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Treating Acne in Transgender Persons Receiving Testosterone: A Practical Guide.

Rakan Radi1, Sarah Gold1, Juan P Acosta2

  • 1Department of Dermatology, Emory University School of Medicine, Atlanta, GA, USA.

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Summary
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Testosterone therapy for transgender men commonly causes acne, impacting quality of life. This guide offers practical strategies for managing acne in transmasculine patients, ensuring culturally competent care.

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Area of Science:

  • Dermatology
  • Endocrinology
  • Gender-affirming care

Background:

  • Masculinizing hormone therapy (testosterone) in transgender individuals can cause significant dermatologic side effects.
  • Acne is a prevalent adverse effect, negatively impacting body image, mental health, and quality of life for transmasculine patients.

Purpose of the Study:

  • To provide a practical guide for the clinical management of testosterone-induced acne in transmasculine patients.
  • To outline recommendations for culturally competent care, including inclusive history-taking and patient-centered examinations.

Main Methods:

  • Review of current literature and clinical guidelines for acne treatment in transgender populations.
  • Discussion of considerations for reproductive potential, contraception, and interactions with gender-affirming therapies.
  • Examination of isotretinoin therapy, including indications, contraindications, and the iPLEDGE program.

Main Results:

  • Acne management requires a comprehensive approach, integrating dermatologic, endocrine, and mental health perspectives.
  • Patient-centered care involves creating a welcoming environment and addressing individual needs and concerns.
  • Multidisciplinary collaboration is essential for optimizing treatment outcomes, especially for severe or refractory acne.

Conclusions:

  • Effective management of testosterone-induced acne in transmasculine patients necessitates specialized knowledge and a holistic, gender-affirming approach.
  • Addressing acne is crucial for improving overall well-being and quality of life in this population.
  • Clinicians must be prepared to navigate unique challenges, including reproductive health and specific medication programs.