Does Testosterone Cause Acne?

If you’ve ever noticed more breakouts when your hormones change, you’re not alone. One of the biggest triggers of acne is testosterone, a sex hormone found in both men and women. People often see more pimples pop up when their testosterone levels rise. This can happen during puberty, while on testosterone replacement therapy (TRT), or when starting hormone therapy (HRT) for gender transition, especially for FTM (female-to-male) individuals.

In this blog, we’ll talk about why testosterone can lead to acne, how it affects your skin, and what you can do to treat or prevent these breakouts.

Does Testosterone Cause Acne?

Short answer: yes, it can. Many people ask, “Does high testosterone cause acne?” or “Can testosterone make you break out?” And the truth is, it often does.

Testosterone tells your body to produce more sebum, which is the oily substance your skin naturally makes. When there’s too much oil, it can mix with dead skin cells and clog your pores. This creates the perfect environment for acne to form (Dermato-Endocrinology, 2009).

That’s why people going through puberty or on TRT sometimes notice more pimples, especially on the face, chest, or back.

Why Does Testosterone Trigger Acne?

To understand why testosterone causes acne, you need to know about sebaceous glands. These are tiny glands in your skin that produce sebum (oil). Testosterone boosts the activity of these glands, making them pump out more oil than usual.

Too much oil leads to clogged pores. When dead skin cells and oil get trapped inside, it becomes a breeding ground for bacteria, which causes redness, swelling, and those painful breakouts (Archives of Dermatological Research, 2017).

This is especially common during puberty, when hormone levels spike, or in adults who are on TRT or undergoing HRT. These changes in sex hormones can make your skin more oily and acne-prone.

Common Areas Affected by Testosterone Acne

Testosterone-related acne can show up almost anywhere on your body, but some areas are more common than others. The face is usually the first place people notice breakouts. But testosterone can also cause acne on your back (often called bacne) and even on your chest or shoulders.

This is especially true for people on TRT (testosterone replacement therapy). You might hear people talk about TRT back acne or testosterone pimples on back, it’s a well-known side effect. Both men and women can get acne from testosterone, and it often shows up in areas with more oil glands. Even people undergoing gender transition (FTM acne) may deal with new or worsening acne during hormone therapy.

How Long Does Testosterone-Related Acne Last?

Acne from hormone changes can be short-term or stick around longer, it really depends on your body. If you’re starting HRT, you may experience a few weeks to months of acne flare-ups as your hormones shift. The same goes for TRT: it’s common to break out in the beginning, but for some people, it fades over time.

In a 2023 prospective study on transmasculine patients undergoing testosterone therapy, rates of facial acne jumped from 35% to 82.4%, and back/chest acne from 15% to 88.2%. Although acne may improve with time or treatment, many require medical support.

For long-term users, persistent or worsening acne may need prescription treatment, such as isotretinoin, which has shown success in case series and clinical reports among people on TRT and HRT.

How to Treat and Prevent Testosterone Acne

You don’t have to live with acne. Here are a few ways to treat and prevent breakouts caused by high testosterone:

A. Topical Treatments

Start with products that go directly on the skin:

Topical retinoids: help unclog pores and speed up skin turnover.
Benzoyl peroxide: kills acne-causing bacteria.
Salicylic acid: helps remove dead skin cells and keep pores clear.

B. Oral Medications

If topical products aren’t enough, oral options may help:

Oral antibiotics: reduce bacteria and inflammation.
Oral contraceptives: can help women balance hormone levels and lower testosterone-related acne.

C. Lifestyle Tips

Wash your face daily, but don’t over-wash, this can make things worse.
Keep skin clean after sweating, especially if you exercise often.
Reduce stress, since stress can trigger acne and make it harder to treat.

D. TRT or HRT Support

Always talk to a healthcare professional if acne is affecting your quality of life.
Your provider may adjust your dosage or suggest a different treatment option to help balance hormones without making your skin break out.

How to Stop or Prevent Back Acne from Testosterone

Back acne, also called bacne, is a common side effect of testosterone, especially for people on TRT or HRT. It can be tough to treat, but it’s not impossible.

Try these tips:

Shower after sweating, especially after exercise. Dr. Aaron Farberg, Medical Director of Clear Health, recommends taking a shower 15 minutes after working out. Click to watch the video
Use body washes with benzoyl peroxide or salicylic acid.
Avoid tight, sweaty clothing, wear loose-fitting fabrics.
Stick with topical or oral treatments as prescribed.

If the acne is deep, painful, or not responding to basic care, your provider might recommend Isotretinoin (also known as Accutane). This medication has been shown to effectively treat testosterone-induced acne in clinical case series and retrospective studies, including among transmasculine patients.

Worried about side effects? Clear Health offers a Micro-dose Protocol, a low-dose version of isotretinoin that’s personalized to your body. It’s designed to reduce the risk of side effects while still delivering real results. This option is especially helpful for those on long-term hormone therapy.

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When to See a Doctor

Sometimes acne needs more than just good skincare. You should see a doctor if:

Your acne is severe, painful, or leaving scars.
You’re on TRT or HRT and notice new or worsening breakouts.
Over-the-counter treatments aren’t working or your acne keeps coming back.

A healthcare provider can help figure out the cause and build a treatment plan that works for your skin and hormone levels. This is especially important if you’re using hormone therapy or dealing with long-term acne.

Final Thoughts

Yes, testosterone can cause acne, but the good news is, it’s treatable. Whether you’re dealing with breakouts from puberty, TRT, or HRT, there are options to help you get clearer skin.

With the right products, lifestyle habits, and support from your healthcare provider, you can manage acne, prevent scars, and feel more confident in your skin.

If you’re looking for a gentler treatment option, consider Clear Health offers a Micro-dose Protocol, a personalized, low-dose approach to acne care that’s designed to work with your hormones, not against them.