If you thought acne breakouts were only a teenage problem, think again. Testosterone — the same hormone that fueled those adolescent flare-ups — can continue to influence your skin well into adulthood.
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If you thought acne breakouts were only a teenage problem, think again. Testosterone — the same hormone that fueled those adolescent flare-ups — can continue to influence your skin well into adulthood.
As the primary male sex hormone (androgen), testosterone is good for a lot of things, like a deeper vocal range, a more muscular build, and the development of your sex drive. But it’s not all glamour and masculinity. Case in point: Testosterone and acne.
High levels of testosterone can turn your face into an oily canvas — a perfect environment for opportunistic acne to stake its claim.
Whether you’re still in your teen years, have recently changed up some of your lifestyle habits, or are on testosterone replacement therapy (TRT), you might be wondering if your hormone levels are sabotaging your skin.
Below, we’ll explain the testosterone-acne connection, why it happens, and more importantly, how to get rid of hormonal acne altogether.
While some research says people with acne vulgaris may produce more testosterone than people without acne, the hormone itself doesn’t directly cause acne. However, it can set off a chain reaction in your skin that may lead to breakouts.
Here’s how it works:
Testosterone stimulates the sebaceous glands in your skin, telling them to produce excess sebum (oil).
When there’s an oily substance overload, it mixes with dead skin cells and clogs your pores, the openings to your hair follicles.
Add some acne-causing bacteria into the mix, and boom, you’ve got a recipe for outbreaks of uninvited pimples, blackheads, and whiteheads.
By the way, if you’re wondering where Cutibacterium acnes (C. acnes) comes from, it’s already a normal part of your skin microbiome — but if the bacteria dominate the balance too much, it can trigger an immune response, inflammation, and resulting skin changes.
Acne often flares up during puberty, when testosterone levels naturally surge in boys.
In one large clinical study of healthy adolescents, 85 percent of late-pubertal boys had acne compared to 15 percent of girls at the same stage. In both sexes, teens with acne showed significantly higher levels of dihydrotestosterone (DHT) — a potent testosterone derivative — than those without acne.
Only a small fraction of circulating testosterone is converted to dihydrotestosterone (DHT) (commonly cited estimates range from a few percent to about 10 percent), but DHT is generally more potent at the androgen receptor than testosterone. Because of its higher receptor affinity, DHT is an important driver of effects in the skin (including sebum production). More testosterone generally means more DHT, and with it, a greater likelihood of breakouts.
Guys on TRT or anabolic-androgenic steroids (AAS) may notice more breakouts than usual.
With TRT under the supervision of a healthcare professional, the effect is usually mild. Higher testosterone can boost sebum production, but research shows the impact is typically minimal.
It’s a different story with anabolic steroids. These substances aim to raise your body's testosterone levels beyond the normal range and are often associated with misuse. Unsurprisingly, acne is one of the most common side effects, reported by about 43 percent of users. At these supraphysiologic levels, more testosterone means more androgen receptor binding, more sebum, and more activity from C. acnes — all of which raise the risk of acne vulgaris and, in rare cases, acne fulminans. The former shows up as the usual blackheads, whiteheads, and cysts, and the latter is a severe form with deep nodules and even hemorrhagic lesions.
Gender-affirming testosterone therapy can also bring acne into the picture. The American Academy of Dermatology notes that it’s not unusual to see significant flares after starting hormone therapy. These hormonal breakouts often cluster on the lower third of the face, chest, back, and upper arms.
Even if testosterone is turning up the oil production on your face, it’s not the only culprit behind seemingly random breakouts.
Here are some other common acne aggravators:
Genetics. If your parents had acne at an older age, there's a chance your skin might follow this less-fun family tradition.
Diet quality. Some research has found that eating a diet high in ultra-processed foods and foods with a high glycemic index, like soda and sugary snacks made from white flour, as well as dairy products, may trigger acne for some people.
Skin care habits. How gentle and intentional are you with your skin? Using harsh scrubs, skipping nightly face washing, or going to bed sweaty after the gym can clog pores and irritate your skin.
Stress. We all have stress, but when it’s not managed very well, elevated stress levels can mess with your hormones, potentially triggering more oil production and inflammation.
Overwashing or overexfoliating. It might seem like scrubbing your face raw will help, but overwashing can strip your skin and make it produce even more oil in an act of rebellion.
Certain medications. Some prescriptions, including steroids, lithium (used for certain mood and mental health conditions), and some anticancer drugs, can contribute to acne breakouts.
Sweat and friction. Acne doesn’t just appear on your T-zone. Tight clothes, sweaty workout gear, and even helmet straps can lead to "mechanical acne” (or acne mechanica) on your back, shoulders, and other areas.
The takeaway? Testosterone might light the match, but these other factors can fuel the fire.
Acne varies from person to person, so there’s no universal timeline on how long testosterone-related acne should last.
When teenagers get acne during puberty, their breakouts typically clear up when their hormone levels have settled down, usually in their early 20s.
Studies on transgender individuals taking testosterone show that when they first start testosterone therapy, acne often shows up early, especially in the first six months.
Over time, the acne may improve, stabilize, or be managed with treatment as the body adjusts to elevated hormone levels.
For others, the acne may persist as long as they continue taking testosterone.
Whether your breakouts are coming from puberty, testosterone therapy, or stress, the good news is that testosterone-related acne can be managed.
The trick is finding the right combination of treatments that reduce oil, calm inflammation, and keep pores clear, without stripping your skin or making things worse.
Here’s a breakdown of your options, from at-home hacks to clinical-grade help.
If you're looking for natural ways to manage acne, these everyday habits might help reduce inflammation and control breakouts:
Wash your face up to twice a day and after sweating, but not more, which could backfire.
Use alcohol-free, non-comedogenic (non-pore-clogging) skin care products.
If you sleep in makeup, stop, as this will eventually clog your pores, whether it’s non-comedogenic or not.
Don’t go tanning or get too much sun, which not only increases your risk of skin cancer but can worsen acne.
Use oil-free cleansers and moisturizers to keep your skin clean and balanced without adding more oil.
Avoid touching or picking at your face, as this introduces new bacteria from your hands, which can contribute to acne.
If you’re using acne medication, use it all over, not just where you see breakouts, as this helps treat what’s there and prevent future blemishes.
Home remedies can be a convenient and gentle starting point, but they may not be strong enough for more severe acne.
OTC options are the first (and often most effective) line of defense for many guys. Look for these common ingredients in acne-fighting products:
Benzoyl peroxide. This FDA-approved acne treatment kills acne-causing bacteria and helps dry up active breakouts.
Salicylic acid. This beta-hydroxy acid exfoliates inside the pores, helps prevent clogs, and has anti-inflammatory properties.
Retinoids (adapalene). Retinoids increase cell turnover, reduce inflammation, and prevent clogged pores.
Note that some of these ingredients may dry out your skin, so use them as directed, stick to a routine, and moisturize. It may take six to eight weeks to notice a difference in your skin condition, so practice patience.
If your acne is persistent or severe, it’s time to call in the healthcare pros. Dermatologists can tailor treatments to your skin type and hormone profile and might recommend these oral or topical treatments:
Prescription retinoids. Prescription retinoids are stronger and often more effective than OTC versions for deep, stubborn adult acne.
Oral antibiotics. Just like when prescribed for a bacterial infection, antibiotics for acne are used in the short term to reduce inflammation and bacteria on your skin.
Combination products. Personalized acne cream for men may include up to five ingredients, such as prescription-strength retinoid and topical antibiotics, to help clear things up. It’s available by prescription if a healthcare provider determines it’s right for you.
Isotretinoin (Accutane®). Isotretinoin is a powerful option for severe, treatment-resistant acne, but it can come with potential side effects that require close monitoring.
Laser or light therapy. While still an emerging treatment option, laser and light-based acne therapy targets inflammation and bacteria beneath the skin’s surface.
Read more in our guide to how to get clear skin for men.
Getting rid of acne is one thing. The real win is keeping it from coming back. If testosterone is involved (naturally or through therapy), prevention is about consistency and smart skin and wellness habits.
Here’s how to stack the odds in your favor:
Stick to a skin care routine. Wash your face twice daily with a gentle, oil-free cleanser and use non-comedogenic (pore-safe) products.
Don’t skip moisturizer. Even oily skin needs hydration. Just choose a lightweight, oil-free option.
Shower after sweating. Post-gym sweat can mix with bacteria and clog pores. Shower up ASAP.
Watch your diet. Sugary foods and dairy can trigger breakouts. Try to limit them if you suspect they’re contributing to your acne. Eat various nutrient-rich foods, like fruits and vegetables, which also provide antioxidants that may help reduce acne.
Manage stress. Stress can mess with your hormones and make acne worse. Regular exercise, good sleep, and even some chill time can help.
Avoid touching your face. Your hands carry bacteria. Keep them off your face, especially if you’re prone to picking.
Be patient with treatments. Don’t jump from product to product too quickly. Most acne treatments take several weeks of consistent use to show results, and it may depend on the type of acne you’re dealing with.
Acne prevention isn’t about perfection. It’s about keeping your skin in check, even when hormones try to throw a wrench in the plan.
No, higher testosterone doesn’t always mean a higher risk of acne. It depends on your skin’s sensitivity to androgens, genetics, and lifestyle habits.
Not always. If you’re prescribed testosterone for low T or gender-affirming care, it’s essential that you don’t attempt adjusting your dosage on your own if you’re dealing with acne. Reducing testosterone without guidance can impact your energy levels, libido, mood, and more. Instead, talk to your provider about what skin care treatments are available.
TRT-related acne may improve over time, but each person responds differently.
Yes. In men with low T, selective estrogen receptor modulators (SERMs) such as clomiphene and enclomiphene citrate can also raise testosterone by stimulating the body’s own hormone production. Because they generally keep testosterone levels within or closer to the physiologic range, they may be less likely to trigger significant acne. That said, acne is still a possible side effect of SERM treatment. The prescribing information for clomiphene — a medication FDA-approved for the treatment of female infertility and sometimes used off-label in men to treat low testosterone — lists acne among the dermatologic adverse reactions reported in postmarketing experience. Long-term safety and efficacy of enclomiphene in men are not fully established, and larger trials are needed.
Testosterone might be fueling your confidence, strength, and masculine energy. Unfortunately, it can also stir up some trouble on your skin. The key is understanding what’s happening beneath the surface and taking action early.
While every guy is different, here are some key things to remember about testosterone and acne:
High testosterone can increase oil production. Increased oil production may clog pores and contribute to acne, especially during puberty or if you’re using testosterone replacement therapy.
Acne isn’t always about high testosterone. Sometimes, factors like your genetics, diet, and skin care habits also play a big role in how your skin behaves.
Acne is treatable. Testosterone-related acne can be managed with the right combo of home remedies, OTC products, and professional care.
If you have hard-to-manage breakouts or other skin changes, it’s best to talk to a dermatologist and build a plan that works for your skin and hormones.
For other questions about your skin, get medical advice from a healthcare professional today.
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