Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Anabolic steroids can cause the development of acne. However, the extent to which it is experienced can be due to a number of varying factors, with the particular steroids and exact dosages used being primary. The skin´s sebaceous glands have a particularly high affinity to Dihydrotestosterone, which is an androgen the body naturally produces from testosterone via the enzyme 5-alpha Reductase. Increased sebaceous gland activity promotes oily skin which can combine with bacteria and dead skin (normal wear and tear) eventually causing pores to become clogged more quickly than the body can cleanse them. This of course, is preventable by using only particular steroids, cleansing the skin regularly, and perhaps using a topical anti-androgen.
In addition to the mentioned side effects several others have been reported. In both males and females acne are frequently reported, as well as hypertrophy of sebaceous glands, increased tallow excretion, hair loss, and alopecia. There is some evidence that anabolic steroid abuse may affect the immune system, leading to a decreased effectiveness of the defense system. Steroid use decreases the glucose tolerance, while there is an increase in insulin resistance. These changes mimic Type II diabetes. These changes seem to be reversible after abstention from the drugs.