Oral and injectable steroids both have their benefits. Primarily, oral steroids offer huge gains in short periods, and injectable steroids offer smaller, higher quality gains over longer periods of time. Most of the bodybuilders and athletes who utilize anabolic steroids will actually use both during a cycle. They will start out with one of the oral steroids as a “kick-start” for their gains, then switch over to an injectable before the side effects become too much to handle. This way, they can enjoy quick gains from the start, then turn them into lean muscle without much water retention throughout the rest of the cycle.
Other combination therapies may lack convenience but are also effective. In the patient with comedones and inflammatory lesions, a comedolytic agent such as tretinoin, adapalene or azelaic acid may be combined with benzoyl peroxide or a topical antibiotic. The combination of clindamycin and tretinoin causes less irritation than tretinoin alone. 30 In using tretinoin and the benzoyl peroxide–erythromycin combination together, the patient should alternate the products daily for two weeks to minimize irritation. When agents that cause irritation are used, patience is necessary, but the results may be well worth the wait.