TRT and Acne: Causes & Treatments

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Are you wondering if TRT and acne correlate with each other? There are a handful of possible side effects of TRT (testosterone replacement therapy). While most side effects of TRT are manageable, if not avoidable, some can be quite serious if the use of exogenous hormones is abused or if simple genetic factors are not correctly dealt with accordingly. Then there are those potential side effects of TRT that are far less serious, but ones we might place in the vanity category. One of these side effects of TRT is acne.

Acne is something most grown men do not concern themselves with; after all, we all think of it as an irritation long since left behind in adolescence. However, for some men, the use of exogenous testosterone can cause this childhood enemy to rear its ugly head once again.

Before we dive into this particular side effect of TRT, there is a significant genetic factor we would be remised if we left out. Those who are naturally predisposed to acne are at the most risk. Those who never had severe acne issues in their youth will unlikely experience an issue while on TRT. Sure, anyone can get a zit even in adulthood. You may find a few pop up here and there on TRT that you normally wouldn’t get. But as it pertains to a serious issue, the genetically predisposed are at the highest risk.

Testosterone and Acne: The Process

Testosterone is a hormone that converts to an even more powerful hormone known as dihydrotestosterone (DHT). Many studies have shown DHT to be upwards of five times more powerful than the testosterone hormone.

DHT is an extremely important hormone in the male body. It is imperative to our sexual health if for no other reason. DHT also causes the body to produce more oil, leading to oily skin and more oil soaking into your pores, resulting in acne. It’s a relatively simple process, but one that can be quite bothersome if not embarrassing. Your health has greatly improved through TRT; you’re now in better shape, leaner, and more muscular, and your sex drive is back to where it used to be, but your face looks like that of a 14-year-old boy. If this doesn’t sound desirable, that’s because it’s not. However, there’s also some very good news: acne related to TRT is more than manageable if not outright avoidable.

Avoiding TRT Acne Through Hygiene

The best thing you can do to prevent TRT related acne is also the simplest: hygiene. Washing your hands and face multiple times a day will have a positive effect. You can choose not to, but you’re only hurting yourself. This is something you should be doing even if you’re not on TRT.

Carry a small towel with you each day and keep your face dry, but let’s not stop there. Acne can also easily appear on our shoulders, back, and chest, so it will be important to keep our entire body clean, especially if we’re predisposed to acne.

Any time you become sweaty, such as after a gym session, working outside, or any other activity that leaves you a little sweaty, take a shower and put on a clean shirt. If you can’t take a shower immediately, let’s at least put on a fresh, clean, dry shirt and shower as soon as we can.

Along with simply being hygienic, there are some good soaps, anti-acne soaps you may want to consider. Any soap containing the ingredients Benzoyl Peroxide or Salicylic acid will be worth a try. Simply wash your troubled areas with this anti-acne soap, rinse and repeat each time you shower.

TRT and Acne: Treatments

If your acne is severe due to TRT, there are several medications you may want to consider. These medications can have a positive effect, but they are not without their own potential risk.

One of the most commonly used medications for the treatment of acne is Accutane. Accutane has a success rate of upwards of 85%. However, while it’s generally used for severe cases, such as cystic acne, some TRT users may find it to be the right course of action. The most common side effect many users concern themselves with is that the drug can lower testosterone levels. However, in your case, you’re already using exogenous testosterone. Your natural production is already subpar. This side effect of Accutane should not be an issue for you.

There are other drugs, such as Sporanox, an anti-fungal medication that some may find helpful.

A full lost of FDA approved medications for treating acne that may be worth consideration if this particular side effect of TRT manifest:

  • Trifarotene Cream
  • Aczone Gel
  • Differin Gel
  • Onextron
  • Altreno
  • Sarecycline (Seysara)

Many natural remedies are available that many may find to be effective, not to mention simply healthier. Three of these remedies include B5, zinc and vitamin D. Some may find B5 useful due to its ability to produce Coenzyme A (CoA). This enzyme will help in the oxidization of fatty acids, primarily in the skin, burning the fatty acids that increase due to DHT.

Then we have the overall fantastic mineral zinc. This mineral plays several important roles in the human body. For our purposes here, zinc helps carry vitamin A to the skin. This greatly aids in preventing the buildup of dead skin, which can clog our pores and lead to acne.

Finally, vitamin D: vitamin D, while it’s not the only source of oxidizing fatty acids, it is one that plays an important role. A mere thirty-minutes of sunlight per day will give you all the vitamin D you need to meet the desired end.

If the use of the various vitamins and minerals discussed doesn’t do the trick, if you’ve found prescription medications to be lacking for your needs, you may need to consider an alternative. This alternative action may be as simple as lowering your testosterone dose. You may only need to lower the total amount per injection and not the weekly dose. For example, if you’re injecting a total of 200mg per week, consider splitting it into 100mg twice a week. If you’re already following such a protocol, you could split the total milligrams injected per week into three or even four smaller injections. If one is following a sub-Q protocol, although injections will be frequent, they will be far less bothersome than 3-4 Intra-muscular injections per week. If that still doesn’t do the trick or you’re simply not interested in multiple injections per week, lowering the total dose of testosterone so that there’s less testosterone to convert to DHT may be your only option


The Role of Zinc in the Treatment of Acne: A Review of the Literature