Acne in Bodybuilding: Causes, Prevention & Treatments

By Big_Ad MuscleTalk Pro-Member and Moderator from MuscleZone

I have read countless questions in regards to acne on the MuscleTalk forums, which usually relate to asking how you can stop acne, how you can reduce the side affect and what treatments are actually available. This article has been written for the people who ask these questions, as I for the last two years on and off I have had mild to severe acne on my neck, chest, shoulders, back and neck.

I know how it feels to have your image taken over by ugly balls of puss that you have little or no control over; I know how it itches when you sweat; I know how they burst all over your clothes in your sleep; and I know how frustrating treatment is! This article I hope will answer most of your questions and give you enough base of information on acne in general.

What is Acne?

Acne is a very common ‘skin disorder’ that many people experience. There are different types and forms of acne, and there can be more than one reason to why acne develops. Acne in general is not a nice thing to have no matter what category it’s in and no matter what age you are, as acne can:

  • Bring you down
  • Decrease or destroy your self-confidence and self-esteem
  • Can make you depressed
  • Can make you angry and frustrated
  • And of course – destroy your self-image

Like I said – not nice!

Spots, zits, blackheads, white heads are all common terms used when describing acne. Realistically though, there are more severe forms, which can be very painful, long lasting and can actually scar your skin. It doesn’t have to be severe acne in order to scar your body, and scaring can actually be permanent. Acne’s type is classified on how severe it is and what its formation is.

Usually a person who suffers from acne gets random breakouts or the acne will flare up. These breakouts sometimes die down but usually get followed by further breakouts (if successful treatment is not introduced). Some people don’t get actual breakouts at all but have rather constant acne. Nevertheless it’s painful and depressing.

How is acne produced?

Acne is formed when the body over-produces oil (sebum) from the sebaceous glands beneath the skin. The oil is produced to lubricate the skin and to keep it soft. The sebaceous glands are located in each tiny area of skin. Sebaceous glands are found in large numbers on the face, back, chest and shoulders. If this oil becomes trapped, bacteria will multiply and that particular area becomes inflamed. The main type of bacteria that causes infection is known as Propionibacterium. The multiplied bacteria can result in clogged pores, further infection, dead skin cells and scaring. It is important to realize that acne is not caused by dirty pores but over-active sebaceous glands. Washing too much too often with the wrong product can actually make your acne worse!

Who gets Acne and why?

Anybody can get acne. It’s basically down to the individual, but there are many variables to consider. A lot of the time you cannot help the development of severe acne, but in regards to the milder forms there are ways to help it getting worse and to help heel it (which will be explained later on). Acne can:

  • Run in the family – You may find that if one of your parents suffered from acne when they were younger, that you may also. However this is not always the case and shouldn’t be used to determine weather you will get acne or not, or to determine what category of acne you could get.
  • Occur due to unhealthy lifestyles and unhealthy diets – Take your health into consideration:

Do you smoke?

Smoking assists in extrinsic (external) aging – which means your skin is affected. It will assist with skin rashes and of course, assist with acne. It’s generally not good for your health or your skin. Smoking will not be the cause of acne but it will definitely not help.

Do you take drugs?

Acne is sometimes a side effect to certain medications. A fine example would be Anabolic Androgenic Steroids (AAS), which are commonly used in the treatments for many specific illnesses. However, AAS are also used without the prescription from a Doctor by many sportspeople and athletes. Acne is a recognized side effect from these drugs. Some AAS may affect you in different ways and more than others; they may also worsen existing acne. Side effects will relate to how you react to the drug used in general, what dosages are used and the concentration of the drug in your system (stability of blood levels). Some specific AAS are partially transformed into DHT in the body, which increases the production of oil in the sebaceous gland, thus resulting in an increase of clogged pores, dead cells and bacteria.

Taking such substances can resemble a hormone imbalance, which also affects acne in general if prone. The more androgenic the steroid, the higher risk of acne. Acne is common at the beginning of AAS cycles, during cycles, during post-cycle therapy (PCT) and for a time after PCT. AAS can kick start future problems in regards to acne if you are prone to it, which is what happened to me.

Do you suffer from stress?

Acne has recently been connected to stress:

A study published in the Proceedings of the National Academy of Sciences (May, 2003), detected a possible chemical relationship between stress, acne and other skin disorders. Stress causes the hypothalamus, a portion of the brain, to release a chemical called corticotropin-releasing hormone (CRH). Oil glands in the skin have been shown to produce both CRH and CRH-receptors. When the CRH-receptors come into contact with CRH, oil glands are triggered to produce more oil, one of the causes of acne breakouts.

So far, oil glands have only been seen to produce the CRH stress chemical in the laboratory, but these results imply that CRH is also produced naturally in the human skin. If so, a very clear relationship between acne and stress is indicated. In addition, researchers note that testosterone lowers the production of CRH receptors, while human growth hormones increase CRH-receptor production. This interaction may explain why males and females are susceptible to acne skin disorders at different ages.

What’s your diet like?

So called ‘Bad fats’ tend to promote inflammation in the body and therefore contribute to the amount of oil produced in the skin. Diet is not the cause of acne, but it does relate to your skin and its health just like it does the rest of your body.

Make sure your body intakes sufficient daily recommend amounts of important vitamins, minerals and nutrients through wholesome foods or supplementation.

  • Occur during Puberty – Acne is most common with adolescents. Children develop and mature at all different ages, some start earlier than others some start later. Puberty is the period in which children begin to mature biologically and physiologically. Hormones are what cause these drastic changes. As the child’s body develops and changes, there are major hormone fluctuations. The hormones that cause physical maturation also cause the sebaceous glands of the skin to produce more oil. It’s the androgenic male hormones, which have the greatest affect on the sebaceous glands. Some adolescents get acne – some don’t! The majority of those who get acne have mild acne that soon goes on its own or with the use of mild treatments. Some people however, find it hard to treat the acne with regular treatment methods such as over the counter products and GP prescribed drugs like as antibiotics.

What are the different types of Acne?

There are a few different formations of acne:

  • Acne Vulgaris
  • Acne Rosacea
  • Severe Acne

See for in-depth information on the different Acne profiles above.

What makes Acne worse?

  • Squeezing and picking at acne will irritate and may cause further inflammation and a higher probability of scaring of the skin.
  • Stress
  • Washing too much too often will make the skin produce even more oils
  • Hormonal changes that occur during a menstrual cycle
  • Contraceptive pills
  • Excessive production of hormones
  • Some medications

What makes Acne better?

  • Keep the acne areas clean by washing twice a day
  • Use only un-perfumed soups and cleansers
  • The sun and sun beds also assist, as they dry up the acne helping them to heel, personally I have found 2-3 times a week effective
  • Not picking and squeezing them!
  • If you’re acne is bad to the point where they burst in clothing and when your sleeping – make sure you change the specific clothing with the bacteria to prevent spreading
  • And of course – treatment (either prescription or non-prescription – whichever works best – see below)

What are the available treatments and where can I get them?

The treatments available depend on the state of your acne. There is no current treatment available that will completely cure acne; treatments are more to help prevent it, to improve on current acne and to help prevent scaring. There are many effective over the counter treatments available for purchase from pharmacies and health stores; these usually contain anti-bacterial agents such as Benzoyl Peroxide (which opens up the blocked pores, and assists in killing the bacteria).

With regular treatment, washing twice a day with un-perfumed cleansers it will definitely assist in helping to prevent acne and help clear up existing acne.

There are many different over the counter treatments available; you may find yourself trying out different ones to find what works for you best. If you find yourself trying out different treatments time after time for lengthily periods with no success – it is advised you visit your GP. Over the counter, prescription-free methods may help for mild acne, but doubtful to make much difference at all with severe acne. Always read the label, read instructions carefully when using home treatments.

What are the prescription treatments available and where can I get them?

First step is to make sure you try non-prescription based treatments. If your acne is constant or more severe and non-prescription treatment isn’t working, the next step is to visit your GP. Explain to your GP that you have been suffering, explain how having acne makes you feel, explain how long its gone on and what you’ve gone through. He will place you on a series of antibiotics. You are required to try different types of antibiotics for months at a time, to try and find a cure without using the last resort (which in this case – is visiting your Dermatologist at your local hospital).

If the antibiotics work, then your GP will decide on how long you will be using them and at what dosages. This may vary depending on how you react to them, what drug it is and of course the GP’s general decision.

If antibiotics aren’t working for you – you will get referred to a specialist; a Dermatologist. The drug they prescribe will be Roaccutane, or Isotretinoin. These are very powerful drugs and your local GP cannot prescribe you them. You will not get given these drugs on a plate; you will need to have attempted other cures by going through your GP, trying out different medications such as antibiotics. The waiting list to see a Dermatologist is usually a lengthily period, a 6 month wait is not uncommon for a first appointment, and on that day, if you don’t meet up to specific expectations in regards to what other methods of treatments are available, you could very easily get turned away and told to try other methods from your GP.

Roaccutane and Isotretinoin are very very powerful drugs, and they will not prescribe it unless you actually require it. It may be a good idea to take clear, high quality photographs of areas of your body that are affected and when they are particularly bad, in case on the day your acne isn’t as bad as it has been, and consequently the Dermatologist may decide you acne isn’t actually bad enough for their treatments!

What happens if I get referred to a Dermatologist?

On your first visit to your Dermatologist, you will get asked numerous questions regarding your acne; your background, what you have tried to help with your acne, what drugs, what dosages and how long you’ve been using them. They will check what you say with your GP. They will give you a list of side effects to the drugs they prescribe, and they will carefully inform you on everything you need to know, a leaflet may also be provided.

If you are ok about the side effects (listed further on in this article), they will then ask you to get blood tests done, and will typically test to see if you are ok for using the drug they will prescribe, i.e. liver values, cholesterol etc. You will then get another appointment, where you will be weighed, as the dosages of Roaccutane / Isotretinoin are run according to your weight. This will be the visit where you will get your prescription if your blood test results are fine.

What is Roaccutane / Isotretinoin and what are the side affects?

These drugs are the same, some specialists prefer to use one rather than the other, but the drug itself is the same, it’s just a different brand name. The drug comes under a class of medication called ‘retinoids’ which are used to treat severe acne that has not responded to other alternative methods of treatments. This is a prescription only drug and cannot be purchased over the counter or legally.

These drugs come in capsule form and are taken orally, once or twice a day, along-side meals. You should use the drug according to what your Dermatologist advises. Many specialists like to start their patients off on half dosage at first to see how they react in terms of side effects. If you are fine with the side effects, your specialist may request you take the full dosage for a set amount of weeks or months. If you don’t think you can stand the side effects, you will run the course of treatment on the half dosage, but the course will be longer. It is important you complete the course! Never take more or less than you are told to do so.

A lot of people who are using this treatment or have used this treatment, found that their acne got worse before it got better, and that there was a flare up at the beginning of treatment. People see a difference usually within 6 weeks or so of treatment.

There is a long list of side effects, which can put people off, but if you have severe acne they won’t even compare. Milder side effects include:

  • Dry mouth
  • Dry, cracked and sore lips
  • Dry nose
  • Thinning of hair
  • Inflamed, itchy or dry eyes

More serious side effects are:

  • Joint pain
  • Chest pains
  • Difficulty of breathing
  • Severe headaches
  • Depression
  • Skin pealing and infections
  • Muscle aching
  • Rectal bleeding
  • Hearing problems
  • Vomiting
  • Dizziness
  • Severe diarrhoea
  • Suicidal thoughts

If you experience any of these more serious side affects, it is important you notify your GP immediately.

Roaccutane / Isotretinoin is a very powerful drug. It is very harsh on the liver, so you should avoid drinking alcohol and using oral-based AAS when on a course as they will put a large amount of further stress on the liver.

Roaccutane / Isotretinoin does not cure acne, but it will help breakouts for long periods of time and it will help clear up current acne. It is a very very effective drug, and the majority of people who have used this drug have referred to it as a ‘wonder drug’. But like everything, it depends on how the individual reacts!

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