Prednisone Side Effects And Warnings

Learn Facts and Information About Prednisone, Both Side Effects and Benefits

Acne Caused By Prednisone

Prednisone and Acne

Prednisone is a steroid that significantly impairs the body's natural immunity against infections and diseases. However, at the same time, prednisone is helpful in managing autoimmune diseases and uncontrolled inflammatory processes within the body. While prednisone therapy is associated with a number of positive benefits and therapeutic advantages, it is also associated with certain side effects and complications, one of which is acne. Acne caused by prednisone is often referred to as acneiform eruption[2].

Who is at Risk of Developing Acne with Prednisone Intake?

Although virtually any person who is on prednisone therapy can develop acne, it is most frequently reported in individuals who have a history of adolescent acne. Androgens, including testosterone and estrogen, which contribute to the development of adolescent acne, are similar in chemical composition to glucocorticoids or prednisone.

Acne caused by prednisone is mainly concentrated on or around the face, chest, upper back and neck region, but can involve any or every part of the body, including uncommon areas like the shoulders, abdomen, thighs, groin etc. The severity of lesions also varies significantly, ranging from mild papules and pustules to large nodular and cystic lesions.

Once ingested, prednisone mimics endogenous steroids in the body, and one of the primary effects of steroids is the increased production of sebum from the sebaceous glands of the skin. The oil then clogs the ducts and pores ultimately resulting in inflammation that leads to acne flaring. Prednisone also increases the basal metabolic rate and energy expenditure, which increases the core body temperature and sweat production - another factor that contributes to the development of acne.

How Can You Manage Acne Caused by Prednisone Intake?

Little can be done to manage acne as long as you are taking prednisone. However, tapering the dosage or discontinuing the therapy will likely resolve the acne. In most cases, prednisone acne (or steroid acne) goes away within a couple of weeks, without any treatment after cessation of prednisone therapy. Be sure, however, to taper off the dosage instead of abruptly withdrawing.

Other options that may help in resolving prednisone acne are:

  • Over the counter acne medications like benzoyl peroxide and the topical application of sodium benzoate help in decreasing flares and resolving active lesions with minimal risk of scarring.
  • Although, with severe flaring of acne, isotretinoin (or Accutane) can be given, it is generally not the first line of therapy. Likewise, if prednisone is being consumed for the management of inflammatory bowel disease, the consumption of Accutane can further aggravate the inflammation of the bowel.
  • Maintain optimal cleanliness of the skin by adopting a habit of regular cleansing and using quality skin care products. Use cosmetics that are water-based.
  • Oral antibiotics (like doxycycline) can be prescribed to reduce inflammation by destroying acne-causing bacteria and controlling inflammation-producing elements.
  • Healthcare providers suggest zinc supplements and a low glycemic index diet to minimize flaring.
  • Drink plenty of water and implement dietary modifications and improvements, if necessary.

What Are Some Other Skin Lesions That Are Seen in Prednisone Users?

Long-term prednisone intake is associated with several other skin lesions besides acne, such as:

  • Easy bruising due to moderate damage to blood vessels and superficial skin layers.
  • Increased tendency to develop ulcers and poor healing of minor wounds.
  • Appearance of abdominal striae at places where skin undergoes stretching.
  • Redness or flushing of face, also known as plethora.
  • Fluid retention is another known complication of prednisone therapy that is marked by edematous face (puffiness around the eyes and neck).

Is Prednisone/Steroid Therapy Always a Bad Thing?

Many people operate under the misconception that steroids in any form can lead to acne and skin lesions, which is simply not true. In clinical practice, steroids like prednisone and other similar formulations are helpful in treating nodular and cystic lesions such as acne conglobata[2]. Other skin lesions that are controlled by the intake of prednisone are lupus erythematous, allergic skin conditions, psoriasis and hirsutism.

If you are developing acne and other skin lesions due to prednisone therapy, it is best to seek the advice of your primary healthcare provider for dosage modification or to seek dermatological advice in order to receive appropriate therapy for the control of your acne lesions.


  1. Kaidbey, K. H., & Kligman, A. M. (1974). The pathogenesis of topical steroid acne. Journal of Investigative Dermatology, 62(1), 31-36.
  2. Plewig, G., & Kligman, A. M. (1973). Induction of acne by topical steroids. Archiv für dermatologische Forschung, 247(1), 29-52.
  3. Yu, H. J., Lee, S. K., Son, S. J., Kim, Y. S., Yang, H. Y., & Kim, J. H. (1998). Steroid acne vs. Pityrosporumfolliculitis: the incidence ofPityrosporum ovaleand the effect of antifungal drugs in steroid acne. International journal of dermatology, 37(10), 772-777.

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