Dermatologic Conditions in Transgender Populations

The document from 2019 emphasizes the need for proper diagnosis and treatment of dermatologic conditions in transgender patients, especially those undergoing hormone and surgical gender-affirming treatments. It notes that hormone therapy can lead to skin issues such as acne, male pattern hair loss, hirsutism, and pseudofolliculitis barbae. For transmasculine individuals, acne is common with testosterone therapy, and a study of 21 adults showed increased facial and back acne after 4 months. Treatments for acne include topical retinoids, benzoyl peroxide, and oral antibiotics, with severe cases possibly requiring isotretinoin. Male pattern hair loss can be treated with topical minoxidil and oral finasteride, which was shown to increase hair counts by 25% in a study of 10 patients without affecting testosterone levels. For transfeminine individuals, estrogen and antiandrogens do not typically halt facial hair growth, necessitating hair removal methods like shaving, plucking, waxing, topical eflornithine, electrolysis, and laser hair removal. The document also discusses complications from dermal fillers, the prevalence of keloids and hypertrophic scars, and the management of conditions like melasma, lichen sclerosus, HPV infections, and HIV-associated dermatologic conditions. It underscores the importance of comprehensive care and multidisciplinary coordination to improve the quality of life and mental health of transgender patients with skin diseases.