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

Endocrine Practice 2023 March 7
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 1/1/2000-1/1/2019, 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.

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