Managing Dermatologic Effects of Gender-Affirming Therapy in Transgender Adolescents

October 2022 in “ Adolescent Health, Medicine and Therapeutics ”

Christina Huang, Sarah Gold, Rakan Radi, Seth Amos, Howa Yeung

acne hair growth hair loss pubertal suppression hormone therapy androgenic alopecia testosterone therapy topical retinoids antibiotics antiandrogens oral antibiotics spironolactone hormonal contraceptives oral isotretinoin topical minoxidil 5-alpha-reductase inhibitors Rogaine Propecia

From the encyclopedia

Spironolactone →

powerful topical and oral anti-androgen used mostly by women

Minoxidil →

An essential vasodilator with some anti-androgenic effects

Finasteride →

Frontline, gold standard treatment for combatting androgenic alopecia

Studysummary This article discusses the dermatologic impacts of gender-affirming medical care in transgender adolescents and emphasizes the importance of patient-centered care to improve dermatologic and overall outcomes; it reports no new clinical results.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

The document discusses the dermatological effects of gender-affirming therapy in transgender adolescents, including acne and hair growth or loss. Pubertal suppression can alleviate acne, reducing gender dysphoria and acne mental health burdens. However, hormone therapy can cause acne and androgenic alopecia. Acne affects approximately 85% of patients between the ages of 12–25 and can increase with gender dysphoria. For transmasculine adolescents, testosterone therapy can generate or worsen acne. The document also discusses various treatments for acne, including topical retinoids, antibiotics, antiandrogens, oral antibiotics, spironolactone, hormonal contraceptives, and oral isotretinoin. It also covers hair therapy, including the use of topical minoxidil for hair growth in transmasculine adolescents and the treatment of androgenic alopecia with 5-alpha-reductase inhibitors. The document concludes by calling for more research on the dermatological impact of gender-affirming therapy.

View this study on dovepress.com →

Discuss this study in the Community →

Research cited in this study

16 / 16 results

research Case Report: Successful Use of Minoxidil to Promote Facial Hair Growth in an Adolescent Transgender Male

1 citations , September 2021 in “Frontiers in Endocrinology”

This case report describes the use of topical minoxidil to successfully promote facial hair growth in a 17-year-old trans male unable to start testosterone therapy, with skin dryness as the only reported side effect.

research Dermatologic Care of Hair in Transgender Patients: A Systematic Review of Literature

4 citations , July 2021 in “Dermatology and therapy”

This review examines changes in hair physiology and treatment options for transgender patients on hormonal therapy but reports no new clinical findings, offering treatment recommendations based on the authors' experiences.

research Is There a Role for 5α-Reductase Inhibitors in Transgender Individuals?

10 citations , August 2020 in “International Journal of Andrology”

This commentary examines whether 5α-reductase inhibitors are effective and safe for transfeminine and transmasculine individuals, highlighting the lack of efficacy and safety data in gender diverse populations and suggesting that clinicians discuss potential benefits and risks with patients considering their use.

research Androgenetic Alopecia in Gender Minority Patients

8 citations , November 2019 in “Dermatologic Clinics”

This study highlights the importance of clinicians understanding the effects of gender-affirming hormones like testosterone, estrogen, and antiandrogens on hair growth, to effectively diagnose and treat androgenetic alopecia in gender minority patients.

Physical Changes, Laboratory Parameters, and Bone Mineral Density During Testosterone Treatment in Adolescents with Gender Dysphoria

research Physical Changes, Laboratory Parameters, and Bone Mineral Density During Testosterone Treatment in Adolescents with Gender Dysphoria

71 citations , August 2019 in “The journal of sexual medicine”

In this study, transgender adolescents treated with testosterone for a median of 12 months experienced effective virilization, including voice deepening and increased hair growth, but also showed decreased HDL cholesterol and BMD z-scores, and increased hematocrit, with no short-term safety issues reported.

Dermatologic Care of Sexual and Gender Minority/LGBTQIA Youth, Part 2: Recognition and Management of the Unique Dermatologic Needs of SGM Adolescents

research Dermatologic Care of Sexual and Gender Minority/LGBTQIA Youth, Part 2: Recognition and Management of the Unique Dermatologic Needs of SGM Adolescents

13 citations , July 2019 in “Pediatric dermatology”

This review addresses dermatologic health disparities in sexual and gender minority adolescents, highlighting the need for improved pediatric dermatologic care; it does not report new clinical results.

research Hair Transplantation Techniques for the Transgender Patient

14 citations , March 2019 in “Facial Plastic Surgery Clinics of North America”

This review discusses hair restoration procedures for transgender patients undergoing gender transformation surgery and describes the authors' surgical approach but reports no clinical outcomes.

research Effect of Testosterone on Chests and Abdomens of Transgender Men

10 citations , January 2019 in “Journal of the American Academy of Dermatology”

This study found that transgender men using testosterone therapy had higher rates of acne and increased body hair growth, resembling male patterns more closely than those not on testosterone.

research Understanding and Addressing Hair Disorders in Transgender Individuals

32 citations , January 2018 in “American Journal of Clinical Dermatology”

This article provides a framework for understanding hair disorders and treatment options in transgender individuals undergoing hormonal therapy and reports no new clinical results.

research Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline

2170 citations , September 2017 in “The Journal of Clinical Endocrinology & Metabolism”

This updated guideline from the Endocrine Society highlights the importance of endocrinologists in providing safe and effective hormone regimens for gender-affirming care, especially for adolescents who have entered puberty.

research Consecutive Cyproterone Acetate and Estradiol Treatment in Late-Pubertal Transgender Female Adolescents

36 citations , May 2017 in “The journal of sexual medicine”

In this retrospective study, cyproterone acetate treatment in late-pubertal trans-girls was found to be generally safe and led to mild feminizing effects, with more rapid feminization occurring when combined with estrogens.

research Oral Spironolactone for Acne Vulgaris in Adult Females: A Hybrid Systematic Review

117 citations , February 2017 in “American Journal of Clinical Dermatology”

This systematic review concluded that the support for using spironolactone at commonly prescribed doses is based on evidence of limited quality.

research Spironolactone for the Treatment of Acne: A 4-Year Retrospective Study

22 citations , January 2017 in “Dermatology”

In this retrospective study, spironolactone improved acne in 86% of patients while showing minimal side effects, suggesting it as a safe treatment option for postadolescent acne with a low risk of short-term adverse effects like hyperkalemia.

research Hormonal Therapies for Acne

26 citations , October 2016 in “Clinics in Dermatology”

This article discusses various hormonal therapies for acne and provides practical treatment guidelines for managing hormonally related acne, but it reports no new research findings.

research Short- and Long-Term Clinical Skin Effects of Testosterone Treatment in Trans Men

110 citations , October 2013 in “The Journal of Sexual Medicine”

This study found that testosterone therapy in trans men increased facial and body hair growth while the prevalence and severity of acne peaked at 6 months but were primarily mild after long-term treatment.

research Effects of Sex Steroid Deprivation and Administration on Hair Growth and Skin Sebum Production in Transsexual Males and Females

176 citations , August 2000 in “The Journal of clinical endocrinology and metabolism/Journal of clinical endocrinology & metabolism”

In this study, cross-sex hormone therapy affected hair growth patterns differently, with estrogen reducing hair growth in male-to-female transsexuals and testosterone increasing it in female-to-male transsexuals; however, male typical hair diameters were not fully reached in the latter group after 12 months.