Can High Testosterone Cause Acne?

What Is Testosterone and What Does It Actually Do?

So first off, testosterone isn’t just a “male hormone.” You produce it too—even if you're female—and it plays a role in more than just puberty or sex drive. It’s part of a larger hormonal orchestra handled by your endocrine system.

In men, it’s produced mainly in the testes. In women? It’s made in smaller amounts in the ovaries and adrenal glands. It helps with:

• Muscle growth and bone density

• Libido and reproductive health

• Mood regulation (yes, hormones are emotional saboteurs too)

• Oil production in your skin (we’ll get to that in a minute)

It’s also converted into a more potent version called DHT (dihydrotestosterone)—and that’s where things start getting greasy. Literally.

The Science Behind Acne (a Quick, Unfiltered Breakdown)

Here’s the not-so-glamorous chain reaction: your skin produces oil (sebum), which is supposed to keep your skin moisturized. But when your sebaceous glands get a little too enthusiastic—usually thanks to hormonal shifts—they go into overdrive.

That extra oil gets trapped in your pores, mixes with dead skin cells, and becomes the perfect breeding ground for bacteria (specifically Cutibacterium acnes—formerly known as P. acnes). This combo leads to inflammation, and boom: breakouts.

And guess what? Testosterone fuels this oil surge.

How Testosterone Affects the Skin

This part's pretty straightforward—and frustrating. Higher levels of testosterone, especially when it converts to DHT, can bind to androgen receptors in your skin. That makes your sebaceous glands kick into high gear, producing more oil than your skin can handle.

That’s why you'll hear the phrase “testosterone breakouts” tossed around in gyms, dermatology forums, and yes, whispered in hushed tones in skincare aisle conversations.

Real-world cue: Ever notice teens (especially boys) getting major acne during puberty? That’s not just bad luck—it’s the testosterone surge.

High Testosterone in Men vs. Women: Same Hormone, Different Skin Chaos

Now, high testosterone doesn’t hit everyone the same way. The fallout really depends on your baseline hormone balance.

In men, it often shows up during puberty or later in life if they're supplementing with testosterone (more on that in a second). You'll see:

• Deep cystic acne along the jawline and back

• Increased body hair

• Oily skin that feels impossible to manage

In women, high testosterone is often tied to PCOS (Polycystic Ovary Syndrome), and it shows up differently:

• Hormonal acne along the chin, jaw, and sometimes cheeks

• Irregular periods or hair growth in odd places (chin, upper lip, etc.)

• Oily skin even if you have a dry-type elsewhere

Here’s a quick comparison based on what I’ve seen with clients (and frankly, myself):

Testosterone Therapy (TRT): The Side Effect Nobody Warns You About

Let’s say you're an athlete, bodybuilder, or just someone navigating low testosterone levels later in life—testosterone therapy (TRT) might be part of your journey. But what people often don’t tell you? It can wreck your skin.

TRT = spike in DHT = spike in sebum = breakouts.

You’ll sometimes hear people call it steroid acne, and it’s a whole thing. I’ve had clients come to me post-TRT or after anabolic steroid cycles, frustrated that their skin went from clear to chaotic in just weeks.

Common signs?

• Sudden cystic acne after starting injections or gels

• Breakouts on the chest, shoulders, and butt (places you never even thought could break out)

• Skin becoming visibly oilier despite washing more

It’s not always permanent—but it’s definitely something you want to track. And please, don’t just throw harsher scrubs at it. That never ends well.

Treating Hormonal Acne: What Actually Helps

I wish I could say there’s a one-size-fits-all solution, but hormonal acne is stubborn. What works is usually a combo approach—skin, lifestyle, and hormones all need to get in sync.

Here’s what I’ve seen work best:

Topical Treatments

• Tretinoin or adapalene – helps keep pores unclogged

• Benzoyl peroxide – kills acne-causing bacteria (use it sparingly)

• Salicylic acid – especially for blackheads or oily skin

Hormonal Regulation

• Birth control pills – some types (like those with drospirenone) help reduce testosterone impact

• Anti-androgens (like spironolactone) – game-changer for women with PCOS-related acne

• Isotretinoin – usually a last resort, but effective for severe cases

Lifestyle Factors

• Diet: High-sugar, high-dairy diets often worsen hormonal breakouts (at least in my experience).

• Stress: Increases cortisol, which messes with hormones even more.

• Skincare routine: Consistency > fancy. Also, avoid over-cleansing—it backfires.

Supplements & Skin Support
I've also seen clients have decent results when pairing topical treatments with internal skin support. For example, NuBest White is one that gets brought up often. It’s a supplement aimed at improving overall skin health and tone—especially for dull or uneven complexions. If you’re dealing with acne and looking to brighten and even out skin tone (post-acne marks included), it’s worth considering.

When to See a Doctor (Seriously—Don’t Wait Too Long)

If your acne isn’t improving—or it’s getting worse despite your best efforts—it’s time to call in the pros.

Here’s when I’d nudge you toward a dermatologist or endocrinologist:

• Your acne is painful, cystic, or leaving scars

• You suspect a hormonal imbalance (especially if your periods are irregular or you’re on TRT)

• OTC products aren’t working, or they’re making things worse

• You're considering starting or stopping hormone therapy

They’ll likely run a hormone panel, maybe refer you for ultrasounds (in PCOS cases), or suggest prescription-strength treatments. And no, you’re not being “extra” for wanting help.

Final Thoughts: Balancing Hormones and Skin Health (a Lifelong Dance)

Look, I get it. Hormonal acne feels like a betrayal—especially when you’re doing all the “right” things. But your skin is often just the messenger, not the enemy.

What’s helped me—and so many people I’ve worked with—is shifting from a “fix the acne” mindset to a “balance the system” one. Your hormones, skin barrier, diet, stress levels…they all talk to each other.

Some days, your skin will rebel no matter what. But on most days? Building a routine that supports hormone health—through nutrition, smart skincare, stress care, and even the right supplements like NuBest White—can slowly tip the scale in your favor.

Just remember: this is more of a slow waltz than a quick fix. You won’t see miracles overnight. But trust your body, track your patterns, and don’t be afraid to ask for help.

(And please, don’t fall for that “you’ll grow out of it” myth. Adult acne is real. And it’s not your fault.)