Detecting High Testosterone: Key Indicators to Look For

Testosterone is an androgen or sex hormone that plays an essential role in our health. It is helpful in regulating the sex drive, maintaining muscle mass and producing sperms, among other things. But an abnormally high testosterone production can have several unwanted effects like triggering acne flares.

Please read this article to see how testosterone can be responsible for acne breakouts and how the fluctuations in its levels can lead to skin problems.

Does Testosterone Cause Acne?

Yes, testosterone can be one of the many reasons for acne production. Research has shown an association between high testosterone and acne breakouts. According to a 2011 study, testosterone causes an increase in sebum production which can lead to acne breakouts by clogging the pores (Saturia, 2021).

Sebum is produced by the sebaceous glands in the body and is an essential substance for our skin health. But excessive sebum production can cause inflammation of the sebaceous glands, leading to acne.

Acne is caused when the pores in our skin are clogged. These pores can get blocked in a number of ways, including increased sebum production and dead skin cells. These factors can increase the risk of acne breakouts which can manifest in many forms. You might only get a few whiteheads or blackheads, or you can also develop inflamed and painful cysts or nodules (Elsaie, 2016).

Can Testosterone Trigger Acne in Women?

Once again, the answer is yes. While testosterone is generally considered a male sex hormone and plays a significant role in the development of male sexual characteristics, a small amount of testosterone is also present in women. In fact, women also have a small amount of other androgens that are found in abundance in men. An increase in testosterone levels in women can be a reason for acne trouble in them (Uysal, 2017).

According to a small study conducted on women aged between 18 and 25, 72% of women who had acne also had raised levels of male sex hormones, including testosterone. Polycystic Ovarian Syndrome or PCOS was found to be the most common cause of these raised levels. PCOS is a common endocrine disorder in females that can cause ovarian cysts, irregular menstruation and increased androgen production also known as hyperandrogenism (Uysal, 2017; Leon, 2021)

What Causes Testosterone Levels to Fluctuate?

In women, hormonal changes happen mainly during pregnancy, menstrual cycles, and menopause. The level of testosterone is also affected during these processes, which can also impact women's skin health (Elsaie, 2016). Some testosterone level fluctuations are expected as it continues to rise and fall during different developmental stages. In men, testosterone levels peak during puberty and start to decline as they age. This starts to happen as men reach 30 years of age (Zirkin, 2012).

Apart from these normal fluctuations that are a part of the aging process, any dramatic elevations in testosterone level can be a reason for severe acne breakouts. Following conditions can play a role or directly cause a dramatic rise in your testosterone levels (Nassar, 20122; Sizar, 2022):

Hyperandrogenism

Hyperandrogenism is described as an increase in androgen or sex hormone production. There are a number of conditions that can boost your androgen production. The cause of hyperandrogenism can include the following:

• Adrenal diseases like congenital adrenal hyperplasia or benign or malignant tumors
• Ovarian or testicular tumors (this is rare)
• Anabolic steroids
• Testosterone replacement therapy (to reverse low testosterone levels)
• Testosterone masculinizing therapy (gender transition) (Park, 2019)
• Over-the-counter androgen supplements like DHEA

How Do You Treat Hormonal Acne?

Many acne treatments are available that are equally effective for both men and women.

As hormonal fluctuation is the main reason for acne breakouts, treating the causative factor is necessary for such cases. It is advised to see an endocrinologist to diagnose and treat the exact cause of your hormone flare-ups. An endocrinologist is a specialist of deals with hormonal imbalances.

But if you are facing a mild to moderate form of acne, you can try the following topical treatments to help reduce the acne breakouts (Eslaie, 2016):

• Cleansers with salicylic acid
• Benzoyl peroxide
• Topical antibiotics
• Topical retinoids (Tretinoin, Adapalene)

If you have moderate to severe acne, your healthcare provider may opt for more aggressive treatment approaches. They might use a combination of both topical and oral medications. These may include (Elsaie, 2016):

• Anti-inflammatory medications
• Oral antibiotics
• Oral isotretinoin (Accutane) (avoid this if you are pregnant)
• Birth control pills like oral contraceptive pills can treat hormonal imbalances in women.
• Anti-androgen medications to help lower testosterone levels in women
• Laser treatment (Boen, 2017)

Another way to avoid skin problems is to eat low glycemic foods, as they can also cause acne. According to some studies, a hormone called insulin-like growth factor 1 (IGF-1) can cause an increase in sebum production. Excess sebum is known to be associated with acne and inflammation. Eating foods with processed sugars and high glycemic content can increase sebum production and cause acne (Elsaie, 2016; Kim, 2017).

How Do You Treat Acne Related to Testosterone Therapy?

Testosterone replacement therapy is used to treat low testosterone levels. Sometimes, this therapy can cause testosterone levels to increase beyond the normal range. In this case, your healthcare provider can help you adjust your therapy dosage or discuss other available treatment options for your acne. For instance, transgender men undergoing virilization treatment with testosterone sometimes require adjusting their dosages to combat acne and other symptoms of high testosterone (Park, 2019).

Other Tips for Acne-Prone Skin

A healthcare provider dealing with skin problems can go over specifics about acne treatment options and provide the best possible skin care regimen.

Here are a few tips by The American Academy of Dermatology to take care of your acne-prone skin (AAD, 2021):

• Wash your face gently, and only twice a day or in case of sweating. Washing your face repeatedly can make your skin dry, cause it to secrete more oil, and flare up your acne even more.
• Avoid exfoliation or harsh rubbing as it can increase inflammation.
• Do not pick your pimples, which can lead to increased inflammation and scarring.
• Use non-comedogenic skin products like sunscreens and moisturizers to avoid clogging your pores.

Conclusion

Hormonal acne can be unpleasant and sometimes depressing as it mainly occurs on the face and affect your appearance. But there are several ways to treat it effectively. If you suspect your acne is caused by hormonal fluctuations, it is recommended to see your healthcare provider. They can make a definitive diagnosis to see if high testosterone is the reason behind your acne and decide a treatment course which is best in your case.