Estrogen and testosterone are two hormones that have a significant effect on your body. From mood, to sexual function, to bone health, these hormones are key players in your health and everyday life.

Hormone replacement therapy (HRT) is a medical treatment that boosts estrogen or testosterone for people whose levels are too low. This treatment causes a range of changes that can include changes to the skin.

Hormones play a role in your skin’s overall health. Hormone loss as we get older is linked to some of the signs of aging, including wrinkling and loss of skin volume. That’s part of why it’s so common to see claims that taking estrogen or testosterone will benefit skin appearance and health for people of any gender.

Although many people taking HRT do report seeing skin improvements, scientific studies don’t always fully back up these claims. Let’s look at how HRT might affect your skin.

Estrogen skin benefits for cisgender women

Estrogen has been prescribed to cisgender women going through menopause for decades. Estrogen declines during menopause and this hormonal change is linked to skin thinning and wrinkles. Some studies have shown that estrogen can help promote skin health, increase skin thickness, and both prevent and reduce wrinkles.

However, the formulations and recommended dosages for estrogen therapy for cisgender women experiencing menopause have changed several times as medical science has gained a greater understanding of the effects of estrogen.

Anecdotal evidence suggests that newer formulations, both topical and oral, do provide skin benefits. Full studies on the skin benefits of estrogen at the current most commonly prescribed dosage and formulation are still needed.

Estrogen skin benefits for transgender women

The full estrogen skin health benefits for transgender women haven’t been fully studied. However, many transgender women report receiving skin benefits from taking estrogen.

It’s common for transgender women to experience skin benefits such as increased hydration, softness, elasticity, and firmness after beginning estrogen.

A side-by-side image a trans woman before and after HRT. Share on Pinterest
In transgender women, HRT can soften the face and create a rounder and “more feminine” appearance. Yanping Nora Soong at English Wikipedia, CC BY-SA 3.0, via Wikimedia Commons

Does estrogen stop facial hair growth for AMAB people?

Estrogen can slow down and stop the growth of facial hair in many AMAB people.

However, it’s important to remember that some cisgender women also have facial hair. Estrogen will reduce and slow down facial hair growth, but it might not stop facial hair growth completely. Genetics plays a large role in your body’s response to any hormone.

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Testosterone skin benefits for cisgender men

The use of testosterone supplementation for cisgender men is still being studied, and its benefits are still being debated. Although HRT is often prescribed for cisgender men with conditions such as hypogonadism, experts don’t agree on whether it should be prescribed for cisgender men whose testosterone has declined with age.

Some experts feel that prescribing testosterone can benefit heart, bone, muscle, brain, and sexual health. Others feel that testosterone levels in cisgender men can be increased without the use of HRT.

The specific benefits of testosterone on skin health in cisgender men haven’t been scientifically studied. However, some cisgender men who use testosterone supplementation report experiencing skin tightening and improved skin elasticity. It’s also possible that if testosterone supplementation does improve overall health, improvements to skin health might follow.

However, it’s worth mentioning that cisgender men who are interested in conceiving should not take testosterone, as excess testosterone can decrease sperm production. If you’re experiencing side effects of low testosterone and do not want any negative effects on your sperm, speak with a fertility specialist to discuss alternative ways to increase testosterone that don’t harm sperm production.

Testosterone skin benefits for transgender men

Transgender men taking testosterone often experience changes to facial volume that can change the appearance of the skin on the face.

Other changes, such as facial hair growth, and temporary acne as the body adjusts to new hormonal levels, can also affect the skin’s appearance. Some transgender men report additional effects such as skin tightening and improved elasticity, but these are not fully researched and studied effects.

HRT skin benefits for intersex and nonbinary people

Intersex and nonbinary people sometimes take HRT for health or gender affirmation. Often, this is done at lower doses. It might also be taken for shorter lengths of time.

The effects of HRT on the skin at these doses aren’t well studied. Some people, on both estrogen and testosterone, do report skin improvements, such as increased firmness or elasticity, but there isn’t data to fully support this.

Does HRT make your skin look younger?

Some people report more youthful-looking skin as a result of HRT. There is research to support estrogen having this effect on cisgender menopausal women, however, more data is needed for other genders.

Additionally, although many people who take estrogen and testosterone report more youthful skin, studies of the effects of HRT on people of all genders are needed to confirm these anecdotal reports.

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Hormonal levels can also cause problems such as dryness, oil, acne, and early aging. When your hormones are out of balance, or when your body is adjusting to new hormones, skin problems can arise. This is why acne is so common during puberty. It’s also why HRT often results in temporary skin problems.

Can high or low estrogen cause skin problems?

Low estrogen can cause your skin to become dry, thin, and irritated. These are common complaints during menopause, and they’re a big reason why there are specialty skin care products formulated for cisgender women during and after menopause.

High estrogen levels won’t directly affect your skin, but they can cause symptoms such as bloating and trouble sleeping that can damage your skin.

Can high or low testosterone cause skin problems?

High testosterone levels can lead to oily skin and acne. This is common in transgender men when they first begin HRT and in anyone else taking testosterone HRT for any reason.

As the body adjusts to new and higher testosterone levels, acne almost always follows. This is because testosterone causes glands to make excess sebum, an oily substance that protects the skin. Excess sebum can clog your pores and cause acne.

HRT acne can sometimes be tough to fight. Some people have success using facial washes and serums with acne-targeting ingredients such as:

The right products for you depend on your skin, skin type, and the severity of your HRT acne. A product that works for one person with HRT acne might not help another person.

In cases of difficult-to-control HRT acne, visiting a dermatologist is often the best bet. A dermatologist can prescribe medicated washes and creams to better target and control your HRT acne.

If you believe that HRT is causing your acne, talk with your doctor about it. They may be able to adjust your dosage level or recommend a dermatologist experienced with HRT.

How long does HRT-related acne last?

It’s difficult to predict exactly how long HRT acne will last. Your body needs time to adjust, and your hormones need to balance.

For people taking smaller doses, this can take several months. For transgender men who are taking a larger dose of HRT, this can take 2 or 3 years, similar to puberty.

However, not everyone will experience acne at all, and not everyone will have the same acne timeline. Your genetics and other individual body factors can influence how your skin responds to HRT.

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HRT has effects on the entire body. Some effects are well studied and well understood. Some effects, including those on the skin across all genders, need additional research.

People of all genders taking HRT report benefits such as more youthful skin, improved skin elasticity, and increased skin firmness. Some data backs up these reports for cisgender women who are experiencing menopause and taking estrogen HRT, but there isn’t yet data on forms of HRT for other populations.

Testosterone HRT causes acne in most people. This is a result of your body adjusting to new hormonal levels. It often reduces and resolves with time. Until it does, acne-fighting creams and cleansers can be used to manage acne. A dermatologist can help with difficult-to-control or severe acne.

People who are considering using HRT should talk with their doctor before starting any form of hormonal therapy. HRT is not without side effects and risks and the dosages used are very important. Do not start any hormonal regimen without the supervision and guidance of a doctor or healthcare professional, as it could drastically change your risk for serious health conditions.