Acne is often present. Acne conglobata is a particularly severe form of acne that can develop during steroid abuse or even after the drug has been discontinued. Infections are a common side effect of steroid abuse because of needle sharing and unsanitary techniques used when injecting the drugs into the skin. These are similar risks to IV drug abusers with increased potential to acquire blood-borne infections such as hepatitis and HIV/AIDS . Skin abscesses may occur at injection sites and may spread to other organs of the body. Endocarditis or an infection of the heart valves is not uncommon.
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[Change] in facial shape and texture is also observed for subjects who undergo gender transformation through hormone replacement therapy (HRT). Gender transformation through HRT effects face fat distribution thus causing a change in the overall shape and texture of the face. Reduced fat distribution can allow for fine wrinkles and lines to become apparent whereas an increase in fat distribution stretches the dermis removing fine wrinkles and lines. For example, female to male gender transformation causes the face to become more angular (masculine) by reducing the fat distribution in the face. (The reduction in fat cells is caused by a shrinkage of the cells not an eradication of the cells.) In addition, the skin is either thinned (male to female) or thickened (female to male), thus introducing texture variations to the face region. It has also been shown that the factors influencing skin aging process are significantly improved as a result of HRT . The result of HRT gender transformation is an increase in the within-class variation and reduction in between-class variation.