Treating acne in transgender and gender-diverse youth

Healthcare providers are being urged to take consideration when treating transgender and gender diverse (TGD) youth for skin conditions like acne.

According to the Department of Pediatrics, University of Washington School of Medicine and Seattle Children’s Hospital acne is most severe in the six months following hormone treatment, which means that early access to acne treatment is required for this group. 

The use of gender-affirming hormones (GAH) and puberty and reproductive hormone blockers, can have impact acne. A common side effect is often a reduction in the skin condition since hormone blockers suppress androgen production (testosterone) in the body. 

And while this may sound promising, there is not a lot of data around the use of hormone blockers to treat acne. This is mainly due to cost and side effects, which can include symptoms related to menopause. 

Transmasculine individuals (those assigned female at birth but identify as male or nonbinary) are more likely to experience moderate to severe acne, with 31.1 per cent of the 988 respondents reporting moderate to severe acne after taking testosterone. 

Additionally, topical acne treatments for transfeminine individuals (assigned male at birth but identify as female or nonbinary) could result in unpleasant side effects like stinging, dryness, redness and skin peeling, which is attributed to the increased intake of estrogen. 

These side effects can be reduced by lowering the strength of topical creams and gels or by moisturising twice daily.

Considering the right acne treatment and being aware of the skin changes that may occur with hormonal therapy is crucial.

Reference: Pediatric Dermatology. 2022, July, 31; 866-869.