Acne: a side‐effect of masculinizing hormonal therapy in transgender patients

Summary Background Masculinizing hormonal treatment in transgender men has the potential to increase the level of androgens at end organs, including the pilosebaceous unit. Androgen‐induced sebocyte growth and differentiation, sebum production and infundibular keratinization may underlie the development of acne vulgaris among patients receiving this therapy. Objectives The aim of this article is to familiarize dermatologists with the sensitivities and challenges of treating acne in transgender male individuals. Methods This review article discusses the pathogenesis and treatment of acne in transgender men on testosterone therapy and highlights the unique considerations in treating this underserved patient population. Results Despite the incidence of treatment‐related acne and the unique considerations in treating transgender men, studies addressing this topic among this patient population are limited. Conclusions Generally, the standard guidelines for the treatment of acne can be followed in treating these patients; however, several medical, social and psychological factors should be considered. What's already known about this topic? Acne vulgaris is a known side‐effect of masculinizing hormonal therapy. Treatment with isotretinoin in these patients poses several ethical challenges. What does this study add? This review article discusses the pathogenesis and treatment of acne in transgender men on testosterone therapy. This article highlights the unique considerations in treating this underserved patient population. Plain language summary available online