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AndroGel (Testosterone Topical) Acne: Alternatives Without This Side Effect

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At a glance

  • AndroGel trial acne / 4% of the AndroGel group in a 4-week dry-eye trial of 50 patients, men and women [1]
  • Testosterone gel 1% label / 1% at 50 mg, 3% at 75 mg, 8% at 100 mg [3]
  • Across formulations / 0.6% to 9.1%; lowest with oral [2]
  • UK survey of men on TRT / 24% of 905 men reported acne [4]
  • DHT blockers / lowered DHT, acne not measured [5]
  • Secondary exposure (gel 1% label) / Boxed warning on virilization in children [3]

Does AndroGel Cause Acne?

Yes. The testosterone gel 1% label lists acne among its most common adverse reactions, at 5% or more [3]. The one AndroGel-specific acne figure is 4% of the AndroGel group in a 4-week randomized trial of 50 dry-eye patients with androgen deficiency, men and women [1]. The dose figures below come from the generic testosterone gel 1% label, not from an AndroGel 1.62% label [3].

A 2025 survey of 905 UK men on testosterone replacement found 24% reported acne, without tying it to a product [4].

Are Some Formulations Less Likely to Cause Acne?

The clearest formulation signal is a 2026 scoping review of ten studies in adult men: acne ranged from 0.6% to 9.1%, the lowest incidence was with oral formulations, and injectables were generally associated with higher rates than topical or oral products [2]. Most of the studies lacked standardized reporting, and the review did not test switching from AndroGel to an oral product [2].

Does Lowering the Gel Dose Reduce Acne?

In the 180-day trial in the testosterone gel 1% label, acne was reported by 1% of men at 50 mg, 3% at 75 mg and 8% at 100 mg [3]. The label also lists acne in 3.1% of men over a 3-year flexible-dose extension [3]. These are rates across dose groups in one program, not proof that a dose reduction clears existing acne.

Do 5-Alpha Reductase Inhibitors Help?

Finasteride and dutasteride lower DHT. In a 2007 randomized trial of 99 healthy men, dutasteride 0.5 mg suppressed serum DHT by 94% and finasteride 5 mg by 73% versus placebo over a year, but the trial measured semen parameters and hormones, not acne [5].

What About Secondary Exposure?

The boxed warning in the gel 1% label covers virilization in children who are exposed to the gel through contact with unwashed or unclothed application sites [3]. The label lists inappropriate changes in genital size or pubic hair development in children, and signs of virilization in adult women such as a significant increase in acne or changes in body hair distribution [3].

Frequently asked questions

Is acne more common at higher testosterone gel doses?
In the testosterone gel 1% label, acne was reported by 1% of men at 50 mg, 3% at 75 mg, and 8% at 100 mg in a 180-day trial [3].
Do oral testosterone products cause less acne?
A 2026 scoping review found the lowest acne incidence with oral formulations, within an overall range of 0.6% to 9.1% [2].
Do finasteride or dutasteride clear testosterone gel acne?
A 2007 trial in 99 healthy men found they lowered DHT, but it did not measure acne [5].
Can a partner or child get acne from my testosterone gel?
The gel 1% label lists a significant increase in acne in an adult woman among the signs of virilization from secondary exposure; in children it lists genital enlargement and pubic hair [3].

References

  1. Supalaset S, Tananuvat N, Pongsatha S, Chaidaroon W, Ausayakhun S. A Randomized Controlled Double-Masked Study of Transdermal Androgen in Dry Eye Patients Associated With Androgen Deficiency. Am J Ophthalmol. 2019;197:136-144. A Randomized Controlled Double-Masked Study of Transdermal Androgen in Dry Eye Patients Associated With Androgen Deficiency
  2. Abou Chawareb E, Campos L, Savio L, Hartman-Kenzler J, Mahdi M, Hammad MAM, et al. Dermatological adverse effects of testosterone replacement therapy: a scoping review of the literature. Sex Med Rev. 2026;14(1). Dermatological adverse effects of testosterone replacement therapy: a scoping review of the literature
  3. U.S. National Library of Medicine, DailyMed. Testosterone gel 1% topical (generic) prescribing information, effective 2025-09-30. Testosterone gel 1% topical prescribing information
  4. El-Osta A, Liu VN, Huang D, Foster J, Johnson H, Alaa A, et al. A cross-sectional survey of experiences and outcomes of using testosterone replacement therapy in UK men. Transl Androl Urol. 2025;14(5):1295-1307. A cross-sectional survey of experiences and outcomes of using testosterone replacement therapy in UK men
  5. Amory JK, Wang C, Swerdloff RS, Anawalt BD, Matsumoto AM, Bremner WJ, et al. The effect of 5alpha-reductase inhibition with dutasteride and finasteride on semen parameters and serum hormones in healthy men. J Clin Endocrinol Metab. 2007;92(5):1659-65. The effect of 5alpha-reductase inhibition with dutasteride and finasteride on semen parameters and serum hormones in healthy men
Evidence overview for AndroGel (Testosterone Topical) Acne: Alternatives Without This Side Effect