Can Prednisone Give You Acne?

Types, Risks, and Treatment of Steroid Acne

Corticosteroids, and especially prednisone, are often prescribed to treat many inflammatory conditions, including inflammatory bowel disease (IBD). Some people who take steroid medications such as prednisone can develop a type of acne (pimples or zits) called "steroid acne." 

Far from being a trivial adverse effect of a medication, acne breakouts can have a significant negative effect on quality of life. People with IBD may feel as though dealing with the acne or having it treated is secondary to the IBD, and may hesitate to bring it up with healthcare providers. However, quality of life and feeling good about one's appearance is also vital to coping with the IBD and getting a flare-up under control. 

Prednisone Side Effects

Prednisone is a cheap, effective medication and is prescribed by many physicians to get a flare-up of Crohn's disease or ulcerative colitis under control. Ideally, it should only be used for a short amount of time, but is sometimes used for longer periods in cases where the IBD isn't responding to anything else. The current goal of treatment for IBD is to control inflammation without using steroids or at least using them for as short a time as possible. 

Prednisone is associated with many adverse effects, some of them very troublesome to patients, such as being hungry or moody, and others that are serious or long-lasting, such as eye problems. For these reasons and more, patients and physicians should try to use prednisone for the shortest amount of time possible if at all.

Once prednisone is started, it cannot be abruptly stopped due to the risk of severe withdrawal symptoms. Depending on how long you've been on prednisone and/or the size of the dose, the tapering off process can take weeks and even months.

Types of Steroid Acne

Acne is often thought of as a problem for adolescents, but steroid acne can happen to anyone taking steroids regardless of age. That said, it tends to be more common in teens and adults. Steroid acne can appear on the face, chest, or back and is commonly associated with two form: Acne vulgaris and Malassezia folliculitis.

Acne vulgaris is the term used to describe the man type of acne in adult and teens and the one that occurs most commonly with prednisone therapy. It often appears as very uniform lesions and might be more prevalent in people who have a tendency towards acne in the first place.

Malassezia folliculitis is a type of acne caused by a fungus present in and around hair follicles. It is estimated that anywhere from 75 percent to 98 percent of people have this type of fungus on their skin. While the presence of the yeast is normal, the overgrowth of it is not. M. folliculitis is most common on the chest and trunk and is characteristically itchy.

Steroid acne will begin to recede once prednisone is discontinued. During prednisone treatment, acne remedies can be used to help control outbreaks.

Treatment

The type of treatment that is used will depend on the type of acne present as well as several other factors such as other medications that are being taken and the severity of the acne. 

Accutane (isotretinoin) is usually not recommended for treating acne in people with IBD as it may trigger diarrhea and rectal bleeding. Instead, topical cleansers and anti-acne agents such as benzoyl peroxide are recommended as the first step in treating acne.

For moderate to severe steroid acne, oral antibiotics like doxycycline, minocycline, and tetracycline are commonly prescribed. Fungal acne is best treated with topical antifungals, oral antifungals like itraconazole, or a ketoconazole shampoo.

A Word From Verywell

Anyone who has concerns about acne that develops during prednisone therapy should consult a gastroenterologist or a dermatologist who has experience in treating people with IBD. Remember that even though acne, especially on the face, can be difficult to live with, the acne will clear up when you taper down off the steroids.

In the meantime, receiving treatment for the acne may help to clear up the skin until the prednisone is stopped.

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