is necessary; the advantages and disadvantages of reducing a previous medication regimen must be weighed against each other in order to make a responsible decision. Not in all cases, however, does a change in medication lead to a spontaneous cure of steroid acne. In cases in which a change of medication is not possible for medical reasons or in which a change of medication did not bring the desired success, symptomatic treatment of the steroid acne is often carried out. One possible method of symptomatic therapy of steroid acne is the so-called dermabrasion; here, skin layers of the changed skin areas are removed with the help of a medical abrasive head. The skin symptoms of steroid acne can also be treated by local application of so-called retinoids (chemical substances). One of the surgical procedures for the treatment of steroid acne is cryosurgery: in this procedure, altered skin tissue is surgically removed by applying very strong cold. In addition, in the so-called cauterization, altered skin tissue of steroid acne can be surgically removed, for example, with the application of intense heat or chemical agents.
Prevention
Steroid acne can be prevented, for example, by reducing risky medications (if medically reasonable) or replacing them with alternative medications. If such a measure is not medically justifiable and steroid acne has already occurred, methods of symptomatic treatment of steroid acne can be used to prevent symptom worsening.
Follow-up
Steroid acne should be considered primarily as a severe side effect of a decided drug intake. In principle, the decisive measure is to discontinue the triggering drug or doping agent. In this way, the symptoms can be alleviated in the long term. The skin changes themselves can be treated with typical home remedies and care products.In addition to the classic skin care products, there are also some natural remedies that are easily available in the drugstore. Especially the latter are characterized by positive effects for the skin. These are, for example, infusions with herbal tea as well as essential oils. In order to avoid scarring, contact with troublesome pimples should be avoided if possible. It is recommended to treat the skin with cooling compresses. Cold helps to relieve pain and reduce itching. In contrast, moisture opens the pores. Only if the steroid acne does not subside or even intensifies, the way to the dermatologist is inevitable. It cannot be completely ruled out that in some cases the steroid acne is caused by an intolerance or an allergy. This must be clarified. Since steroid acne often causes depression or psychological upsets, the patient should not hesitate to seek psychological help if necessary. Thus, in the end, any bullying can be effectively countered and goal-oriented aftercare can be carried out.
What you can do yourself
Steroid acne primarily represents a severe side effect of medication intake. The most important measure is to discontinue the triggering drug or doping agent. This can provide long-term relief from the symptoms. The skin changes themselves can be treated with typical home remedies and skin care products. In addition to the classic skin care products from the drugstore, which should only be taken in consultation with a doctor due to aggressive ingredients, there is a whole range of natural remedies that have positive effects on the skin. These include infusions with herbal tea or essential oils. To avoid the formation of scars, contact with the pimples should be avoided as much as possible. It is recommended to treat the skin with cooling infusions. Cold relieves pain and reduces itching, while moisture opens the pores. If steroid acne does not subside or even strengthens, a dermatologist must be consulted. Occasionally, the condition is based on an intolerance or an allergy that needs to be clarified. For this, patients should consult a physician at an early stage, who can initiate these steps and, if necessary, directly suggest a therapy.