CHAPTER 106

Acne

“Four out of every five steroid users experience at least one of the more common side effects such as acne, gynecomastia, hair loss, stretch marks, testicle shrinkage and mood swings. Users tend to accept these complications as a necessary consequence.”

– Dr. Nick Evans, bodybuilding expert, author and MuscleMag International columnist

Few four letters have caused as much grief to teens, athletes and bodybuilders alike as acne. For teens the arrival of the first facial blemish conjures up fears of rejection and the end to their social lives. For bodybuilders the dreaded pineapple look only adds to the stress of pre-contest dieting and training. And as for the rest of us, skin that bears a striking resemblance to the lunar surface makes going shirtless at the beach all the more difficult.

One of the intriguing things about acne is that it’s not picky; just about everyone will experience it to a greater or lesser degree at some point in their lives. It is the extent, however, that shows marked variation. Some experience only one rash of pimples that quickly disappears. Others have acne so bad they don’t want to leave the house.

Generally speaking there are three categories of individuals who experience acne: teens, athletes and steroid users. Let’s look at all three.

TEENS

As if the dramatic physical and emotional changes that take place during puberty were not enough, most teens can also look forward to developing acne. For some the first pimple is welcome as it signifies the beginning of the changes that will lead them into adulthood. For others, however, the slightest skin blemish is seen as an insult to their social standing.

“Bacne” – a common side effect of steroid use.

The development of acne can be very traumatic for many teens. At this stage in their lives much of their self-worth is based on physical appearance. For a shy, 14-year-old male, those extra facial pimples may be the difference between asking that cute girl to the junior prom or not.

You’d think that something so common among the general population would be fully understood, but such is not the case. The most commonly accepted theory is that the hormonal changes that signal the beginning of puberty increase the skin’s oil production, which serves as a perfect medium for bacteria-causing acne.

ATHLETES

The second group of individuals who may experience acne are athletes. Just about everyone who exercises on a regular basis can be included. Once again the exact cause is unknown, but a number of theories have been put forward. The first is that the increased amount of sweating causes an increase in waste production. Some byproducts of cellular respiration then act as a breeding ground for bacteria.

Another theory is that most sports cause an increase in testosterone production, and this hormone has been linked to an overproduction of skin oil (from sebaceous glands). As a result, a perfect growing medium for acne-causing bacteria has been produced.

The final theory is what could be called the chafing effect. Most sports require the athlete to make repetitious movements of the arms and legs while wearing some sort of uniform. Often the rubbing of the uniform material over the skin produces a rash, which in turn may become inflamed, leading to acne.

STEROID USERS

Most steroid users will experience acne. While this acne could take the form of facial pimples, it often reveals itself as large, blood-filled cysts along the shoulders and back. Minor skin blemishes tend to clear up after steroid use is discontinued, but the large black cysts often produce lifelong scars.

The prevailing theory for steroid-induced acne is related to oil production and an increase in skin bacteria.

Photo by Steve Neece

TREATMENTS

Whether building a physique for the beach or stage, the last thing you want is a skin surface full of indentations and protrusions. There are numerous ways to treat acne – some based on folklore (don’t eat chocolate, etc.) and others based on medical science. As with cold remedies, it seems everyone has a solution for clear skin.

Since oil is one of the prime conditions that leads to acne, it’s not surprising that various acne cures are based on drying out the skin. The simplest is sunlight, which has the advantage of being free and easily obtainable. The downside, of course, is that exposure to the sun has been linked to skin damage. You may end up trading in acne for a dose of skin cancer. Despite its sometimes gruesome look, acne is not life threatening, but I assure you skin cancer is.

The alternative to sunlight is a tanning bed. Most of the newer tanning beds have the harmful rays filtered out, but there is a risk just the same. And unlike Mother Nature, which gives you sunlight for free, tanning salons will charge you a pretty penny. For someone with severe acne this may mean year-round visits – a considerable financial investment.

Besides light, various drying creams, oils and lotions have come on the market. They work by reducing the buildup of oil, dead skin and other waste that serves as a breeding ground for those dastardly little acne-causing bacteria. For some acne sufferers the results are nothing short of miraculous, but for others the condition may in fact get worse, especially when using some of the creams and lotions.

In extreme cases of acne, the weapons of choice are antibiotics and Acutane^®. As the name suggests, antibiotics work by killing the bacteria that cause acne. Again, the results vary from individual to individual. One of the drawbacks to long-term antibiotic treatment is the development of antibiotic-resistant strains of bacteria, such as MRSA. Since few antibiotics are specific for one type of bacteria, the risk of developing drug-resistant disease-causing bacteria is ever present.

Acutane^® is a powerful drug that is perhaps the most effective method for treating acne. Virtually everyone who uses it shows a marked improvement in their skin, but unfortunately there are drawbacks. For starters Acutane^® is very expensive and only available by prescription. Not everyone has insurance that covers it. Perhaps the main reason physicians are reluctant to prescribe Acutane is its side effects: fatigue, nausea, dry skin and eyes, headaches, depression and fetal abnormalities.

BACNE

Bacne, or back acne, causes red and purple pimples and bumps that line the upper back and neck of many bodybuilders. Apart from being embarrassing at the beach and gym, this skin condition can be painful and may cause more serious skin infections if it’s not treated. If you suffer from bacne, here’s some advice to help clear things up and prevent future breakouts.

• Do avoid tight-fitting clothing that can trap sweat and prevent airflow.
• Do avoid wearing backpacks for long periods of time.
• Do wear clothes made of cotton that will absorb sweat better, decreasing the chances of clogging pores.
• Do remove sweaty clothes as soon as possible.
• Do wash regularly with antibacterial soap. Scrub your back to remove dead cells and impurities. This will unclog your pores.
• Do avoid sun damage. Too much sun exposure can scar sensitive acne-covered skin.
• Don’t use steroids or supplements that contain hormones. These products can increase your hormone levels, leading to severe body acne.
• Don’t use moisturizing lotions or oils that clog pores and irritate your skin. They may enhance the appearance of your muscles, but those zits will be emphasized as well. Nobody wants to see that.
• Don’t squeeze acne – it will spread bacteria and lead to scarring.
• Do seek treatment if you have severe acne.

Photo of Paul Dillett by Paul Buceta