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AndroGel (Testosterone Topical) Acne: Diet Protocols That Help

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At a glance

  • Gel 1% label trial, acne / 1% at 50 mg, 3% at 75 mg, 8% at 100 mg [1]
  • 3-year extension, acne / 3.1% of 162 men [1]
  • 2026 review of TRT studies, acne / 0.6% to 9.1%, higher with injectables [5]
  • 2025 UK survey, acne / 24% of 905 men on testosterone [6]
  • Low-glycemic-load trial / 43 males, 12 weeks, ordinary acne [2]
  • Omega-3 trial / 45 people, 10 weeks, 2,000 mg EPA plus DHA [3]

How often does testosterone gel cause acne?

The testosterone gel 1% label lists acne among the most common adverse reactions and gives these rates from its 180-day Phase 3 trial: 1% of the 77 men on 50 mg, 3% of the 40 men on 75 mg and 8% of the 78 men on 100 mg [1]. In the 3-year flexible-dose extension study it was 3.1% of 162 men [1]. That label covers a generic testosterone gel 1% product, not AndroGel specifically.

A 2026 scoping review of ten testosterone replacement studies put acne at 0.6% to 9.1% of participants and found injectable formulations generally carried higher rates than topical or oral ones [5]. In a separate 2025 survey of 905 men using testosterone, 24% reported acne [6]. The survey rate is not directly comparable with the gel trial rates [1].

Low-glycemic-load diet

Smith and colleagues randomized 43 males aged 15 to 25 with acne to a low-glycemic-load diet (25% of energy from protein, 45% from low-glycemic-index carbohydrates) or a control diet emphasizing carbohydrate-dense foods for 12 weeks [2]. Total lesion counts fell by 23.5 in the low-glycemic-load group and 12.0 in the control group (P=0.03) [2]. The low-glycemic-load group lost an average of 2.9 kg while the control group gained 0.5 kg, and insulin sensitivity improved more with the diet; the authors noted that further studies are needed to separate the effect of weight loss from the diet itself [2].

Milk and dairy

Adebamowo and colleagues followed 4,273 teenaged boys who reported their diet between 1996 and 1998 and their acne in 1999 [4]. Comparing the highest intake (more than 2 servings a day) with the lowest (less than once a week), the prevalence ratio for acne was 1.16 (95% CI 1.01 to 1.34) for total milk and 1.19 (95% CI 1.01 to 1.40) for skim milk; whole and 2% milk was not significantly associated (1.10, 95% CI 0.94 to 1.28) [4]. Acne in that study was self-reported, and the analysis did not adjust for steroid use [4].

Omega-3 fats

Jung and colleagues randomized 45 people with mild to moderate acne to 2,000 mg a day of EPA plus DHA, to borage oil providing 400 mg a day of gamma-linolenic acid, or to a control group for 10 weeks [3]. Inflammatory and non-inflammatory lesions decreased significantly with supplementation, skin samples showed less inflammation, and no severe adverse effects were reported [3].

What do the dose data tell us?

In the testosterone gel 1% trial, acne was reported more often in the higher-dose groups [1]. The label lists daily dose steps of 50, 75 and 100 mg, adjusted on total serum testosterone [1]. None of the diet studies above tested a diet in men on testosterone gel.

Frequently asked questions

Does diet clear acne from testosterone gel?
The diet trials enrolled people with ordinary acne. A low-glycemic-load diet cut lesion counts more than a control diet in 43 young males [2], and omega-3 supplements reduced lesions in 45 people [3]; higher skim-milk intake was linked to more acne in teenaged boys [4].
How common is acne with testosterone gel?
In the 180-day trial of testosterone gel 1%, acne judged possibly related to treatment was reported in 1% of men on 50 mg, 3% on 75 mg and 8% on 100 mg, and in 3.1% of 162 men in the 3-year extension [1]. A 2025 survey of 905 men on testosterone found 24% reported acne [6].
Would switching to injections change acne?
A scoping review of ten testosterone replacement studies found injectable formulations generally had higher acne rates than topical or oral ones [5]. A 2026 review of injectable dosing says some men on weekly injections still report early acne or oily skin, and that dose timing and peak-trough variation may be the cause; it describes more frequent lower-dose schedules as optional tools [9].
Do omega-3 supplements help acne?
In a 10-week trial of 45 people with mild to moderate acne, 2,000 mg a day of EPA plus DHA was followed by significantly fewer inflammatory and non-inflammatory lesions, with no severe adverse effects reported [3].

References

  1. U.S. National Library of Medicine, DailyMed. Testosterone gel 1% topical (generic) prescribing information, effective 2025-09-30. Testosterone gel 1% topical prescribing information
  2. Smith RN, Mann NJ, Braue A, Mäkeläinen H, Varigos GA. A low-glycemic-load diet improves symptoms in acne vulgaris patients: a randomized controlled trial. Am J Clin Nutr. 2007;86(1):107-15. A low-glycemic-load diet improves symptoms in acne vulgaris patients: a randomized controlled trial
  3. Jung JY, Kwon HH, Hong JS, Yoon JY, Park MS, Jang MY, et al. Effect of dietary supplementation with omega-3 fatty acid and gamma-linolenic acid on acne vulgaris: a randomised, double-blind, controlled trial. Acta Derm Venereol. 2014;94(5):521-5. Effect of dietary supplementation with omega-3 fatty acid and gamma-linolenic acid on acne vulgaris: a randomised, double-blind, controlled trial
  4. Adebamowo CA, Spiegelman D, Berkey CS, Danby FW, Rockett HH, Colditz GA, et al. Milk consumption and acne in teenaged boys. J Am Acad Dermatol. 2008;58(5):787-93. Milk consumption and acne in teenaged boys
  5. 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
  6. 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
  7. Lincoff AM, Bhasin S, Flevaris P, Mitchell LM, Basaria S, Boden WE, et al. Cardiovascular Safety of Testosterone-Replacement Therapy. N Engl J Med. 2023;389(2):107-117. Cardiovascular Safety of Testosterone-Replacement Therapy
  8. Gollnick HP, Draelos Z, Glenn MJ, Rosoph LA, Kaszuba A, Cornelison R, et al. Adapalene-benzoyl peroxide, a unique fixed-dose combination topical gel for the treatment of acne vulgaris: a transatlantic, randomized, double-blind, controlled study in 1670 patients. Br J Dermatol. 2009;161(5):1180-9. Adapalene-benzoyl peroxide, a unique fixed-dose combination topical gel for the treatment of acne vulgaris: a transatlantic, randomized, double-blind, controlled study in 1670 patients
  9. Farzam K. Individualizing Injectable Testosterone Replacement Therapy in Primary Care: Pharmacokinetics, Symptom Stability, Safety Monitoring, and Injection Frequency. Cureus. 2026;18(6):e110570. Individualizing Injectable Testosterone Replacement Therapy in Primary Care: Pharmacokinetics, Symptom Stability, Safety Monitoring, and Injection Frequency
Evidence overview for AndroGel (Testosterone Topical) Acne: Diet Protocols That Help