Anabolic-androgenic steroids (AAS) are image and performance enhancing drugs (IPEDs) that can improve endurance and athletic performance, reduce body fat and stimulate muscle growth. The use of steroids has been studied in the medical and psychological literature, in the sociology of sport, health and masculinity, and relatively recently in criminology. Whilst there is significant medical and psychological evidence on the short term and longer side effects of AAS, there is surprisingly very little evidence based on the users' perception of the negative aspects of AAS use. Drawing on ethnographic research conducted in a locale in the Northeast of England and additional interviews with 24 AAS users, the article offers an account of the negatives aspects of AAS as put forwards by users (acne, abscess, and mood alterations), and highlights the ‘code of silence’ that exists around AAS use. This ‘code’ makes AAS users a ‘hard-to-reach’ group for medical professionals. By listening to the participants' perspectives, forensic and medical professionals can be better informed towards monitoring and reducing harms from AAS.