Because of these side effects, doctors frequently choose safer medications, such as the 5-ASA drugs and antibiotics, as initial therapy. But there are a number of ways to reduce the risk of developing side effects. These include rapid but careful tapering off of steroids; alternate-day dosing; rectally applied corticosteroids; and rapidly metabolized corticosteroids such as budesonide (described above). To help prevent osteoporosis, many doctors routinely prescribe calcium supplements as well as multivitamins that contain vitamin D. Another option is the use of bisphosphonates, such as risedronate (Actonel®) and alendronate (Fosamax®). These compounds, which have been shown to help avert bone loss, are effective in treating and preventing steroid-induced osteoporosis.
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.