One common side effect of Testosterone Replacement Therapy (TRT) is acne. This occurs due to hormonal fluctuations that affect the skin’s oil production, bacterial activity, and inflammation levels. Understanding why TRT causes acne can help individuals manage this side effect effectively.

Increased Sebum Production

One of the primary reasons TRT leads to acne is the increased production of sebum, an oily substance secreted by the sebaceous glands. Testosterone, especially when converted into dihydrotestosterone (DHT), stimulates these glands, leading to excessive oil buildup on the skin. When too much sebum is produced, it can clog pores, creating an environment that promotes acne development.

Hormonal Fluctuations and Skin Sensitivity

When beginning TRT, the body undergoes hormonal changes that may temporarily disrupt its natural balance. Some individuals experience an initial surge in testosterone levels, which can lead to increased DHT conversion. DHT is a more potent androgen that has been strongly linked to acne formation. Moreover, people with genetically sensitive skin may react more aggressively to these hormonal changes, making them more prone to breakouts.

Bacterial Growth and Inflammation

The excess oil produced due to TRT provides an ideal breeding ground for acne-causing bacteria, particularly Cutibacterium acnes (formerly known as Propionibacterium acnes). This bacterium thrives in clogged pores, where it multiplies and triggers inflammation. The body’s immune response to the bacterial overgrowth results in red, swollen, and sometimes painful acne lesions.

Changes in Skin Cell Turnover

Another contributing factor is the altered rate of skin cell turnover. Normally, skin cells shed regularly, but hormonal imbalances caused by TRT can disrupt this process. When dead skin cells accumulate and mix with excess sebum, they can clog pores and exacerbate acne formation. This is particularly noticeable in individuals who already have a history of acne-prone skin.

How to Manage TRT-Induced Acne

While acne can be a frustrating side effect of TRT, several strategies can help minimize its impact:

  • Skincare Routine: Use a gentle cleanser, oil-free moisturizers, and non-comedogenic products to keep the skin clean without over-drying.
  • Topical Treatments: Over-the-counter treatments containing benzoyl peroxide, salicylic acid, or retinoids can help reduce oil buildup and unclog pores.
  • Diet and Hydration: Reducing high-glycemic foods and dairy intake while staying hydrated may help control breakouts.
  • Adjusting TRT Dosage: In some cases, working with a healthcare provider to modify the dosage or delivery method (e.g., gels, injections, or patches) can help minimize acne flare-ups.
  • Medications: If acne persists, a doctor may prescribe antibiotics, hormonal blockers, or isotretinoin for severe cases.

Learn more about TRT and acne. Boost health Clinic can help you get acne under control.