Awareness and educational efforts are working to help prevent anabolic steroid abuse in schools and communities. The Adolescents Training and Learning to Avoid Steroids (ATLAS) and the Athletes Targeting Healthy Exercise and Nutrition Alternatives (ATHENA) programs, funded by the NIDA, and supported by the Oregon Health & Science University programs is teaching athletes that they do not need steroids to build powerful muscles and improve athletic performance. These programs provide weight-training and nutrition alternatives, increase healthy behaviors, less likelihood to try steroids, and less likelihood to engage in other dangerous behaviors such as drinking and driving, use of marijuana and alcohol , and and improved body image. Bother Congress and the Substance Abuse and Mental Health Services Administration endorsed these model prevention programs. 4
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.
Depending on the number and character of their functional groups, steroid molecules may show diverse reactivities. Moreover, the reactivity of a functional group varies according to its location within the molecule (for example, esters are formed readily by 3-OH groups but only with difficulty by the 11β-OH group). An important property of steroids is polarity —., their solubility in oxygen-containing solvents (., water and alcohols ) rather than hydrocarbon solvents (., hexane and benzene ). Hydroxyl, ketonic, or ionizable (capable of dissociating to form electrically charged particles) groups in a steroid molecule increase its polarity to an extent that is strongly influenced by the spatial arrangement of the atoms within the molecule.