Muscle enhancement using intramuscular injections of oil in bodybuilding: review on epidemiology, complications, clinical evaluation and treatment

Abstract

Background: Self-administered intramuscular injection of site enhancement oil (SEO) is a cosmetic and performance-enhancing procedure used to reshape muscles in the bodybuilder subculture, but its consequences and complications are only sporadically described.Methods: A systematic search in MEDLINE and EMBASE databases during the spring of 2009 and 2010. Internet searches were performed, and bodybuilder pharmacopoeias were consulted to describe SEO use and the clinical complications known.Results: One review and seven case reports were identified. Eight case reports describe oleomas caused by repeated intramuscular injections of anabolic steroids.Conclusions: SEOs cause sclerosing lipogranulomatosis and its progression may lead to lifelong complications. Thorough radiologic evaluation is important to plan surgical revisions in active phases. Also antibiotics, steroids, and compression therapy have been successful and should be employed at different stages.

The injecting use of image and performance-enhancing drugs (IPED) in the general population: a systematic review

“…This study mentions the practice of ‘homebrewing, where users follow instructions posted online to mix together their own oils for self‐injection’ (Schafer et al . ). However, practices such as these are not well described in the literature, with a lack of data on what products are used in homebrews.…”

“…No studies to identify vendor websites have been conducted for melanotan, synthol or dermal fillers, although the existence of such websites, and the presentation of products sold, has been discussed in previous studies (Pickett & Mewies , Pickett , Schafer et al . , Breindahl et al . , Kimergard et al .…”

“…Synthol injection and unregulated Botox/dermal filler injectables were chosen as the most undocumented scientifically despite anecdotal reporting of high prevalence of use (Pickett & Mewies , Pickett , Schafer et al . , Zilinskas & Coleman, ).…”

Long-term adverse effects of intramuscular oil injection

“…The medical uses of paraffin include skin care and as a laxative, but when injected intramuscularly, complications such as paraffinomas (chronic sclerosing lipogranulomas), ulcerations, infection, systemic embolism and an often-negated irreversible muscle damage may develop within weeks or up to several years after abuse 2. Sadly, no curative treatment is available, but surgery, corticosteroids, compressions or antibiotics may be required, depending on the presentation 3. Surgery should be reserved for the most severe cases, as it may further reduce functional performance.…”

Subcutaneous Oleomas Following Sunflower Oil Injection: A Novel Case and Review of Literature

“…Although subcutaneous injection of these materials is not recommended due to the late onset of serious complications, it is still misused by body builders, passive homosexuals, and transsexuals. Foreign material self-injection is a worldwide entity with thousands of users because the market is illegal and there is no legislation for the distribution of anabolic steroids and supplements (3). Diagnosis and treatment is a challenging owing to the lack of considerable medical literature and unawareness of physicians about foreign material injection.…”