Does High Estrogen Cause Acne?

Generally speaking, elevated estrogen is due directly to elevated testosterone and elevated DHT. It's the DHT that's usually the culprit as it causes oily skin thus acne. So while E2 may not be the cause directly it's related due to the the pathway.
 
I have low DHT 40 on a 16-79 scale and high Estrogen and my back and arms were totally destroyed with acne. With my E much MUCH lower, I can now shower once per day, use regular body wash, etc etc I of course had a corresponding reduction in my TRT Cyp protocol but it was Estrogen, by an overwhelming margin. For me.

DHT isn't the obvious answer.
 
For me it was definitely DHT.

Vitamin B5 (aka pantothenic acid) works wonders. But I have to preload with up to 5g per day when it gets really bad. Then maintain with 1000 -1.5K mg and not necessarily every day.

Saw palmetto is another option and it's good for prostate health. Although I'm not sure if it's helping with acne as much as B5.
 
I can only speak to my experience. When my E2 was high, my acne was horrible. Now that I have better control of my E2 my acne problem has disappeared.

I remember when I tried pellets and my doctor overshot on the number of pellets and my T levels soared to 1600. My E2 also soared to over 100. My doctor would not put me on an aromatase inhibitor. My acne was worse than anytime since I was in high school for the next couple of months.

I switched to a T-cream about six weeks ago. I've only taken my anastrozole maybe twice in that time and can tell just by how I feel that my E2 is in range. Just wondering if the cream is going to help keep my hematocrits in range as well. I'm not due for labs for a while so this is based on how I feel.

J-
 
In my case using the same amount of testosterone and only adjusting AI up or down I would get acne if my E2 got closer to the high end of the range (labcorp range). Interestingly my acne got way better after I started TRT (and my estradiol before TRT was in the single digits).
 

hCG Mixing Calculator

HCG Mixing Protocol Calculator

TRT Hormone Predictor Widget

TRT Hormone Predictor

Predict estradiol, DHT, and free testosterone levels based on total testosterone

⚠️ Medical Disclaimer

This tool provides predictions based on statistical models and should NOT replace professional medical advice. Always consult with your healthcare provider before making any changes to your TRT protocol.

ℹ️ Input Parameters

Normal range: 300-1000 ng/dL

Predicted Hormone Levels

Enter your total testosterone value to see predictions

Results will appear here after calculation

Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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