Acne on TRT - A low dose Accutane?

[Ragnar73]

Hello gents.

I have annoying problems with acne on scalp and some on face too.
Not horrible, but I keep getting it, for quite a while now and its really bumming me out at my age.

About me.
47 yo.
120kg. about 15% bf...I think?
I use 250mg Test E every week (high level, I know).
Work out 4 days a week. For 30+ years now.

I was on Accutane and it helped, but some time after, the acne started coming back.
There seems to be a relation to dairy products and maybe gluten?
So I have cut both 95% out of my diet.
I think it helped, but not enough.

Here the gyms are closed, for months now (corona) and I train some at home in stead.
In that time the acne problem picked up.
I dont sweat like I usually do in the gym. Might be that?

I have tried ALL the usual solutions

1. New pillowcase every nigh (use a tshirt over pillow).
2. Benzoyl Peroxide.
3. Tea Tree Oil.
4. Zinc soap.
5. Shower twice a day.
6. Antibiotics.
7. Topical cremes.

etc.
.....No permanent solution.

I used to do a cycle of steroids every summer before I started TRT.
Even efter 8 months off Testosterone after every summer, I still got the acne, so it might not be TRT related?

I have 200, 20mg Accutane caps on hand right now and consider using 20mg EOD for the next year or so.
Have any of you tried using Accutane like that?

Do YOU have any advice that helped you?

Thank you for reading this.

 

[Fernando Almaguer]

same struggle. lowering dose, saunas, all the typicals, showers, ect... seem to help some but no solution so far and its been 5 years for me.

cutting carbs and lowering inflammation might be the next go to for me. Also some lowering of e2 by ais helps my acne on shoulders. Not sure why!

maybe Accutane is a last resort.

 

[madman]

Hello gents.

I have annoying problems with acne on scalp and some on face too.
Not horrible, but I keep getting it, for quite a while now and its really bumming me out at my age.

About me.
47 yo.
120kg. about 15% bf...I think?
I use 250mg Test E every week (high level, I know).
Work out 4 days a week. For 30+ years now.

I was on Accutane and it helped, but some time after, the acne started coming back.
There seems to be a relation to dairy products and maybe gluten?
So I have cut both 95% out of my diet.
I think it helped, but not enough.

Here the gyms are closed, for months now (corona) and I train some at home in stead.
In that time the acne problem picked up.
I dont sweat like I usually do in the gym. Might be that?

I have tried ALL the usual solutions

1. New pillowcase every nigh (use a tshirt over pillow).
2. Benzoyl Peroxide.
3. Tea Tree Oil.
4. Zinc soap.
5. Shower twice a day.
6. Antibiotics.
7. Topical cremes.

etc.
.....No permanent solution.

I used to do a cycle of steroids every summer before I started TRT.
Even efter 8 months off Testosterone after every summer, I still got the acne, so it might not be TRT related?

I have 200, 20mg Accutane caps on hand right now and consider using 20mg EOD for the next year or so.
Have any of you tried using Accutane like that?

Do YOU have any advice that helped you?

Thank you for reading this.

This is way too high a dose for trt which would have your TT/FT let e2 levels through the roof!

Most men on trt are injecting 100-200 mg/week (considered high end) and even than many would never need 200 mg/week to achieve a healthy FT level.

Some can even hit higher TT/FT levels using <100mg/week!

Post full set of labs?

You are over medicated and it is clear as day:

I have annoying problems with acne on scalp and some on face too.
Not horrible, but I keep getting it, for quite a while now and its really bumming me out at my age.

Bet your FT level is through the roof!

 

[madman]

Look into lowering your so-called trt dose before f***ing with Accutane.

 

[madman]

Sure some men may even struggle with oily skin/acne when using a
a lower dose of T and running lower TT/FT levels but this is usually in the genetically prone and far from common.

Most men on trt struggling with acne are running way too high TT/FT levels.

Your issue is most like from sky-high FT levels!

 

[madman]

Post full set of labs!

 

[drkelp]

Nizoral kicks butt on this... I'm at 280mg cyp/wk. Some guys just seem to require this much, 3+ years now, no idea why.

 

[madman]

Nizoral kicks butt on this... I'm at 280mg cyp/wk. Some guys just seem to require this much, 3+ years now, no idea why.

Sure some men that would be considered outliers may require slightly higher doses >200 mg/week but this is very rare.

Even then what is your SHBG and where do your trough TT/FT levels sit on such dose?

Unless you have used the most accurate assays when testing for TT (LC/MS-MS) let alone FT using the gold standard Equilibrium Dialysis or Ultrafiltration (next best) then you have no idea where your FT level truly sits on such protocol.

 

[madman]

Post labs?

 

[Gianluca]

my 2 cents, beside perhaps your dose being too high, check Progesterone levels

 

[Ragnar73]

Post labs?

Hi madman.

I cannot get labs in Denmark.
Medicare is "free" but comes with limitations
Convincing the doctor that you need thoose labs is no easy task.

When I did cycles, back in the day, of 750+ Testosterone EW I had no acne.

Like i also write, then i had problems before TRT, Before my summer cycle.

I could be non T related?

 

[Ragnar73]

Nizoral kicks butt on this... I'm at 280mg cyp/wk. Some guys just seem to require this much, 3+ years now, no idea why.

How do you use it? Nizoral?

 

[Ragnar73]

same struggle. lowering dose, saunas, all the typicals, showers, ect... seem to help some but no solution so far and its been 5 years for me.

cutting carbs and lowering inflammation might be the next go to for me. Also some lowering of e2 by ais helps my acne on shoulders. Not sure why!

maybe Accutane is a last resort.

I feel your struggle man

 

[drkelp]

Nizoral is a topical antifungal. I discovered a long time ago for use with Sebhorretic dermatitis. It also wipes out acne pretty well. Ask your doctor.

 

[Ragnar73]

Nizoral is a topical antifungal. I discovered a long time ago for use with Sebhorretic dermatitis. It also wipes out acne pretty well. Ask your doctor.

Thank you for your input, drkelp

 

[Arcane]

my 2 cents, beside perhaps your dose being too high, check Progesterone levels

Does low progesterone cause acne

 

[Ragnar73]

Update!

I now use 125mg Test E E6D.
That still caused acne problems so for now I use below protocol to have clear skin:

20mg Accutane EOD.
3x2g L-carnitine ED.
3x500mg Vitamine B5 ED.

I am gonna run out of accutane eventually and hope the B5/L-carnitine mix will be enough to keep the acne away.

Ps. and i wash with Emu oil soap everyday.

 

[Gman86]

Does low progesterone cause acne

Not directly. But when progesterone levels are low DHT and E2 run a little more wild than when natural. Natural guys usually have a good amount of progesterone, and progesterone opposed E2 and DHT, and keeps the conversion of Test into E2 and DHT in check. Progesterone is mainly made in the testicles, so when we go on exogenous testosterone, most guys will have very low progesterone levels, and therefore less inhibition of test converting into E2 and DHT, and therefore can increase the chances of acne

 

[Gman86]

@Ragnar73 Sounds like ur on the right track as far as getting ur acne under control. The main thing is definitely diet and lowering inflammation. So the main things are zero/ very little gluten, and zero/ very little crap dairy. U can do dairy as long as it’s grassfed, raw (unpasteurized), unhomogenized, and preferably organic. But non-grassfed, pasteurized dairy is horrible for u, and will increase inflammation like crazy. Obv there’s a ton of other ways to reduce inflammation through diet, but those are two of the biggest culprits.

As far as accutane goes, ur kind of on the right track. But u want to stay away from synthetic vitamin A, it’s basically a poison to the body in that form. Vitamin A is definitely a great remedy for acne however. So what u want to do is stick to the most bioavailable and natural form of vitamin A that the body prefers, which is retinol. It’s mainly found in animal products. The #1 source being liver. I personally eat raw liver twice per week. About 7oz total per week. I get grassfed beef liver from my local farmers market. Just cut it up in tiny pieces and swallow it down with water, don’t even chew it. Been doing this for years. If ur opposed to eating liver, the next best thing is taking a desiccated grassfed beef liver supplement. They come in capsules with the desiccated ground up beef liver in them. The brand I recommend is ancestral supplements. Whichever one u get just make sure they use liver from cows that are grassfed year round, and are grass finished. Make sure they never intake any grains or crap food. There’s obv other sources of retinol, but in amounts nowhere near liver. But I think pastured egg yolks have a bit, and I think some fish like salmon have some retinol. Just look up top sources of retinol on Google. I think grassfed cheese has a decent amount of retinol as well.

The member above mentioning progesterone is spot on as well. Progesterone is produced mainly in the testicles, so most of us have very low levels while on TRT. Progesterone opposes E2 and DHT and controls the conversion of test into E2 and DHT. So getting ur progesterone levels into a healthy range should help with any acne issues

And the last thing to look into is DIM and Calcium D-Glucarate. Not the biggest fan of DIM as it’s also an anti androgen, and inhibits MTOR and IGF-1 production, which means it inhibits growth. And if building lean muscle tissue is of importance to u, DIM doesn’t seem like the best thing to be taking. But CDG seems to control E2 and acne for a lot of men on TRT, without the growth inhibiting aspect. Here’s a quick video of a guy talking about how both help control his acne while on TRT

 

[Gman86]

Here’s a video Dr. Paul Saladino just put out a few days ago if u want to learn a bit more about retinol

And here’s a whole channel where a doctor basically says all forms of vitamin A are poison. But it seems like he doesn’t truly understand the differences between synthetic vitamin A and retinol. But just wanted to share his channel to try and help u understand the negative effects accutane is unfortunately doing to ur body in the background. Definitely try and drop it asap. Ur doing much more harm than good while using that stuff