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Hormones and acne in men: what drives it and what treats it

By Nicki Wilson in Accutane · Published October 7, 2026 · Updated October 9, 2026

Hormones and acne in men: an unlabeled white tube with a navy cap, a dab of cream, a safety razor on a folded towel, a white foaming pump bottle, a wooden bowl and a sink

Quick answer: Hormones and acne in men are linked mainly through androgens, the hormone group that includes testosterone. The American Academy of Dermatology says during puberty androgens enlarge the skin’s oil glands so they make more oil. In mild to moderate acne, blood androgen levels are often normal, and MedlinePlus says testing isn’t needed in most cases. Spironolactone, a hormone-blocking pill, isn’t prescribed to treat acne in men. A board-certified dermatologist uses other treatments for men instead.

Most men who search this want to know whether their testosterone is too high, or whether a hormone pill would fix their skin. Many also wonder whether something they take is making it worse. This article answers each one with what the American Academy of Dermatology, FDA drug labels, and published studies say. It’s also honest about what nobody has proven yet.

The Goal Is Clear is an acne care service with a path built for men called BruhRX. That gives us a stake in this topic, and we’d rather say so up front. The medical claims below link their sources, so you can check each one yourself. BNG Health Services, LLC operates the brand and is not the prescribing physician.

What hormones cause acne in men?

Androgens are the hormones most closely tied to acne in men, and testosterone is the one most people know by name. The American Academy of Dermatology explains that during puberty androgens increase the size of the skin’s oil glands, and those glands start making more oil, which can clog pores. The academy says hormones may explain why acne is so common in teenagers.

The oil itself isn’t the enemy, because your skin needs some of it. MedlinePlus, the patient site of the National Library of Medicine, says each pore opens to a follicle, which contains a hair and an oil gland. When oil and skin cells block that opening, you get a plug, which is a whitehead or a blackhead. If bacteria get trapped in the plug, your immune system may react, causing pimples. Acne deep in the skin can cause hard, painful cysts.

The academy says scientists are still working out why some people’s skin breaks out more, and that hormones likely play a role. A review of androgens and acne calls androgen-driven oil production the key step in how acne develops.

Hormones aren’t the only factor in the mix. The same MedlinePlus page notes that acne tends to run in families, and it lists heavy sweating, humidity, greasy hair products, and rubbing the skin as triggers. If your gym shirt, your helmet strap, or your pomade sits on the spots that break out, that’s useful to tell whoever reviews your skin.

Do men with acne have high testosterone?

In mild to moderate acne, often they don’t, and that surprises a lot of guys. A review of androgens and acne indexed by the National Library of Medicine reports that higher blood androgen levels go along with severe nodular acne in men and women. The same review says those levels are often within the normal range in mild to moderate acne. Its authors ask whether the oil glands of people with acne make extra androgen locally, inside the skin itself.

In plain words, your skin can keep breaking out while your blood androgen levels look normal. MedlinePlus says testing isn’t needed in most cases of acne, and that a clinician can diagnose acne by looking at your skin. A dermatologist may still order labs when something else in your history points that way, and that’s their call.

Stress can push androgens up too. The American Academy of Dermatology says the body makes more androgens in response to stress, and those hormones stimulate oil glands and hair follicles. The academy also says women tend to get adult acne more often than men do. So a breakout in your late 20s or 30s deserves a real diagnosis, not just a stronger wash.

Can testosterone, steroids, or gym supplements cause acne?

Yes, androgens your body didn’t make on its own can trigger acne, according to the sources below. MedlinePlus lists certain medicines, including steroids and testosterone, among the things that may trigger acne. Anabolic steroids, which some lifters use without a prescription, have their own research trail.

Testosterone, steroids and gym supplements and acne in men: an unlabeled whey protein tub, scoop and shaker bottle on a gym locker room bench

The gym link has been studied too. A German paper on anabolic steroid abuse and bodybuilding acne reports that acne occurs in about 50 percent of people misusing these drugs. Its authors call acne an important clinical sign of that use, especially in young men aged 18 to 26. They also note that steroid misuse can trigger severe forms called acne conglobata and acne fulminans.

Supplements can be part of it too, even ones sold as harmless. A review of acne linked to dietary supplements names whey protein, high-dose vitamin B6 and B12, and iodine, which it says may be related to kelp supplements. It also names muscle-building products that may be contaminated with anabolic steroids. The authors say acne tied to a supplement generally clears once the supplement is stopped. They also urge dermatologists to ask acne patients directly about supplement use.

If a prescribed medicine might be behind your breakouts, the American Academy of Dermatology says to keep taking it and talk with the doctor who prescribed it. Don’t stop testosterone therapy on your own to clear your skin. Whatever you take, from a shaker of whey to a cycle you’d rather not mention, tell the dermatologist who reviews your case. Nobody can account for a product that never gets mentioned.

Why aren’t hormone therapy pills used for acne in men?

The hormone pills the American Academy of Dermatology lists for acne are treatments for women. The American Academy of Dermatology states that spironolactone isn’t prescribed to treat acne in men due to side effects. The academy adds that men have developed breasts while taking it for acne. The other hormonal option the academy names for acne is the birth control pill, which is a women’s treatment.

This is where a lot of online advice goes wrong for male readers. The American Academy of Dermatology’s 2024 acne guideline does give conditional recommendations to combined oral contraceptive pills and spironolactone. The academy’s own patient page presents both as treatments for women, and it says spironolactone isn’t prescribed to treat acne in men.

Our own men’s page says the same thing in its own words. Our acne treatment for men page states that “Spironolactone is generally not used for male acne because of anti-androgen effects that can cause feminizing side effects”. It adds that the board-certified dermatologist will choose other options. If an online service offers a man spironolactone for acne, ask for a different plan.

What treats hormone-driven acne in men?

A board-certified dermatologist treats hormone-driven acne in men with the options the 2024 guideline grades highest, and none of them are hormone pills. The American Academy of Dermatology’s 2024 guideline makes strong recommendations for benzoyl peroxide, topical retinoids, topical antibiotics, and oral doxycycline. Its good practice statements add combining topical treatments that work in different ways and limiting systemic antibiotic use.

One prescription cream is labeled as an androgen receptor inhibitor, and it isn’t a pill. The FDA label for Winlevi (clascoterone) cream calls it an androgen receptor inhibitor for treating acne in patients 12 years and older. Across its two main trials, 38 percent of the people were male. The same label says its exact mechanism in acne is unknown. It also warns that hypothalamic-pituitary-adrenal (HPA) axis suppression was observed and may occur during or after treatment. The 2024 guideline gives clascoterone a conditional recommendation, so it’s a choice your dermatologist weighs, not a default.

When acne is severe or scarring, isotretinoin is a treatment that acts on the oil gland itself. The guideline strongly recommends oral isotretinoin for acne that is severe, that causes scarring or psychosocial burden, or that has failed standard oral or topical therapy. The Accutane® prescribing information says improvement in nodular acne goes along with a drop in oil output. The label adds that this drop reflects smaller oil glands, and that it’s temporary and tied to the dose and length of treatment.

Which step fits is your dermatologist’s call. If you want the details on a specific step, we’ve written about doxycycline for acne and Accutane® versus tretinoin. If testosterone is your worry about isotretinoin itself, read our article on Accutane® and testosterone. The side effects of Accutane® for men are covered in their own article.

What does iPledge look like for a man on isotretinoin?

Every man prescribed isotretinoin in the United States enrolls in iPledge, the FDA-approved safety program for the drug. MedlinePlus confirms that men also need to be enrolled, even though the program’s strictest rules exist to prevent pregnancy. A man who cannot become pregnant enrolls as a patient who cannot become pregnant, and the Accutane® labeling lists monthly pregnancy test entries only for patients who can become pregnant. Patients who can become pregnant follow stricter rules, and the FDA requires their pre-treatment pregnancy tests in a medical setting.

iPledge for men on isotretinoin: a coiled navy strap, folded white gauze, a cotton ball, a small beige bandage strip and a navy bandage roll on a padded white chair seat

The monthly rhythm is simpler for men, and it still has a clock you can’t ignore. Until the November 15, 2026 changes take effect, the FDA-approved labeling says a patient who cannot become pregnant must get the prescription within 30 days of the office visit. The same labeling has the prescriber confirm patient counseling in iPledge each month, also until that date. A man who cannot become pregnant has no monthly iPledge test or form of his own. Our iPledge page explains that, until November 15, 2026, the prescription is released after the prescriber confirms counseling.

Those rules are about to change, and the date matters. The FDA approved changes to iPledge on February 9, 2026 and moved the planned start to November 15, 2026. Once they take effect, the FDA says there’s no longer a 30-day window for patients who cannot get pregnant, and monthly counseling documentation for them is no longer required. As of October 7, 2026, those changes aren’t in effect, so the current rules apply until the November 15, 2026 changes take effect.

From running these courses every day, a few things trip men up more than anything clinical. The lab order is its own document, separate from the visit note, and people regularly show up at the draw site with the wrong paper. In our experience iPledge sends no warning email when a window has been missed, so the dates need a system that tracks them. Our iPledge Concierge exists to track those dates. The last month catches people too, because the course isn’t over until someone picks up the final fill.

How does the BruhRX path work for men?

BruhRX is The Goal Is Clear’s acne path for men, and a board-certified dermatologist licensed in your state reviews every case. Our men’s FAQ says the company “does not use nurse practitioners or physician assistants for acne diagnosis or prescription decisions”. Plans can include prescription topicals, oral antibiotics, or Accutane® with an iPledge concierge when the board-certified dermatologist agrees it fits.

You take a short quiz, upload clear photos of your skin, and choose a Clear Course plan. A board-certified dermatologist reviews the case within 24 hours, and you see their name, photo, and state license before treatment starts. If treatment is prescribed, the partner pharmacy runs your insurance on the medication, or quotes a cash price if you’re uninsured, then ships it. A prescription is never guaranteed, and if Accutane® isn’t right for you, the board-certified dermatologist says so and says why.

The Clear Course is cash-pay, labs aren’t inside the Clear Course price, and some eligible insured patients pay as low as $0 for the prescription. Plan prices are on the pricing page, and the split between care, medication, and labs is on our page about what Accutane® costs. For men on Accutane®, the iPledge Concierge tracks windows, testing cadence, and refill timing through the course. Accutane® is available in all 50 states plus Guam, with state eligibility confirmed at intake. Teens 13 and up can enroll with a parent or guardian’s consent.

Common questions about hormones and acne in men

What hormone causes acne in men? Androgens are the hormones most linked to it, and testosterone is the most familiar of them. The American Academy of Dermatology says that during puberty androgens enlarge the skin’s oil glands and make them produce more oil, which can clog pores. A review indexed by the National Library of Medicine found blood levels of these hormones are often normal in mild to moderate acne.

Should a man get his testosterone checked for acne? For mild to moderate acne, usually not, because a review of androgens and acne found blood levels often normal there. MedlinePlus says testing isn’t needed in most cases of acne. A dermatologist may order labs if your history suggests another cause, and that decision is theirs to make.

Can a man take spironolactone for hormonal acne? It isn’t prescribed for that purpose in men. The American Academy of Dermatology says spironolactone isn’t prescribed to treat acne in men because of side effects, including breast development. A board-certified dermatologist chooses options such as topical retinoids, benzoyl peroxide, doxycycline, clascoterone cream, or isotretinoin instead.

Can testosterone therapy cause acne in men? It can, since MedlinePlus lists testosterone and steroids among medicines that may trigger acne. Keep taking a prescribed medicine and talk with the doctor who prescribed it, which is what the American Academy of Dermatology advises. Tell your dermatologist about it too, so the acne plan accounts for it.

Does hormonal acne in men go away on its own? Acne in general often does, since MedlinePlus says most of the time acne goes away after the teenage years, though it may last into middle age. Acne that scars or keeps coming back is a reason to see a dermatologist rather than wait. Our article on who qualifies for Accutane® explains when a dermatologist considers isotretinoin.

When should a man see a dermatologist about hormonal acne?

See a dermatologist when drugstore products haven’t helped after several months, or sooner if your acne leaves scars. MedlinePlus says to contact your provider when self-care and over-the-counter medicine don’t help after several months. It also warns that severe acne left untreated can scar. A hormone you can’t change isn’t a reason to put up with breakouts, because the guideline’s strongly recommended acne treatments aren’t hormone pills.

Bring a short list to that first visit, wherever you go. Write down every medicine, supplement, and gym product you take, how long the acne has lasted, and what you’ve already tried. If you’d like a board-certified dermatologist to look at your case online, take the two-minute quiz or read more about getting Accutane® online first.

This article is general information, not medical advice. A prescription is never guaranteed, and treatment decisions stay with the board-certified dermatologist who reviews your case. Accutane® is a registered trademark of its respective owner, and isotretinoin is the generic name. Winlevi is a trademark of its respective owner. The Goal Is Clear is operated by BNG Health Services, LLC, which is not the prescribing physician; independent board-certified dermatologists prescribe.

Sources

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General information from published sources, not medical advice. Your dermatologist makes every treatment decision after reviewing your case. The Goal Is Clear is operated by BNG Health Services, LLC, which is not the prescribing physician.

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