Acne is a common challenge for transgender and gender diverse (TGD) patients, especially those undergoing hormone therapy. Whether they are starting testosterone or estrogen, acne can have a significant impact on mental health. Studies show that more than a third of TGD individuals with acne have a history of depression or suicidality, making it essential for prescribers to address acne early.

For patients on testosterone, acne prevalence can jump from 6.3% to as high as 80%, particularly in younger patients with higher testosterone levels. Proactive measures, such as starting topical retinoids or benzoyl peroxide washes before acne worsens, can prevent complications. On the estrogen side, while anti-androgens like spironolactone can help with acne, they may lead to dryness, which requires careful management.

Acne is more than a cosmetic concern for TGD patients—it’s a quality-of-life issue. By addressing acne early, you can prevent scarring, improve mental health, and ultimately enhance patient outcomes. Plus, your patients will thank you for helping them avoid the dreaded "tretinoin face."