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Steroid Acne: Causes And Treatment
Steroid Acne – A Complete Guide
Steroid‑induced acne is one of the most common skin side‑effects of both topical and systemic corticosteroid therapy. The condition can be distressing, cosmetically embarrassing and sometimes difficult to treat if left unchecked.
Below you’ll find a comprehensive discussion that covers the what, why, how and what next. Each heading is addressed in turn so you can easily locate the information that matters most to you.
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What Is Steroid Acne?
Steroid acne, also known as corticosteroid‑induced acne, is a form of inflammatory acne that arises after exposure to corticosteroids. It typically presents with:
Papules (small, solid bumps)
Pustules (pus‑filled lesions)
Nodules in severe cases
Unlike classic acne, steroid acne can affect the upper back, chest, and shoulders – areas where the drug is most often applied or absorbed.
How Does Steroid Acne Develop?
Corticosteroids alter skin physiology by:
Increasing sebum production
Suppressing immune response
Reducing keratinocyte turnover
These changes create an environment conducive to follicular blockage and bacterial proliferation, leading to inflammatory lesions.
What Are the Risk Factors for Steroid Acne?
High‑dose topical steroids (especially potent classes)
Prolonged use beyond 4–6 weeks
Large surface area application
Use on thin skin areas (e.g., face, eyelids)
Concurrent systemic steroid therapy
How to Prevent Steroid Acne?
Limit potency and duration of topical steroids
Apply the minimal effective dose over a small area
Alternate with non‑steroidal treatments when possible
Use barrier creams or moisturizers to protect skin
Monitor for early signs (redness, itching)
Management of Existing Steroid Acne
Step Intervention
1 Discontinue or taper steroid if feasible
2 Topical retinoids (tazarotene, adapalene) for comedonal and inflammatory lesions
3 Antibiotic therapy: topical clindamycin + benzoyl peroxide; oral doxycycline if widespread
4 Systemic retinoid (isotretinoin) for severe or refractory cases, with appropriate monitoring
5 Supportive skincare: gentle cleanser, non-comedogenic moisturizer
Monitoring: Regular follow-up visits to assess treatment response and adjust therapy.
5. Summary
Diagnosis:
- Primary diagnosis is chronic acne vulgaris (persistent inflammatory lesions).
- The "mild" descriptor likely reflects current lesion count or severity, but does not negate chronicity.
Management Plan:
- Begin topical therapy (retinoid + benzoyl peroxide).
- Add systemic antibiotic if needed; consider oral isotretinoin for refractory cases.
- Provide patient education and lifestyle counseling.
Follow‑up:
- Regular dermatologic reviews every 4–6 weeks, with potential medication adjustments.
- Reassess diagnosis and treatment efficacy at each visit.
Conclusion:
The appropriate ICD-10 code is L70.0 (Acne vulgaris); the patient’s presentation reflects a chronic condition requiring ongoing dermatologic management rather than a single episode of acne. The coding should reflect the chronic, ongoing nature of the disease to align with both clinical documentation and reimbursement requirements.
Gender: Female