Anabolic Steroids: The Superficial Side Effects

Over the past 10-15 years there has been a significant growth of the fitness industry. With this growth came a proliferation and “normalization” of anabolic steroid use (among other performance enhancing agents). Of course, when you swallow and inject anabolic hormones that are 10 times the clinically recommended amount or intake hormones intended for animals – there will certainly be issues! Now before getting into the nitty gritty details I would like to add that this article is in no way meant to take a position on the topic of anabolic steroid usage; rather it is meant to educate on a couple of side effects that are less frequently discussed.

Many of the commonly reported side effects are internal: decreased kidney & liver function, elevated LDL (bad) cholesterol, suppression of the endocrine system and so on. However, some of the side effects happen to be “external” and are characterized superficially. The two commonly reported superficial side effects that are associated with steroid use are hair loss & acne. These side effects are reported among both men & women but with opposing age distributions!

Hair Loss & Male Pattern Baldness

When it comes to hair loss, unfortunately genetics are the number one factor. In fact, male pattern baldness is entirely genetic. There is also a common myth that circulates around: that your mother is responsible for giving you those “hair loss genes” (but that’s a story for another article!). In scientific terms, people with male pattern baldness “inherit hair follicles” that are more sensitive to dihydrotestosterone (DHT) which is a naturally produced hormone that is far more androgenic and anabolic than testosterone. DHT interferes with the Wnt-beta-catenin pathway which on a macro level means stem cell differentiation of scalp dermal papillae is stopped (but upregulated when facial hair is concerned!). Translation to English: DHT binds to the hair follicles and ultimately causes both thinning of hair and hair loss. This whole mechanism of hair loss occurs in a variety of patterns but typically begins at the front of the scalp.

How Is This Relevant To Steroids?

It’s actually quite simple in that usage of exogenous anabolic hormones directly correlates to increased DHT. Testosterone itself is converted to DHT via the enzyme 5-alpha reductase. In fact, a very common drug that is used to treat hair loss is Finasteride which is an inhibitor of the 5-alpha reductase enzyme. However, DHT is not alone as a variety of steroid hormones are often utilized and each carry significant potential for damaging the hair follicles. Now whether or not steroid use will definitively cause hair loss (or hair thinning) depends on the individual’s genetics. Depending on the person’s age they may not be susceptible yet to hair loss but their timeline is effectively sped up as soon as they begin a steroid cycle. For many people this means that balding begins over a decade early!

Steroid Induced Acne

A very common side effect of anabolic steroid use that ends up working against the “aesthetic benefits” is acne. The severity tends to be based around how acne prone the individual is but many people who have had minimal acne in the past suddenly breakout with very severe acne.

When androgen levels (DHT in particular) rise during puberty, there is a sharp increase in sebaceous gland activity which then leads to an increase in sebum production. This exact same mechanism occurs when exogenous steroid hormones are administered. The increased sebum goes onto clog the skin pores and it also helps Propionibacterium Acnes grow, which is the bacteria that causes acne. As well, there is a marked increase in inflammation in the skin and this largely leads to acne scarring and overall worsening of the acne. The cumulative effects of increased sebum are why versatile products like the natural acne eliminator cream show high levels of efficacy whereas isolated and singular products often do not.

Prevention & Treatment

The best way to prevent and treat hair loss & acne that is caused by steroids is simply to not take them! If that isn’t an option, suddenly every single acne and hair loss strategy becomes much more critical. Skincare techniques are more diverse as far as acne is concerned but unfortunately hair loss is more limited in how it can be treated. The consensus for hair-loss has been to stimulate blood flow to the hair follicles whereas acne treatment has been based around a combination of anti-bacterial effects + anti-inflammatory effects + acceleration of the skin cycle. These generalized treatment strategies are meant to be implemented by anyone (not just steroid users!). Hence the professional hair thickening serum and the natural acne eliminator cream were developed in the context of those strategies.  

In conclusion, I would like to add once again that this is not in any way meant to take a position in favor or against usage of steroids, but rather to educate why certain side effects occur.