Over the past decade or so, testosterone replacement therapy has become quite popular. Three times as many men are using prescriptions for testosterone now as in 2001 (O’Connor, New York Times, June 3, 2013). Supplemental testosterone can improve bone volume and density (Snyder et al, JAMA Internal Medicine, April 2017). Men whose testosterone is low may feel better and function better sexually if they get additional testosterone (Traish, Sexual Medicine Reviews, online Nov. 8, 2017). But what can they do about side effects such as testosterone-induced acne?
Discouraged About Testosterone-Induced Acne:
Q. I’m a 57-year-old male in good health taking testosterone cream (pharmacy compounded) and DHEA as a hormone replacement therapy. My testosterone level is now in the normal range.
I’m pleased with the results except for the side effect of acne. My back has been covered with acne, which has now moved to my shoulders.
My doctor prescribed antibiotics for the acne, but they have been unsuccessful. Is there anything that can be done about this side effect other than stopping the testosterone and DHEA?
Treating Testosterone-Induced Acne:
A. Acne is a well-recognized complication of testosterone treatment. Androgens like testosterone stimulate the production of oil, contributing to acne (Kimball, Journal of Reproductive Medicine, Sep. 2008). Stopping both DHEA and testosterone should clear the lesions (Kazandjieva & Tsankov, Clinical Dermatology, March-April, 2017).
Treating this side effect with antibiotics is probably not very helpful. It is driven more by hormones than by acne-associated bacteria. There may, however, be a few non-drug approaches that would be worth a try. These include avoiding foods with lots of sugar or refined starch, which seem to contribute to the development of acne (Burris et al, Journal of the Academy of Nutrition & Dietetics, Sep. 2017). In addition, research suggests that topical use of a pomegranate extract might be beneficial (Lee et al, International Journal of Molecular Sciences, Jan. 12, 2017). This has not been tested for testosterone-induced acne, but it should not have serious side effects if you decided to try it.