Steroid acne refers to a skin condition resembling acne that emerges in individuals with elevated levels of corticosteroids circulating in their bodies. This can be a result of having Cushing’s disease or undergoing systemic steroid treatments. An additional type of severe acne arises as a consequence of using anabolic steroids.
There exist two variations of steroid acne: standard acne and Malassezia folliculitis.
Steroid acne should not be confused with steroid rosacea, which is caused by the prolonged application of topical corticosteroids.
Those most susceptible to steroid acne are typically teenagers or adults who have been consuming moderate to high doses of oral steroids like prednisone or dexamethasone for several weeks. This condition can manifest in individuals with various underlying medical conditions.
The key clinical features of steroid acne tend to appear primarily on the chest, although they can also emerge on the face, neck, back, and arms. The presentation of acne vulgaris can be aggravated by steroids, potentially affecting any area prone to acne. These lesions often appear more consistent in appearance compared to typical acne.
Notably, in many cases, steroid acne is synonymous with Malassezia folliculitis. This variant is triggered by an overgrowth of Malassezia yeasts (also referred to as pityrosporum). It displays as itchy superficial papules and pustules mainly on the chest and back. Unlike acne vulgaris, lesions in Malassezia folliculitis are generally uniform in size, and comedones are not commonly observed.
Steroid acne might improve even if the use of steroid medications continues, but typically, it persists until the steroid treatment is discontinued.
The course of treatment depends on the severity and cause of the condition. For example, acne is frequently managed with topical antiacne products and tetracycline antibiotics, such as doxycycline. Malassezia folliculitis is treated using topical antifungal agents like ketoconazole shampoo or oral antifungal medication like itraconazole. In severe cases of steroid acne, oral isotretinoin may be prescribed, which is effective for both forms of the condition.
Centre for Medical and Surgical Dermatology offers various treatment options for acne which are unique for every patient.
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