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.
Animal welfare groups claim that animal husbandry and urine collection methods used in the production of Premarin cause undue stress and suffering to the mares involved. Animal activists have made claims of abuses ranging from inadequate stall size, long periods of confinement, cumbersome urine collection, and continuous breeding cycles. After reaching advanced age, many of the mares are adopted for recreation use, while some are sent to feed lots for slaughter. Despite the controversy, the USDA called the Premarin HRT industry a model of self-regulation.