Dermatological adverse effects of testosterone replacement therapy: a scoping review of the literature.

Acne was the most frequent dermatological adverse effect of TRT, affecting 0.6% to 9.1% of participants across included studies.

• Acne incidence ranged from 0.6% to 9.1% across all included studies.
• The lowest incidence of acne was observed with oral formulations.
• Injectable formulations were generally associated with higher rates of acne than topical or oral preparations.
• Ten studies met eligibility criteria: eight prospective clinical trials and two retrospective chart reviews published between 2006 and 2025.

Pruritus occurred in up to 10.0% of TRT recipients, representing one of the more common cutaneous adverse effects.

• Pruritus was reported in up to 10.0% of participants across the included studies.
• This was identified through a scoping review of studies reporting dermatologic adverse events related to TRT in adult men.
• Databases searched included PubMed, Scopus, and Cochrane.
• Data were extracted and summarized narratively due to heterogeneity in reporting.

Rashes and abnormal hair growth each occurred in up to 5.3% of TRT recipients.

• Rashes were reported in up to 5.3% of participants.
• Abnormal hair growth was reported in up to 5.3% of participants.
• These findings were consistent across the ten included studies.
• Most studies lacked standardized reporting or detailed management strategies for these adverse events.

Injectable TRT formulations were generally associated with higher rates of acne and systemic reactions compared to topical or oral preparations.

• Injectable formulations showed higher rates of acne and systemic reactions than topical or oral preparations.
• Oral formulations were associated with the lowest incidence of acne (as low as 0.6%).
• Dermatologic side effects varied by delivery method and patient susceptibility.
• The review included studies across multiple TRT delivery methods to allow for cross-formulation comparison.

Dermatological adverse effects of TRT are underreported in the literature compared to cardiovascular and oncologic risks.

• The review was motivated by the observation that cutaneous complications are underreported relative to other TRT adverse effects.
• Most included studies lacked standardized reporting or detailed management strategies for dermatologic adverse events.
• Only ten studies met eligibility criteria across PubMed, Scopus, and Cochrane databases.
• The authors identified a need for future research to standardize dermatologic outcome measures and explore prevention and management strategies.

Dermatological side effects of TRT, though often considered non-severe, can significantly impact patient satisfaction, adherence, and quality of life.

• The review emphasizes that cutaneous reactions carry clinical significance beyond their perceived severity.
• Patient satisfaction, adherence, and quality of life were identified as outcomes affected by dermatologic adverse events.
• The authors called for clinician awareness and patient counseling regarding these effects.
• The scoping review methodology was used to synthesize existing evidence and inform clinical practice.