Alen, Reinila, & Reijo (1985) observed that serum testosterone level tended to increase throughout a 26 week cycle of various AAS until abruptly dropping below normal levels during cessation. When athletes discontinue the use of AAS they experience a refractory period where they do not produce physiological amounts of endogenous testosterone (Di Pasquale, 1992a). Anabolic-androgenic steroid can reduce endogenous testosterone, gonadotrophic hormones and sex hormone-binding globulin (Yesalis, Wright, & Bahrke, 1989). Weight trained athletes have been shown to have low serum testosterone concentrations immediately after cessation of an AAS cycle but return to normal within weeks (Alen, Reinila, & Reijo, 1985).
The most common side effect of topical corticosteroid use is skin atrophy. All topical steroids can induce atrophy, but higher potency steroids, occlusion, thinner skin, and older patient age increase the risk. The face, the backs of the hands, and intertriginous areas are particularly susceptible. Resolution often occurs after discontinuing use of these agents, but it may take months. Concurrent use of topical tretinoin (Retin-A) % may reduce the incidence of atrophy from chronic steroid applications. 30 Other side effects from topical steroids include permanent dermal atrophy, telangiectasia, and striae.
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