Acne and Testosterone Boosters: Are hormones the cause of spots?

Acne and Testosterone Boosters

Ben BA(Hons), PGCert

There are many pictures of muscular men suffering from back acne. We want to understand what causes this and if supplements can make the issues worse.

LAST UPDATED: March 2019 by Ben

Author: Nicola is a competitive athlete with a number of championships to her name across many disciplines.

This article is supported by 31 cited references.

Contents show

Spots and Hormones

Does high testosterone cause acne? Let’s look at the evidence about testosterone levels and bad skin.

Summary: Acne and spots are caused by sebum secretion which blocks the pores along with dead skin cells.

Androgenic hormones which include testosterone are responsible for increased sebum production.

However, evidence suggests that acne is a hereditary inflammatory skin disease with very little external factors at cause, and it is the inflammation which triggers the hormones to increase sebum production.

You might think acne is something only teenagers have to deal with, but the truth is that bad skin – even acne – can be a problem for men or women of any age.

Data suggests that it is not uncommon for guys to struggle with painful, unsightly acne blemishes usually found around the neck, face and upper torso well into their 30s and 40s.

Also consider that this is not just a male problem, because women account for 80% of adult acne and lifestyle choices such as smoking can exacerbate the problem. [1]

“Women account for 80% of adult acne cases”

So, if you have acne, you may find solace in the fact that you are not alone…

This is due to acne is considered the eighth most prevalent inflammatory skin disease, therefore, in many cases, this cannot merely be attributed to your own actions. [2]

But, we will find out more about this as we discuss the evidence.

So, what really causes acne?

And, can testosterone levels, test boosters, and testosterone replacement therapy (TRT) make it worse?

Causes of acne

At a basic level, the development of acne is triggered by androgen hormones.

There are other contributing factors, however, it is the androgenic hormones that increase the production of sebum.

Sebum is a natural waxy oil that is secreted through the pores to help moisturize your skin.

‘Acne is the result of pores clogged with shed skin cells combined with sebum in the hair follicle.’ [3]

While sebum is completely normal and natural it can become problematic when too much is produced.

In a nutshell, this excess sebum, which is a complex group of oils, is a route cause of the follicles becoming clogged up with shed skin cells.

Moving back on to hormones…

These androgen hormones regulate the development of the male characteristics and are synthesized in the testes of a man and the ovaries in a woman.

The main androgen and the most commonly known is testosterone, this hormone is significant in the development of adolescent to adult males.

Yet, they have a responsibility for libido and sexual arousal in women. So don’t be fooled in to thinking women don’t produce testosterone.

As already mentioned testosterone is the most commonly thought of androgen, but there are additional androgen hormones such as androstenedione and Dihydrotestosterone (DHT).

It has already been mentioned that androgens are key for sebum production, and they are a major cause of acne development, particularly when there is an overproduction of androgen hormones. [4]

While these androgen hormones are important in human development, it is DHT and testosterone which are particularly relevant to the production of the aforementioned sebum. [5]

We know this because those patients with acne tend to demonstrate a higher level of testosterone and DHT when compared to other individuals who are not suffering from acne.

Furthermore, a study involving people who are changing sex noted that those who were transgressing from female to male, and therefore subject to more testosterone, saw an increased level of sebum secretion. [6]

‘…converted into testosterone and DHT. These potent androgens subsequently regulate dermal physiology through intracrine or paracrine manners…’ [7]

What Can Cause Bad Skin?

The process of spotty skin is as follows:

Spots and bad skin are typically caused by pores or hair follicles becoming blocked with excess sebum and dead skin cells, this causes bacteria to grow, and eventually it all builds up to produce a spot.

Puberty

Hormone changes can increase oil build up further and exacerbate bad skin, which is why acne often starts or peaks during puberty.

When the follicles become blocked which are close to the surface of the skin it can then force itself outwards which cause the white head spot we are familiar with.

Furthermore, bacteria that is present on the skin can then infect the blocked follicles causing more problems.

Inflammation

Acne is, in essence, an extremely common and widespread inflammatory disease of the pilosebaceous follicles. [8]

Additionally…

Adult acne usually has a hormonal cause, too, which is why we need to look at the links between testosterone, test boosters, and acne.

However, there are also a few myths to dispel along the way.

Testosterone

The hormone testosterone falls in to the group of androgens, and androgens, as we have learned are known to stimulate sebum production in the skin.

Androgen hormones can also affect the texture of skin cells, leaving skin more likely to get clogged and congested.

If this happens too much, it can make existing bad skin worse, or even trigger the initial onset of acne.

Now, this is because every pore on our body has minuscule sebaceous glands which produce oily sebum.

These sebaceous glands are sensitive to hormones, such as testosterone. That is because this particular androgen hormone increases the production of sebum.

And, the role of sebum in the skin is to move dead skin cells to the surface so they can be removed, leaving skin free to regenerate and lay down new cells.

However, if sebum production becomes unbalanced, the pores can get blocked as it clings on to the dead skin cells.

It is important to remember that sebum contributes to good skin health, but if sebum is secreted too much or too quickly, it can easily increase the likelihood of acne..

How does testosterone affect acne?

We’ve already established that acne is typically caused by major hormonal changes, when the skin’s sebaceous glands excrete too much sebum.

The skin is an organ, and it is not a major source of androgen synthesis is does still synthesize sex hormones including testosterone.

The sebaceous glands are an important way for the body to express androgen hormones – including test – but this activity can become out of balance.

When people go through the stages of puberty, it is often considered that acne is the result of an increased level of testosterone.

One may think that this would only affect the males, but testosterone levels are also increased in females too which helps maintain muscle and bone strength.

‘The maturing ovaries and testes also secrete the gonadal steroids estrogen and testosterone’ [9]

Additionally, it was universally considered that older people who suffered from acne were also dealing with a hormone problem which was caused by the disease of a endocrine gland.

However, it has since been discovered that they rarely are suffering from a hormone issue at all.

So, in essence, higher androgen levels, of which testosterone is the major one can lead to more oil being produce which can cause pore blockages and subsequently spots or acne. [10]

Testosterone and acne in women

Acne is not just an issue for guys…

Women’s bodies produce testosterone too of course, so a change in hormones can be a factor in female acne problems.

The body also produces weaker androgens such as androstenedione and dehydroepiandrosterone (DHEA), but even these get converted to testosterone by the fat and muscle tissues. [11]

If women have other symptoms that are suggestive of high test levels (excess facial hair or body hair, unusually deep voice, irregular periods) then she may well also have problems with bad skin as they ares sometimes associated.

However, acne can be triggered by other reasons, and, as it has already mentioned, adult acne is more prevalent in women rather than men with 41% of adult women being affected by persistent acne. [12]

“41% of women suffer with persistent acne”

Plus, not only are women more susceptible to acne, their lesions are more severe than those typically associated with men and that the symptoms of acne carried over from adolescent development in to adult life, sometimes for decades. [13]

It has been concluded that those females suffering from continued acne are living with a condition known as hyperandrogenicity: higher levels of serum androgen. [14]

Low Testosterone and Acne

If you are suffering from low testosterone it can also impact other areas of your health.

You could have been diagnosed with hypogonadism which is when you have very low levels of testosterone.

Or you may be suffering from the andropause which is when you lose test as you age, this tends to be around 1% annually. [15]

If you are diagnosed with either andropause or hypogonadism you may then be prescribed TRT.

However, one of the side effects can be acne of the trunk area of the torso. So, you guessed it, your back.

Additionally, if you self prescribe androgens that are not expected, or essentially required by your body, so therefore you start using steroids perhaps to increase your physical performance, you too can suffer from acne.

Sometimes, if you are in the gym, you may notice large, muscular men who have spotty backs. This is potentially down to steroid use.

However, it doesn’t necessarily mean that if you take steroids or are prescribed TRT that you will suffer from acne or that it will be particularly bad.

Just remember, it is a possible side effect.

Essentially, more testosterone means more sebum production.

This can clog up pores with dead skin cells causing spots.

‘When serum levels of testosterone are increased, a concurrent increase in the secretion of sebum occurs, which can lead to acne. Despite this known association, this effect is typically minimal.’ [16]

Simple steps to manage bad skin

If you think your test levels are linked to your bad skin, there are a few things you can do to minimize the issue.

Being a man, castration could be an option, although I do not think you may wish to take this route. [17]

Skin Care

If you suffer from acne, you can’t neglect the simple things like washing your face properly, drying it with a clean towel, and keeping your bedding clean.

Some skin products can help with spots and congestion: look for face washes or scrubs that contain salicylic acid which will gently help to unclog pores and remove excess skin cells.

Avoid anything that is greasy, also avoid normal soaps which have a high pH level, try something soap free but also be aware that some anti-bacterial cleansers may irritate sensitive skin. [18]

Too much washing can dry out your skin and cause further issues, further points to know is that lots of touching of the skin can make matters worse so bear this in mind when you shave.

Gyms can be pretty grotty environments, so try to minimize the transfer of dirt and germs to your face.

The only way to do this is simply try not to touch your face during your workouts.

Bear in mind that most of the causes for acne are actually beneath the skin, not actually on the surface.

Wash your hands before leaving the gym, or keep a little bottle of antibacterial hand gel in your kit bag.

It won’t cure acne or prevent excess sebum production but it can help prevent further bacterial infection.

Do not attempt to try and squeeze the spots as this can leave scaring and even push the pus further beneath the skin unless done professionally in a medical environment.

Be aware that there’s also no absolute evidence that confirms sunbeds can improve the symptoms of acne, either.

Diet choices for acne

There’s no definitive proof that any foods cause acne.

However, it is speculated due to some evidence that associates a typical Western diet which includes high amounts of dairy protein and carbohydrates with acne. [19]

There’s also contradictory evidence,

So while the proof is a little uncertain, it does make sense to try and eat a diet full of vitamins, minerals, and micronutrients.

Be sensible: if you know that you don’t eat a lot of fruit, veg, salads, berries, whole grains, and all those other good natural foods, then make some changes.

Potato chips, fries and candy bars won’t cause acne just by themselves.

But if you’re eating junk and neglecting the good stuff, then addressing the balance will benefit your skin.

Supplements for acne

If your suffer with bad skin, it can be a good idea to add a quality multivitamin tablet, greens powder, plus omega 3 supplements into your daily routine.

Supplementing with zinc can also be helpful, because we know that it enhances immune response and can rebalance mineral deficiencies which could contribute to acne. [20]

Vitamin D – the sunshine vitamin – is also key for maintaining strong and healthy skin. It’s a significant anti-inflammatory, too, which could help if you suffer with bad skin. [21]

The B vitamins – especially Vitamin B6 – are another useful natural daily supplement for gym goers who struggle with acne. It plays a key role in healthy skin development and can reduce your chances of spots and other skin conditions. [22] [23]

Polyphenols are found in many natural foods such as fruits and vegetables, but these antioxidants are also found in tea.

One of the antioxidant benefits of polyhenols is their anti-inflammatory effects. [24]

This is important because acne is an inflammatory response of the skin, at all stages of the lesion development. [25]

Therefore, studies have been conducted to understand the role of tea polyphenols on sebum secretion and the resulting acne.

The evidence demonstrates that there is some promise by using oral and topical green tea to help control and minimize excessive sebum secretion and help prevent while also treating acne. [26]

Acne, training and testosterone

The take home message here is that high levels of test can be a good thing if your goal is growing muscle, getting lean, and building an impressive physique.

But it can bring the risk of bad skin and acne. And you spend a lot of time at the gym, which means more likelihood of putting your skin in contact with dirt, germs, and bacteria.

So take extra care with your skin, be sure to have plenty of micro-nutrients in your diet, and supplement with the key vitamins and minerals known to support skin health.

However, bear in mind that the real excessive amounts of testosterone that can be a real cause of acne are more likely to stem from anabolic steroid use which floods your blood stream with extreme levels of synthetic testosterone.

This is why often those on testosterone replacement therapy may develop acne, that is because TRT is essentially an anabolic steroid, and the possible side effects of acne can effect both men and women. [27] [28]

Many natural test boosters contain the ingredients required to help manage bad skin.

Additional contributing factors

You may just be born with it. Unlike that famous Maybelline advert, this is something that probably isn’t that popular with people.

Here’s a twist to consider…

It is theorized that genetics are the reason why you might suffer from spots, in fact it is claimed that genetics are 81% of the cause with a mere 19% other contributing environmental factors such as poor hygiene. [29]

“Genetics are 81% of the cause of acne.”

What we have to understand and remind ourselves is that acne is an inflammatory response by the skin.

As such, it may not be that we are simply producing more sebum due to hormones alone but that your skin is merely sensitive; and the skin is producing more sebum as a reaction to many environmental factors. [30]

Hormones are responsible for secreting sebum, but the hormones can be just intensifying the inflammation reaction that your skin is actually suffering from.

The Take Away

In conclusion, there is a strong relationship between high levels of testosterone and acne.

More testosterone equals more chance of spots. Whether that develops in to acne which is an inflammation disease may actually be more related to your genetics.

But, a higher level of testosterone does produce more sebum, that oily and waxy substance that helps clean the skin in moderate amounts. When there’s an excess being produced it can clog your pores by sticking to dead skin cells which leads to white head spots.

Treatments are not entirely conclusive at the moment, but a thorough skin care routine with a balanced diet including anti-inflammatory nutrients while not using anabolic steroids (unless prescribed) is a good start to help prevent and treat.

Final remarks

Unfortunately if your parents had acne you my well have acne, too, as evidence does suggest that it is hereditary.

Plus, there seems to be no prevention or actual cure for acne, instead there are ways in which we have covered that can help alleviate the issue [31]

However, we have learned that it is hormones such as testosterone that are responsible for producing more of the waxy oil called sebum from the glands. These can then become clogged up and infected.

So, avoid taking anabolic steroids as these load your body with large amounts of synthetic testosterone.

Ensure that if you use a natural testosterone booster supplement that you understand what ingredients are included as some nutrients are good for your skin and are anti-oxidants.

References

[1] https://www.nhs.uk/conditions/acne/causes/

[2] A global perspective on the epidemiology of acne. Tan JK, Bhate K. Br J Dermatol. 2015 Jul;172 Suppl 1:3-12. doi: 10.1111/bjd.13462. Review. PMID: 25597339

[3] https://www.ncbi.nlm.nih.gov/pubmed/16910029

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3051853/

[5] https://www.ncbi.nlm.nih.gov/pubmed/6258368

[6] Effects of sex steroid deprivation/administration on hair growth and skin sebum production in transsexual males and females.Giltay EJ, Gooren LJ. J Clin Endocrinol Metab. 2000 Aug;85(8):2913-21. PMID: 10946903

[7] https://www.ncbi.nlm.nih.gov/pubmed/17326004/

[8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5798558/

[9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3410522/#b41

[10] https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/androgen-deficiency-in-men

[11] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3969667/

[12] https://www.ncbi.nlm.nih.gov/pubmed/11843213/

[13] Post-adolescent acne: a review of clinical features. Goulden V, Clark SM, Cunliffe WJ. Br J Dermatol. 1997 Jan;136(1):66-70. PMID: 9039297

[14] Androgen metabolism in sebaceous glands from subjects with and without acne. Thiboutot D, Gilliland K, Light J, Lookingbill D. Arch Dermatol. 1999 Sep;135(9):1041-5. PMID: 10490108