title: Short- and long-term clinical skin effects of testosterone treatment in trans men.
abstract: BACKGROUND
  Our knowledge concerning the effects of testosterone (T) therapy on the skin of trans men (female-to-male transsexuals) is scarce.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the short- and long-term clinical effects of T treatment on the skin of trans men.
  
  
  METHODS
  We conducted a prospective intervention study in 20 hormone naive trans men and a cross-sectional study in 50 trans men with an average of 10 years on T therapy.
  
  
  METHODS
  Acne lesions were assessed using the Gradual Acne Grading Scale, hair patterns using the Ferriman and Gallwey classification (F&G), and androgenetic alopecia using the Norwood Hamilton Scale.
  
  
  RESULTS
  T treatment increased facial and body hair growth. The F&G score increased progressively from a median value of 0.5 at baseline to a value of 12 after 12 months of T administration. After long-term T treatment, all but one trans man achieved an F&G score indicative of hirsutism in women, with a median value of 24. Only one trans man acquired mild frontotemporal hair loss during the first year of T treatment, whereas 32.7% of trans men had mild frontotemporal hair loss and 31% had moderate to severe androgenetic alopecia after long-term T therapy. The presence and severity of acne increased during the first year of T therapy, and peaked at 6 months. After long-term T treatment, most participants had no or mild acne lesions (93.9%). Dermatological outcome was not demonstrably related to individual serum T or dihydrotestosterone levels.
  
  
  CONCLUSIONS
  T treatment increased facial and body hair in a time-dependent manner. The prevalence and severity of acne in the majority of trans men peaked 6 months after beginning T therapy. Severe skin problems were absent after short- and long-term T treatment.
authors.affiliation: Department of Endocrinology, Ghent University Hospital, Ghent, Belgium.
authors.forename: Katrien
authors.initials: K
authors.lastname: Wierckx
authors.forename: Fleur
authors.initials: F
authors.lastname: Van de Peer
authors.forename: Evelien
authors.initials: E
authors.lastname: Verhaeghe
authors.forename: David
authors.initials: D
authors.lastname: Dedecker
authors.forename: Eva
authors.initials: E
authors.lastname: Van Caenegem
authors.forename: Kaatje
authors.initials: K
authors.lastname: Toye
authors.forename: Jean Marc
authors.initials: JM
authors.lastname: Kaufman
authors.forename: Guy
authors.initials: G
authors.lastname: T'Sjoen
mesh_terms: D000152:Acne Vulgaris / Q000139:chemically induced; D000293:Adolescent; D000328:Adult; D000505:Alopecia / Q000139:chemically induced; D003430:Cross-Sectional Studies; D005227:Fatty Acids; D005260:Female; D006197:Hair / Q000187:drug effects / Q000254:growth & development; D006628:Hirsutism / Q000139:chemically induced; D006801:Humans; D008297:Male; D011446:Prospective Studies; D057829:Gender-Affirming Procedures / Q000009:adverse effects*; D057830:Gender-Affirming Surgery; D012867:Skin / Q000187:drug effects* / Q000473:pathology; D013739:Testosterone / Q000009:adverse effects* / Q000627:therapeutic use; D063106:Transgender Persons; D014189:Transsexualism / Q000188:drug therapy* / Q000601:surgery; D055815:Young Adult
chemical_list: D005227:Fatty Acids; C016173:undecanoic acid; D013739:Testosterone
keywords: Female-to-Male Transsexual; Gender Dysphoria; Gender Identity Disorder; Skin; Testosterone; Transsexualism