Short answer: Yes, though in the label trials it affected a small share of men. Acne was reported in 5.2% of men in the 84-week Aveed study and 2.7% in a 1-year Xyosted study. The Depo-Testosterone and testosterone enanthate labels list acne among androgen side effects without a rate. Androgens are well known to raise oil (sebum) output from the skin, and extra oil is a major factor in acne. Women exposed to testosterone gel can break out too.
Each label reports side effects from its own trials, so the numbers below come from different products, doses and study lengths. The labels themselves say rates from one drug's trials cannot be directly compared with another's.
| Product | Study in the label | Acne |
|---|---|---|
| Aveed (undecanoate, into the muscle every 10 weeks) | 84 weeks, 153 men | 8 men (5.2%); the most common side effect, and one of the reasons men stopped |
| Xyosted (enanthate, under the skin weekly) | 1 year, 150 men | 4 men (2.7%) |
| AndroGel 1.62% (gel) | Open-label period, 191 men | Reported in 2% or fewer; also listed in reports after approval |
| Kyzatrex (oral undecanoate) | 6 months, 155 men | Not in the 2%-or-more table; one man (0.8%) left the study because of acne |
| Depo-Testosterone (cypionate) | No trial table | Listed with seborrhea (oily skin), no rate |
| Testosterone enanthate (generic vial) | No trial table | Listed, no rate |
The labels for Jatenzo, Tlando and Natesto do not name acne among their side effects. That does not mean it cannot happen on them, only that it was not reported often enough in their trials to be listed.
Acne starts in the oil glands of the skin, called sebaceous glands. A 2004 review by Zouboulis says androgens, the hormone group testosterone belongs to, are well known for their effect on how much oil these glands put out, and that more oil is a major factor in acne. A 2019 review by Clayton and colleagues lists androgens among the main hormones that control these glands.
This fits what the older labels list side by side. The Depo-Testosterone label groups "seborrhea, and acne" under skin effects; seborrhea means oily skin. Inflammation and other factors play a part in acne too, so more oil alone does not explain who breaks out and who does not.
None of the labels say whether acne is linked to a higher dose or a higher blood level, or how long it tends to last. If it starts after beginning treatment or after a dose change, those dates are useful to note.
Testosterone gel can pass to other people through skin contact with the area where it was applied. The AndroGel 1.62% label says changes in body hair, a significant increase in acne, or other signs of male hormone effects in an adult woman should be brought to a doctor's attention, along with the chance of exposure to the gel. Its Medication Guide lists "an abnormal increase in pimples (acne)" as a sign in women.
The guide says to stop using the gel and call a healthcare provider right away if a woman or child shows these signs after possible contact. For children it lists signs such as an enlarged penis or clitoris, early pubic hair, and aggressive behavior.
The generic testosterone enanthate label, which also covers use in some women with advanced breast cancer, lists acne among the signs of masculinizing effects to watch for in women on treatment.
The labels do not give acne-specific steps; they list it as a side effect to report. Things worth writing down for your prescriber, or a dermatologist if you see one:
Dose Track keeps each dose with its date and lets you log side effects and lab results next to them, so the timeline is easy to show at the next visit.
Read more on Dose Track: Aveed side effects · Xyosted side effects · AndroGel side effects · Depo-Testosterone side effects · Skin and hair · TRT symptom tracker: what to log