Corticosteroids
Oral corticosteroids are synthetic derivatives of the natural steroid, cortisol, which is produced by the adrenal glands. They're prescribed for a large number of serious inflammatory diseases. They're called "systemic" steroids if taken by mouth or given by injection as opposed to topical corticosteroids, which are applied directly to the skin. Prednisone, prednisolone, and methylprednisolone are examples.
These drugs sometimes produce inflammatory acne lesions consisting of papules or pustules that have a tendency to appear on the chest and/or back (sometimes called steroid folliculitis). They disappear after the medication is stopped. Comedones (blackheads and whiteheads) are generally absent from steroid-induced acne.
This sounds somewhat contradictory, since the oral corticosteroid drugs are anti-inflammatory, and it would appear that they would actually be used to treat acne. If fact, they are used for acne treatment under special circumstances. Sometimes they're used to treat the nodules and scars of acne by injection. Dermatologists prescribe corticosteroids orally for short three-to-five-day, low-dose "bursts" as an "emergency" treatment to wipe out acne for a special occasion (wedding, prom, and so on). They can really wipe out acne fast, but only for short periods of time.
Anabolic-androgenic steroids
Abuse of these hormones can lead to acne and other serious health problems. Besides legitimate medical uses of androgens such as testosterone for hormone deficiencies, widespread use and abuse of these compounds exist, particularly the anabolic- androgenic steroids, as performance-enhancing drugs.
This type of acne is observed in males mainly on their backs, shoulders, and chest, and less often on the face, whereas in female athletes using these drugs, lesions tend to appear on the face as well as on the back and shoulders. An already-existing acne problem may get worse or non existing acne may be evoked.
Androstenedione
Androstenedione (andro) is a hormone produced by the adrenal glands, ovaries, and testes. Andro made the news after the former baseball player Mark McGwire admitted taking it around the time of his record-breaking home run season. Although ads claim that andro containing supplements promote increased muscle mass, studies have shown that andro poses the same kinds of health hazards as anabolic steroids. The U.S Food and Drug Administration (FDA) cautions about the risks for young people who take andro: acne, an early start of puberty, and stunted growth.
DHEA (dehydroepiandrosterone)
This hormone, sometimes billed as the "fountain of youth" hormone, is also a steroid hormone, a chemical cousin of testosterone and estrogen. Because DHEA is converted into testosterone, it has been noted to produce excessive facial and body hair, besides causing acne.
Other oral medications
Other drugs that have been observed to have acnegenic properties include:
Lithium
Iodine
Isoniazid
Diphenylhydantoin
Certain androgenic contraceptive pills.
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