Acne Incidence and Severity in Transgender Individuals

How does acne incidence in transgender individuals initiating gender-affirming hormone therapy compare with matched cisgender individuals?In this multicenter cohort study of 280 997 individuals, transmasculine individuals had 4-fold higher acne risk than cisgender men and 1.5-fold higher than cisgender women, with risk peaking in the first year after testosterone initiation and remaining elevated throughout 5 years. Transfeminine individuals initiating estradiol had higher acne risk than cisgender men but lower than cisgender women.Clinicians should monitor and treat acne in transmasculine individuals prescribed testosterone per clinical guidelines, particularly during the first year, and recognize acne may develop in transfeminine individuals initiating estradiol.

Corresponding Author: Howa Yeung, MD, MSc, Department of Dermatology, Emory University School of Medicine, 1525 Clifton Rd NE, Atlanta, GA 30322 (howa.yeung@emory.edu).

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