Introduction

Testosterone is widely known as the “male hormone,” but it plays an essential role in both men and women—impacting energy, mood, muscle mass, libido, and yes—your skin. If you’ve noticed more breakouts, oily skin, or sudden changes in skin texture after starting testosterone therapy or during hormonal shifts, you’re not alone.

In this blog, we’ll explore how testosterone affects skin health, why it may contribute to acne or other skin issues, and how to manage these effects naturally or alongside hormone therapy. Whether you’re navigating puberty, using testosterone for hormone optimization, or managing conditions like PCOS, understanding the skin-hormone connection is key to clearer, healthier skin.

What Is Testosterone and Why Does It Affect the Skin?

Testosterone is an androgen—a type of sex hormone that regulates a wide range of bodily functions. While men naturally produce more testosterone, women also produce it in smaller amounts through the ovaries and adrenal glands. It influences:

• Sebum (oil) production
• Skin thickness and collagen
• Hair growth (including facial and body hair)
• Wound healing and regeneration

The skin contains androgen receptors, particularly in the sebaceous (oil) glands. When testosterone binds to these receptors, it stimulates more oil production—which is where potential problems begin.

How Testosterone Can Lead to Skin Problems

1. Increased Oil Production and Acne

One of testosterone’s primary effects on skin is to stimulate sebaceous glands. This leads to increased sebum, which, when mixed with dead skin cells and bacteria, can clog pores and trigger acne.

This is particularly common:

• During puberty (when testosterone surges)
• In women with PCOS (who often have elevated androgens)
• After starting testosterone replacement therapy (TRT)
• In female-to-male (FTM) transgender individuals undergoing masculinizing hormone therapy

The result? Acne that often appears on the face, chest, back, and shoulders—known as androgenic acne.

2. Skin Texture Changes

Higher testosterone levels can increase skin cell turnover and alter hydration, sometimes resulting in:

• Rougher texture
• Enlarged pores
• Shiny or greasy appearance

This is especially common in individuals with oily or combination skin types.

3. Hair-Related Skin Concerns

Elevated testosterone and its more potent form, DHT (dihydrotestosterone), can influence:

• Hirsutism: Excess facial or body hair (more common in women with PCOS)
• Folliculitis: Inflammation of hair follicles that mimics acne
• Scalp changes: Including oiliness or hair thinning, especially in men with DHT sensitivity

Does Testosterone Therapy Cause Acne?

Yes, testosterone therapy—especially in the early months—can trigger or worsen acne in some individuals. This is because:

• Testosterone increases sebum production
• Hormonal shifts can disturb the skin’s microbiome
• There’s often an initial surge in testosterone before levels stabilize

This doesn’t mean everyone on TRT or HRT will experience acne. Many factors, including genetics, skin care habits, gut health, and detox capacity, influence how your skin responds.

Testosterone and Women: A Delicate Balance

In women, even small shifts in testosterone can have noticeable effects on the skin. Conditions like PCOS (Polycystic Ovary Syndrome) are characterized by elevated androgens and often present with:

• Adult-onset acne
• Oily skin
• Chin and jawline breakouts
• Hair growth on the face or chest

In these cases, lowering androgen levels (naturally or with medications like spironolactone or herbal anti-androgens) often results in clearer skin.

How to Manage Testosterone-Related Skin Issues

If testosterone is causing acne, oiliness, or other skin concerns, the solution isn’t necessarily to stop treatment. Instead, aim to support your skin from multiple angles:

1. Use Targeted Skincare

• Cleanse daily with a gentle, non-comedogenic cleanser
• Exfoliate 2–3x per week to prevent clogged pores (use salicylic acid or gentle enzyme exfoliants)
• Apply niacinamide to balance oil and reduce inflammation
• Use retinoids (if tolerated) to increase cell turnover and fight breakouts

2. Support Liver and Gut Detoxification

Hormones are metabolized in the liver and eliminated through the gut. Poor detox function can worsen hormone-related skin symptoms.

• Eat cruciferous vegetables (broccoli, cauliflower, arugula)
• Stay hydrated
• Consider supplements like DIM (diindolylmethane), calcium-D-glucarate, and probiotics (consult your provider)

3. Reduce DHT Conversion

DHT is a more potent form of testosterone strongly linked to acne and hair loss. To reduce its conversion:

• Consider zinc supplementation (15–30 mg daily)
• Saw palmetto or spearmint tea (especially in women)
• Avoid anabolic steroids or excessive doses of TRT

4. Balance Other Hormones

Testosterone rarely acts alone. Supporting estrogen, progesterone, insulin, and cortisol levels can indirectly improve skin health. Work with a functional medicine provider to evaluate your full hormone picture.

5. Consider Lifestyle Adjustments

• Manage stress to avoid excess cortisol
• Sleep 7–9 hours per night (testosterone and skin regenerate during sleep)
• Limit high-glycemic foods that spike insulin and worsen breakouts

When to See a Provider

If you’ve tried topical treatments and dietary strategies but still experience breakouts or irritation, it’s worth consulting with a healthcare provider—especially if:

• Acne is severe or painful
• You’re on hormone therapy and unsure about dosage
• You have symptoms of PCOS or insulin resistance
• Skin changes are accompanied by mood shifts, fatigue, or hair loss

A functional medicine or hormone specialist can assess your testosterone, DHT, insulin, and estrogen levels and create a personalized treatment plan.

Final Thoughts

Yes—testosterone can cause skin problems, especially when levels are too high or out of sync with your body’s natural rhythms. However, not everyone will experience breakouts or irritation, and the benefits of testosterone therapy often outweigh the downsides when properly managed.

The key is understanding your individual hormonal landscape, supporting your skin from within, and taking a holistic approach to care.

Need Help Balancing Hormones and Skin Health?

At Sheen Vein and Cosmetics, we offer customized hormone evaluations and skin care plans designed to help you feel and look your best. Whether you’re on testosterone therapy or struggling with breakouts linked to hormonal shifts, we’re here to guide you every step of the way.

Book your consultation today and discover a clear-skin, hormone-balanced future.

‍