Steroids can worsen existing skin pathologies. Athletes being treated for acne often stop responding to normal treatment regimens if they also continue to use the drugs. Some cases of comparatively benign acne can progress to the disfiguring inflammatory types. Psoriasis is an autoimmune disease in which, for unknown reasons, immune cells attack skin cells, resulting in red, scaly patches. One bodybuilder had controlled his psoriasis condition through the use of a topical cream, but when he began using steroids, his condition considerably deteriorated. Eventually his psoriasis became resistant to treatment. But when he stopped using steroids, the psoriasis stabilized and again responded to simple skin-cream treatment. 6
Each user experiences their own unique feelings when using steroids and coming off the drug. When someone chooses to stop using they can experience a variety of withdrawal symptoms linked to addiction. Symptoms can include mood swings, fatigue, restlessness, loss of appetite, insomnia, reduced sex drive, the desire to take more steroids, and depression. Evidence for steroid addiction is certainly not as strong as it is for other drugs like cocaine or heroin. Though it is clear that people develop a tolerance and dependence on them and willingly experience negative consequences when using steroids - both of which are signs for drug dependence.
It is widely suspected that the anaerobic bacterial species Propionibacterium acnes ( P. acnes ) contributes to the development of acne, but its exact role is not well understood.  There are specific sub-strains of P. acnes associated with normal skin, and moderate or severe inflammatory acne.  It is unclear whether these undesirable strains evolve on-site or are acquired, or possibly both depending on the person. These strains have the capability of changing, perpetuating, or adapting to the abnormal cycle of inflammation, oil production, and inadequate sloughing of dead skin cells from acne pores. Infection with the parasitic mite Demodex is associated with the development of acne.   It is unclear whether eradication of the mite improves acne.