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I have strong biases against progesterone treatment since it is well known that it increases the risks of blood clots and fat gain if not dosed properly.

High DHT is not necessarily bad if you do not have prostatic inflammation. DHT is responsible for a lot of the good benefits of TRT.   It is directly linked to sex drive and even strength.  You can manage acne with Nizoral shampoo as a body wash, getting sun once or twice per week, zinc supplementation, and acne washes.