Managing Acne on Testosterone Cypionate: The HealthRX.com Step-by-Step Protocol

What the label says about acne

The Depo-Testosterone label puts acne under skin and appendages reactions, in a group with hirsutism, male pattern baldness and seborrhea, described as reactions that have occurred in men treated with some androgens [1]. No percentage is attached to acne for this product, and the label does not connect acne to injection frequency or to peak testosterone concentrations [1].

Dosing facts the label sets out

Depo-Testosterone is given deep in the gluteal muscle and, per the label, should not be given intravenously; the suggested replacement dose is 50 to 400 mg every 2 to 4 weeks [1]. The half-life of testosterone cypionate after intramuscular injection is about 8 days [1]. Dosage is adjusted according to the patient's response and the appearance of adverse reactions, and acne is one of the reactions listed [1].

HealthRX.com offers testosterone cypionate by prescription.

What acne treatment reviews say

The label names no cleanser, retinoid, antibiotic or isotretinoin schedule. General acne reviews do. An American Family Physician review of acne vulgaris states that topical retinoids are indicated for acne of any severity and for maintenance therapy, that systemic and topical antibiotics should be used only in combination with benzoyl peroxide and retinoids and for a maximum of 12 weeks, and that isotretinoin is used for severe, recalcitrant acne and requires registration in the iPLEDGE program [2]. A systematic review of 54 trials found a topical retinoid combined with benzoyl peroxide improved Investigator Global Assessment in 26.1% to 34.9% versus 7% to 11.8% with vehicle at week 12 [3].

For acne caused by testosterone, a practical guide for clinicians treating transmasculine patients reviews isotretinoin's indications, contraindications and iPLEDGE barriers for severe or refractory cases [4]. These reviews were not run in men treated for hypogonadism with testosterone cypionate.