Incidence and Factors Associated With Acne Among Transgender Patients Receiving Masculinizing Hormone Therapy

Thoreson, Nick; Park, Jason A.; Grasso, Chris; Potter, Jennifer; King, Dana; Marc, Linda G.; Shen, Changyu; Peebles, J. Klint; Dommasch, Erica D.

doi:10.1001/jamadermatol.2020.5347

Cited by 24 publications

(32 citation statements)

References 27 publications

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“…Although many of these concerns have been documented among people on testosterone there is a lack of empirical evidence to support many of these claims. For example, one large study found no association between serum testosterone levels and acne prevalence among transmasculine people, though age at the start of hormones was a risk factor for acne (Thoreson et al, 2021). Other studies have shown mixed evidence of changes in anger following testosterone therapy, with none following up longer than the first years on treatment (Defreyne et al, 2019;Kristensen et al, 2021;Motta et al, 2018;Thoreson et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

Gender affirming hormone therapy dosing behaviors among transgender and nonbinary adults

Restar

Dusic

Garrison-Desany

et al. 2022

Humanit Soc Sci Commun

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Gender-affirming hormones have been shown to improve psychological functioning and quality of life among transgender and nonbinary (trans) people, yet, scant research exists regarding whether and why individuals take more or less hormones than prescribed. Drawing on survey data from 379 trans people who were prescribed hormones, we utilized multivariable logistic regression models to identify factors associated with hormone-dosing behaviors and content analysis to examine the reasons for dose modifications. Overall, 24% of trans individuals took more hormones than prescribed and 57% took less. Taking more hormones than prescribed was significantly associated with having the same provider for primary and gender-affirming care and gender-based discrimination. Income and insurance coverage barriers were significantly associated with taking less hormones than prescribed. Differences by gender identity were also observed. Addressing barriers to hormone access and cost could help to ensure safe hormone-dosing behaviors and the achievement trans people’s gender-affirmation goals.

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Section: Discussionmentioning

confidence: 99%

Gender affirming hormone therapy dosing behaviors among transgender and nonbinary adults

Restar

Dusic

Garrison-Desany

et al. 2022

Humanit Soc Sci Commun

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“…Promoting a lowcalorie diet and eating more fruits and vegetables is a great way to lose. It is important to educate patients about the behavior of weight loss that can be maintained throughout the patient's life 16 Weight loss will reduce the risk of type 2 diabetes, gestational diabetes, dyslipidemia, and other cardiovascular risk factors. In addition, weight loss can help improve ovarian function and stimulate ovulation.…”

Section: Resultsmentioning

confidence: 99%

“…In addition, weight loss can help improve ovarian function and stimulate ovulation. PCOS is the first risk factor for metabolic syndrome, and the risk increases with diagnosis 16,17 . Early intervention in lifestyle change is important to improve patient health and quality of life.…”

Section: Resultsmentioning

confidence: 99%

Association Of Acne Vulgaris With Polycystic Ovarian Syndrome In Patients Visiting UOL Teaching Hospital

Malik¹,

Kazmi²

2021

PJMHS

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Background: Polycystic syndrome (PCOS) is the most common endocrine disorder in the world affecting 8% of women. The main characters of PCOS are enlarged ovaries, chronic ovulation, menstrual cycles disturbance, androgen overdose, and insulin resistance leading to acne, hirsutism, and reproductive problems. Acne is a quite common dermatological condition in daily practice. Aim: To determine the association of acne vulgaris with polycystic ovarian syndrome in patients visiting the University of Lahore Teaching Hospital. Study design: Descriptive cross-sectional study. Place and duration of study: Dermatology Outpatient Department, University of Lahore Teaching Hospital Lahore from March 2019 to March 2020. Methodology: It was a descriptive cross-sectional study from March 2019 to March 2020 conducted at the Dermatology Out-patient Department, University of Lahore Teaching Hospital. All patients between the ages of 18 and 40, with acne vulgaris were included in the study. After obtaining informed consent, 101 women with acne vulgaris in I-IV (Indian stages), between the ages of 18-40 years, presented in the Department of Dermatology, University of Lahore Teaching Hospital, from March 2019 to March 2020, were selected for the study. Pregnant females, lactating mothers, and women on hormonal treatment (oral contraceptives or injections) were excluded from the study. A history of acne, oligomenorrhea, hirsutism, seborrhea, alopecia, acanthosis nigricans infertility, obesity and amenorrhea were taken. Weight and height were measured to calculate BMI. Data were collected in a special statistically tool and analyzed using SPSS-25. Results: A total of 101 women were examined having acne vulgaris issue. A total of 101 female were assessed and having history of acne vulgaris. Out of this, 33 were 18–23 years old, while 24 (23.4%) have ages 24–28 years. There were 18 (17.8%) patients who have 29–33 years old. while 38–40 years were 10 (9.9%) years old. Irregular menstrualcycle was reported 34.6% of the study population. As Perth WHO criteria, only 17% of the participants had BMI in normal weight range. The proportion of women, who were overweight and obese were 50.4% and 32.6% in the study population. Conclusion: Acne vulgaris has been identified as a serious skin disease found in all age groups. PCOS is more common among women with acne and obesity is a major risk factor for PCOS.

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“…Epidemiologic studies of acne in transmasculine persons have mostly relied on limited data from single-center retrospective cohort or self-reported survey studies. In a large, single-center, retrospective cohort of 988 transmasculine patients in Boston, the prevalence of acne increased from 6.3% before testosterone therapy to 31.1% after initiating testosterone for an average of 3.4 years [ 13 ]. Younger age at the time of testosterone initiation was associated with a higher incidence of acne diagnosis [ 13 ].…”

Section: Epidemiology and The Impact Of Acne In Transgender Personsmentioning

confidence: 99%

“…In a large, single-center, retrospective cohort of 988 transmasculine patients in Boston, the prevalence of acne increased from 6.3% before testosterone therapy to 31.1% after initiating testosterone for an average of 3.4 years [ 13 ]. Younger age at the time of testosterone initiation was associated with a higher incidence of acne diagnosis [ 13 ]. In a small cohort study of 20 transmasculine patients in New York, facial and truncal acne diagnoses increased over 4 months of treatment from 35 to 82% and from 15 to 88%, respectively [ 14 ].…”

Section: Epidemiology and The Impact Of Acne In Transgender Personsmentioning

confidence: 99%

Treating Acne in Transgender Persons Receiving Testosterone: A Practical Guide

et al. 2022

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Transgender persons who undergo masculinizing hormone therapy experience a wide array of dermatologic effects as they initiate and maintain testosterone therapy. Acne is one of the most common adverse effects for many transmasculine patients receiving testosterone. Acne can worsen body image and mental health, with significant impact on quality of life in transgender patients. Specific training and awareness are needed for a clinically and culturally competent encounter while providing care for the transgender patient. This article provides a practical guide for the treatment of testosterone-induced acne in transmasculine patients. Recommendations on creating a welcoming clinical setting, taking a gender-inclusive history, and conducting a patient-centered physical examination relevant to acne care are provided. Assessment of reproductive potential and the appropriate contraceptive methods before prescribing acne treatment with teratogenic potential in transmasculine patients are examined. Interactions between acne treatments with gender-affirming therapies are explored. For patients with severe or treatment-refractory acne, indications, contraindications, and barriers to isotretinoin prescription, such as the US iPLEDGE program, are examined. Multidisciplinary approaches to acne care, involving mental health, reproductive health, gender-affirming hormone therapy and surgeries, are adopted to guide isotretinoin treatment.

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Incidence and Factors Associated With Acne Among Transgender Patients Receiving Masculinizing Hormone Therapy

Cited by 24 publications

References 27 publications

Gender affirming hormone therapy dosing behaviors among transgender and nonbinary adults

Gender affirming hormone therapy dosing behaviors among transgender and nonbinary adults

Association Of Acne Vulgaris With Polycystic Ovarian Syndrome In Patients Visiting UOL Teaching Hospital

Treating Acne in Transgender Persons Receiving Testosterone: A Practical Guide

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