Athletes partaking in the use of AAS might seem to be more likely to develop acne versus natural bodybuilders and non-athletes. Steroids contribute to increased sebum production, which contains fatty acids toxic to many benign bacteria. As a result, bacteria such as Staphylococcus aureus and Propionibacterium acnes, are able to thrive much easier due to their resistance to these fatty acids and lack of competing bacteria. This colonization leads to an immune response by the body, which causes the inflammation we know as acne.

The Iranian study took three groups of people:

• 71 users of anabolic steroids
• 23 natural bodybuilders
• 46 non-athletes

The goal was to see how anabolic steroids affected acne caused by Propionibacterium acnes. The table below illustrates the percentage of individuals with the acne causing bacteria. 45% of steroid users’ skin contained the bacteria versus 17% of non-athletes, and surprisingly, natural bodybuilders had the least at 4%.

The types of pimples were also recorded:

• papula – no pus
• pustule – pimples with pus

Surprisingly the group studied with the clearest skin were the natural bodybuilders. One might draw the conclusion that bodybuilders, typically self-critical and health-conscious individuals exhibit healthier skin as a result of lifestyle choices. This study also supports the obvious fact that has been well known in the AAS community for a while – AAS can increase acne volume and severity.