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

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.