How To Spot A Steroid User: Telltale Signs and What to Look For

Anabolic steroid use is everywhere. You see it in Hollywood movies, the Olympics, heck, probably your jacked personal trainer is using performance-enhancing drugs (PEDs), too. While most athletes think they can get away with it, gear use often leaves telltale signs.

I’m betting that there’s at least one individual in your gym who makes you go, “This dude ain’t natural — he looks juicier than a watermelon.” Be it their size, strength, or paper-thin skin, there’s always that one guy who just seems off. 

In this article, we go over science-backed signs associated with steroid use and what you should do if you spot a roid user. That said, this is not about judging gear users. The goal here is to promote awareness and understanding of the potential side effects of PEDs.

Physical Changes Associated with Steroid Use

Everyone hits the gym with the goal of making gains. However, muscles earned through the natural route tend to look different than those boosted by roids. Here are the giveaway signs of PED use:

Rapid Muscle Gain

So, you know a guy who’s been skinny for years and suddenly gains what looks like 50 pounds of lean muscle in a couple of months? He might tell you that a new creatine formulation is the secret behind his gains, but you shouldn’t take him at his word. 

Even if you’re genetically gifted, you still can’t go from zero to Captain America in a few months. An average intermediate lifter can gain up to 2-3 pounds of lean muscle over four weeks. 

It is possible to get more by optimizing your diet, training, and recovery programs. However, if someone is getting stronger by the minute and gaining an excessive amount of muscle astonishingly fast, steroids might be involved. 

Steroid muscle gains usually defy logic and can make a beginner look more jacked and diced than an experienced natural lifter at the gym within eight to 12 weeks. 

Acne and Skin Issues

Many steroid users wear hoodies even in the middle of the summer. They will tell you it is to burn more calories via sweating. However, they are actually hiding something. 

On the rare occasion that a suspected steroid user does remove his covers, you might spot acne. Anyone can get an acne flare-up, but steroid acne is caused by hormonal fluctuations and hits differently. It usually appears on the back, glutes, shoulders, chest, neck, and face. 

Steroids can increase oil production by sebaceous glands and make them more susceptible to infection. Those glands then produce more sebum, a wax-like substance that clogs the pores in larger quantities. 

“Deep creases between the nose and cheeks, swollen deltoid muscles, and a constantly bulging vein on the left side of the neck are a few telltale signs that someone is using PEDs,” said Dr. Andrew Huberman, a professor of neurobiology and ophthalmology at the Stanford University School of Medicine.  

Scar tissue at injection sites is another common sign of steroid use. Repeated injections in the same area can cause knots and scarring, and infections can worsen the effect.

Some elite athletes like former Mr. Olympia champ Hadi Choopan have been accused of synthol (oil) use because of possible scar tissue build-up in his deltoids.

Extended Gut

A bulging belly is one of the most infamous signs of steroid abuse in bodybuilders. PEDs, like human growth hormone (HGH), enlarge internal organs along with muscles. Someone with a distended stomach and a ripped six-pack is probably on the juice.

Bloating

Some PEDs can lead to water retention in the muscles, which causes a swollen appearance. This bloating is mostly seen in the abdomen and face. However, some people can also feel puffy in their ankles and wrists.

Gynecomastia

Gynecomastia, also known as gyno or man boobs, is a condition that causes breast tissue to grow in boys and men, resulting in enlarged breasts. 

Most bodybuilders use testosterone as a base for the majority of the year and then add other anabolic steroids on top of that. The exact gear they use varies depending on their most urgent goals. Switching between PEDs throughout the year can mess with the normal balance of testosterone and estrogen, which can cause issues like gynecomastia.

Notably, there is no way to reverse gynecomastia, and it has to be surgically removed. Elite professional bodybuilders like Ronnie Coleman, Lee Haney, Franco Columbu, and William Bonac dealt with gyno at the peak of their careers. 

Furthermore, steroid use can also cause sexual dysfunctions and an impairment of sperm production. (1)

Hair Changes

The relationship between steroid use and hair changes is pretty complex. Steroid use can magnify hair loss on your head while potentially promoting excessive body hair growth.

Behavioral and Psychological Signs of Steroid Use

Steroid use can have the following psychological implications:

Mood Swings and Aggression

‘Roid rage’ is for real. Anabolic steroids can cause sudden, dramatic mood swings, irritability, and bursts of aggression. No matter how mentally balanced and calm you think you are, gear will impact you mentally. 

Increase Confidence and Risk-Taking

Steroids make you stronger and bigger. It is no surprise they can create a false sense of invincibility, which usually leads people to make unwise decisions and take uncalculated risks in the gym and outside. 

Anxiety and Restlessness

Some PEDs have stimulant-like effects. However, they can cause paranoia, anxiety, and restlessness and make it harder to relax or sleep well. Many athletes develop a fidgety nature as soon as their first steroid cycle. 

Remember, these side effects are almost instantaneous. However, they can take a long time to correct. 

Signs of Obsessive Focus on Bodybuilding

“Using steroids can lead to body dysmorphia, as gaining muscle mass very quickly can make you feel like you are constantly wearing a thick coat, even when you aren’t. This can make it difficult to be comfortable in your own body,” said Dr. Mike Israetel (Ph.D. in Sports Physiology)

A study published in the Addiction Journal highlights withdrawal symptoms, cravings, and continued use despite negative consequences associated with steroid abuse. (2)

Additional Indicators and Considerations

Here are some additional red flags to watch out for:

Age and Lifestyle

While people across demographics use steroids, younger men are more susceptible to the lure of quick gains. Teens or those in their early 20s who seem to blow up like a balloon and have an unnaturally muscular physique are more likely to be on steroids. 

Obsession with Appearance

People who are overly fixated on their looks and tend to check themselves out in the mirror constantly are more likely to pick up the syringe. Sadly, many people begin steroid use just to get someone’s validation. 

Testicular Shrinkage (in men)

Most guys never talk about this (obviously), but this is one of the most common symptoms of roid use. To be fair, this is not a telltale sign unless you’re really close with the steroid user — if you know what I mean. 

PED use can mess with a male’s hormones. Taking synthetic testosterone can make the body stop producing its own testosterone, which leads to a decrease in testicle size. 

Menstrual Irregularities (in women)

Most anabolic steroids are essentially male hormones. When women use them, they can wreak havoc on their normal menstrual cycles. Irregular periods are a common side effect of using PEDs in women. Furthermore, many women report missing periods altogether. 

What To Do If You Suspect Steroid Use

“Most [elite] bodybuilders use steroids 90 to 100% of the year. They may cycle off for a short period of time, but they are never truly off steroids because it takes months to recover from steroid use,” said Derek of the More Plates More Dates YouTube fame. 

If you are like most people, you probably won’t stop after you’ve spotted a steroid user. You might have the urge to call them out, or if it is someone you really care about, you might want to tell them the potential side effects of steroids. 

Here are a few tips on how you should tackle this delicate subject:

It’s None of Your Business

To begin with, you shouldn’t concern yourself with policing others’ choices if they are not directly harming you or others. Forcing the issue can strain the relationship, lead to an unwanted confrontation, or drive the roid user further into secrecy. 

Approaching the Subject with Concern and a Desire to Help

Multiple steroid use signs could point to someone who is struggling and in need of help. Recognizing what you’re seeing is the first step toward understanding a situation. Discussing the side effects of PED use might be a difficult conversation to have with someone, especially if you don’t know them, but it can make a world of difference to them. 

However, make sure you are not stepping over any boundaries. 

Here is how to reach out with a desire to help:

• Choose a Private Setting: Don’t start talking to them about steroids in the middle of the gym floor, where others can see you. 
• Lead with Concern: Don’t be confrontational. Instead, ask open-ended questions that show your concern. 
• Offer Support: Never be judgemental. The individual should feel that you’re there to listen and not lecture. 

Even if you do everything right, know that the people using PEDs often rationalize their decisions or might be in denial. You shouldn’t expect to see immediate results and must respect their boundaries. 

Conclusion

Contrary to what most people think, PED use is not limited to bodybuilders. They are used by athletes across the board who want to excel in their sports, including biking, soccer, basketball, and F1.

Elite bodybuilders are becoming more open about their drug use. Look at professional bodybuilders in the off-season, and you’ll learn to spot some of the physical and psychological signs listed in this article. 

That said, not everyone with these signs is a definite drug user, as underlying medical conditions can also cause them. On the other hand, a regular droid user might not display any of these signs. Spotting a steroid user can be a tricky proposition, so you better be careful. 

If you have any questions about spotting a drug user, drop them in the comments below, and I’d love to help!

References

1. Corona G, Rastrelli G, Marchiani S, et al. Consequences of Anabolic-Androgenic Steroid Abuse in Males; Sexual and Reproductive Perspective. World J Mens Health. 2022;40(2):165-178. doi:10.5534/wjmh.210021
2. Kanayama G, Brower KJ, Wood RI, Hudson JI, Pope HG Jr. Anabolic-androgenic steroid dependence: an emerging disorder. Addiction. 2009;104(12):1966-1978. doi:10.1111/j.1360-0443.2009.02734.x

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