The number of people who self-identify as transgender is on the rise in the United States. In addition to 1.4 million individuals, a 2017 study indicates that an estimated 0.7 percent of youth ages 13 to 17, or 150,000 youth, identify as transgender. Along with this development, the trans community has also started to be more open about what they go through during transition. Nowadays, teens are beginning hormone replacement therapy at an earlier age as more parents are starting to understand and support their transgender children. Those who will undergo the transition process can expect a lot of changes once they begin HRT, and it’s important to know how it affects one’s overall appearance and health, starting with the skin.

Here are all the ways that hormone replacement therapy can affect your skin during transition, and what you can do to keep your skin healthy during this time.

Testosterone And Its Impact On Your Skin

Folliculitis

Those who are taking testosterone to have a more masculine appearance can expect to see a lot of changes, including an increase in body hair and facial hair. You may also experience some hair fall as the hormone results in a decrease in scalp hair. Because of the increase of facial hair, it’s possible to develop folliculitis, a condition wherein hair follicles become inflamed. You’ll know that you have this condition if small, red bumps or whitehead-like growths appear on the hair follicles on your face. Though they’re not life-threatening, having folliculitis can be uncomfortable as it causes itching.

The good news is that folliculitis can clear up within a few days. To prevent it from coming back, avoid shaving, if possible, or shave less frequently. It’s also important to use a moisturizing lotion after shaving to soothe the skin.

Having Thicker And Oilier Skin

One of the immediate effects of taking testosterone is having thicker and oilier skin. Dr. Maddie Deutsch, the Director of Clinical Services at the UCSF Center of Excellence for Transgender Health says that this change will result in having larger pores and increased oil or sebum production. The expert adds that one may develop acne, but it can be managed with common acne treatments and good skin care practices.

The possibility of having severe acne in the early stages of testosterone therapy is high as this is related to hormonal changes in the body. Hormonal acne can cause deep and painful cysts, and once they clear, they often leave dark marks or scars. Often, dermatologists will prescribe topical medication and ointments to address this skin condition, but it’s highly possible that some transgender men will need isotretinoin in order to clear up hormonal acne once and for all.

While isotretinoin may be the answer to this problem, this drug has been proven to be harmful to an unborn fetus, which is why the US Food and Drug Administration requires doctors to register patients by their sex assigned at birth. Though taking the drug is quite safe, some surgeons will require that patients should be off the medication for a few months before a major surgery, such as gender reassignment surgery.

The Effects Of Estrogen On Your Skin

Skin Dryness

Having acne and facial hair may be common for those who are taking testosterone, but it’s the opposite for individuals taking estrogen. This hormone slows the growth of facial hair and it reduces sebum production, which results in softer and smoother skin. However, if your skin is already dry to begin with, then you may experience itching and dry skin.

Fortunately, it’s quite easy to deal with this problem at home. Applying unscented moisturizers, taking short showers instead of baths, and using hydrating skin products can help to alleviate skin dryness.

Having Thinner And More Sensitive Skin

As you continue with your hormone replacement therapy, you may notice that you get cold easily or that your skin feels more sensitive than usual. This is another effect of taking estrogen, and it’s possible that a slight change in temperature or too much pressure on the skin can feel unsettling at first.

You may also notice that your skin is more prone to bruising and cuts in the first few weeks of taking estrogen, and it’s likely that you’ll sweat less too. Hormonal changes can also cause stretch marks, and while they’re quite difficult to get rid of, you can improve stretch marks by moisturizing your skin daily with a rich body cream, lotion, or pure shea butter.

The rate at which your changes take place during the transition period can involve a lot of factors such as your genes, your overall health, and the age at which you start hormone replacement therapy. For some, the changes may come on rapidly, while others may see changes in their skin at a slower rate. Because everybody is different, it is crucial not to compare your experience with that of others. If you’re unsure of how to cope with certain skin changes, consult your healthcare provider and dermatologist with regards to skin problems or issues that may arise during your transition period in order to keep your skin healthy and looking its best during this time.

Sources:

1. New Estimates Show that 150,000 Youth Ages 13 to 17 Identify as Transgender in the US, The Williams Institute UCLA School of Law, https://williamsinstitute.law.ucla.edu/research/transgender-issues/new-estimates-show-that-150000-youth-ages-13-to-17-identify-as-transgender-in-the-us/

2. Folliculitis, Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/folliculitis/symptoms-causes/syc-20361634

3. Information on Testosterone Hormone Therapy, UCSF Transgender Care, https://transcare.ucsf.edu/article/information-testosterone-hormone-therapy

4. Transgender Skin Care: Smoothing The Road To Transition, First Derm, https://www.firstderm.com/transgender-dermatology/

5. My Male To Female Transition: How Estrogen Changed My Life, Ravishly, https://ravishly.com/2016/02/02/my-male-female-transition-how-estrogen-changed-my-life

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