Incidence and Factors Associated with Acne in Transgender Adolescents on Testosterone: A Retrospective Cohort Study

• Type of Material: Article
• Authors: Lena Chu, Emory University; Sarah Gold, Emory University; Carlyn Harris, Emory University; Leslie Lawley, Emory University; Pranav Fupta, Emory University; Vin Tangpricha, Emory University; Michael Goodman, Emory University; Howa Yeung, Emory University
• Language: English
• Date: 2023-03-06
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: Published by Elsevier Inc. on behalf of the AACE.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): https://doi.org/10.1016/j.eprac.2023.02.002
• Title of Journal or Parent Work: Endocrine Practice
• Volume: 29
• Issue: 5
• Start Page: 353
• End Page: 355
• Grant/Funding Agency: Eunice Kennedy Shriver National Institute of Child Health and Human Development; National Institute of Arthritis and Musculoskeletal and Skin Diseases; National Institute on Aging
• Grant/Funding Information: This work is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases [grant numbers L30AR076081, K23AR075888]; and the National Institute on Aging and Eunice Kennedy Shriver National Institute of Child Health and Human Development [grant numbers R01AG066956 and R21HD076387].
• Keywords: acne; transgender; masculinizing hormone therapy; pediatric dermatology; epidemiology; testosterone
• Subject - Topics: Acne; Testosterone; Trans youth

Abstract

Objective: This retrospective cohort study aimed to assess incidence and predictors of acne among transgender adolescents receiving testosterone. Materials and methods: We analyzed records of patients aged <18 years, assigned female at birth seen at Children’s Healthcare of Atlanta Pediatric Endocrinology clinic for testosterone initiation between 1/1/2016–1/1/2019, with at least 1-year follow-up documented. Bivariable analyses to determine association of clinical and demographic factors with new acne diagnosis were calculated. Results: Of 60 patients, 46 (77%) did not have baseline acne. 25 of those 46 patients developed acne (54%) within 1-year of testosterone initiation. Overall incidence proportion was 70% at 2-years; patients who used progestin prior to or during follow up were more likely to develop acne than non-users (92% vs 33%, p<0.001). Conclusion: Transgender adolescents starting testosterone, particularly those taking progestin, should be monitored for acne development, and treated proactively by hormone providers and dermatologists.