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Testosterone & Acne: Is This Hormone Causing Your Zits?

Does testosterone cause acne? In this article, we discuss how testosterone may be the cause of acne and how to treat hormonal acne.

Read on

In men, testosterone plays a leading role in overall health and development.

Namely, the development of sexual organs, facial and pubic hair, hairline shape, muscle size, sperm production, and sex drive to name a few. For women, testosterone is produced in a much smaller amount but plays a synergistic role in ovarian function, bone strength, and libido.

While this androgen is present in healthy men and women, imbalances or sudden surges of this hormone have been linked back to hormonal acne.  In this article, we discuss how testosterone may be the cause of acne and how to treat hormonal acne.

The link between testosterone and acne

We’re all familiar with the idea of puberty-related acne, right?

Well, the likely reason why some teenagers experience persistent bouts of acne is because their hormones are surging and in a constant state of flux. However, this type of acne doesn’t just affect those in puberty -- it also happens to people well into adulthood.

This is what is called adult acne, and can occur for similar reasons. The rise in androgen levels (testosterone) can cause a considerable increase in sebum production, the colonization of acne-causing bacteria Propionibacterium acnes (P. acnes), and disruption in the skin cell shedding process. All of which can greatly contribute to acne.

In a 2019 study with more than 300 participants, researchers found that testosterone and DHEA-S levels were biomarkers for acne severity. In another study with 207 female participants aged between 18 to 45 with acne, researchers found 72% had increased levels of testosterone and other androgen hormones (hyperandrogenemia).

Overall, acne patients have been found to produce more testosterone and 5α-dihydrotestosterone (5α-DHT) as compared to individuals without acne.

Testosterone's relationship with sebum

High levels of testosterone are associated with excess facial sebum - the sworn enemy of acne.

Sebum is an oily, waxy substance that is secreted by the sebaceous glands. While sebum is not at all a bad thing, having too much sebum on your skin can pose an issue.

This excess oil can become trapped in the hair follicles of your skin and create a clogged pore.  Clogged pore = a possible pimple of some sort.  

The severity or appearance of the acne is dictated by many other factors, (such as acne-causing bacteria or inflammation). But, all pimples begin the same way - as a clogged pore. This may be why there is such a positive correlation between testosterone and acne.

How to treat testosterone-related acne

Now we know acne can be caused by testosterone levels, how can you treat this type of acne?

  • Wash twice a day w/ gentle, non-abrasive cleanser

Keep sebum production in check by making sure you’re gently cleansing away the excess sebum in the AM and PM.

  • Try topicals like tretinoin

Prescription retinoids like tretinoin can help keep your pores clear and is an effective acne treatment. This topical pushes clogged pores up to the surface and then acts as a comedolytic, preventing clogged pores.

Learn more: How does Tretinoin work for acne?

  • Severe cases might require oral medications 

Often, birth control is recommended to women with higher levels of testosterone as it may help regulate and rebalance sex hormones. The oral medication isotretinoin, or spironolactone might also be beneficial.

  • Topical antibiotics might help if it’s inflammatory acne

Topical antibiotics like Clindamycin help to kill acne-causing bacteria and help reduce inflammation. High levels of testosterone have been linked to higher levels of acne-causing bacteria Propionibacterium acnes.

Learn more about Clindamycin for acne

If you’re currently receiving testosterone replacement therapy (TRT) and are experiencing new acne, talk to your doctor about your dosage and what you can do to lessen TRT side effects.

Combining tretinoin and clindamycin

Tretinoin and clindamycin are a powerful anti-acne combo.

Clindamycin works as an antibacterial and anti-inflammatory agent while tretinoin unclogs pores and stops new clogged pores from forming.  

This combination is considered more effective than “monotherapies” or using just one agent by itself. This is why this prescription combination is a common defense against acne.

The bottom line

While testosterone doesn’t directly affect acne, research has shown the presence of high levels of androgenic hormones can affect sebum levels which may increase the risk of developing acne.

To treat topically, hormonal acne responds well to tretinoin and clindamycin. This combination of prescription medications is often used topically to enhance effectiveness and reduce side effects.

Often, a mix of lifestyle changes to pinpoint the root cause of imbalance and topical solutions are required.

Strut Health treats acne online

Our anti-acne formula utilizes both tretinoin and clindamycin to help keep hormonal acne at bay.

If you’re dealing with androgenic-related acne, you’re certainly not alone. If you would like to see if our compound prescriptions can help reduce your acne, complete a questionnaire-based online doctor's consultation to see if our anti-acne treatments are right for you.

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