Acne: a side-effect of masculinizing hormonal therapy in transgender patients |
| |
| Authors: | CC Motosko GA Zakhem MK Pomeranz A Hazen |
| |
| Institution: | 1. Ronald O. Perelman Department of Dermatology, NYU Langone Health, New York, NY, U.S.A.;2. Ronald O. Perelman Department of Dermatology, NYU Langone Health, New York, NY, U.S.A.
Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, U.S.A.;3. Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, U.S.A. |
| |
| Abstract: | Acne is a known side effect of masculinizing hormonal therapy used in transgender men. In all people with acne, it can contribute to depression, body image issues and even suicidal ideation. Hormones, particularly testosterone, are often the first treatment for gender dysphoria - the distress that can be caused by feeling and living a different gender to one's assigned gender - in transgender men. These hormones can exacerbate acne, among other hair and skin issues. The aim of this article, from the USA, is to promote understanding for advising and treating transgender men who have acne as a result of masculinizing hormonal therapy. Studies suggest that the severity of acne peaks within the first 4 months of treatment. Although gradual improvement is noted within the first year, acne can be persistent, lasting years after testosterone therapy is started. Severity of acne is variable, with most patients experiencing milder lesions (spots). Acne tends to be most prominent on the back and chest, an area that may already be one of the greatest sources of dissatisfaction among transgender men. Standard acne treatments such as topical medications (creams) and antibiotics can be used, but hormonal therapy is likely to interact with the desired effects of testosterone in transgender men, which requires careful consideration and discussion. In cases that don't improve after these first-line treatments, a powerful drug called isotretinoin is effective in patients on masculinizing therapy, though multiple courses of treatment may be needed. This drug can have unwanted side-effects and doctors have to closely monitor patients on this drug. The study discusses other important considerations for doctors. Although the options for treating acne are similar to those used in cis-gender patients (i.e. whose sense of personal identity and gender corresponds with their birth sex), several medical, social, and psychological considerations must be noted when treating transgender patients. |
| |
| Keywords: | |
|
|
