Testosterone Cypionate Acne: Diet Protocols That Help Clear Skin on TRT

Does testosterone cypionate cause acne?

Yes. The Depo-Testosterone label lists acne under skin and appendages adverse reactions [1], and androgens are well known for their effects on sebum excretion [8]. The label does not evaluate diet.

What does diet research show for acne in general?

A 2013 review of diet and acne found the evidence more convincing for high-glycemic-load diets than for other dietary factors, and said additional research, preferably randomized controlled trials, is warranted [2]. The studies below were done in people with acne in general, not in men taking testosterone cypionate.

Low glycemic load

In a 12-week trial, 43 male acne patients aged 15 to 25 were assigned a low-glycemic-load diet (25% of energy from protein and 45% from low-glycemic-index carbohydrates) or a control diet emphasizing carbohydrate-dense foods [3]. Total lesion counts fell by 23.5 in the low-glycemic-load group and by 12.0 in the control group (P=0.03) [3]. The experimental diet also produced greater weight loss (2.9 kg versus a 0.5 kg gain) and a greater improvement in insulin sensitivity, and the authors said further studies are needed to isolate the effects of weight loss from the diet itself [3].

Dairy and whey

Dairy evidence is observational. In 47,355 women reporting high-school diet, the highest skim milk intake was associated with a prevalence ratio of 1.44 for physician-diagnosed severe teenage acne, compared with the lowest intake [4]. In 6,094 girls, two or more daily servings of total milk were associated with a prevalence ratio of 1.20 [9]. These studies do not show that removing dairy clears acne, and the 2013 review noted no randomized trials of dairy or milk and acne [2].

Whey has case reports only. Five healthy adult men developed acne after consuming whey protein [5].

Omega-3 fatty acids

In a 10-week trial of 45 people with mild to moderate acne, participants were allocated to 2,000 mg of EPA plus DHA daily, to borage oil containing 400 mg gamma-linolenic acid, or to a control group. Inflammatory and non-inflammatory acne lesions decreased significantly with supplementation, and interleukin-8 staining in lesions fell [6].

Zinc

In 332 patients, 30 mg of elemental zinc daily for three months produced a clinical success rate of 31.2%, defined as more than a two-thirds decrease in inflammatory lesions, versus 63.4% for 100 mg minocycline daily. Minocycline was superior by about 17% on mean lesion change [7].

Time frames studied

The low-glycemic-load trial ran 12 weeks [3], and the omega-3 trial ran 10 weeks [6]. Those are the time frames studied, not a promise of response. The American Academy of Dermatology guideline addresses topical and systemic acne management [10].