Acne Cures, Let's Hear Them!

On TRT, originally prescribed 26mg ED (182mg/wk) but dropped down to 20mg/day for 140mg/wk. I take care of my face, washing twice daily, exfoliating, keeping hands clean, trying not to pick at my face, etc. Even use Tretinoin cream to help skin turnover rate… doesn’t ever go away. This hasn’t changed while on TRT. I’ve had acne pretty much as long as I can remember (29 y/o now) but it got worse at 180mg/wk dose, spreading to my shoulders and back in much worse fashion than ever before.

Frequent showers, exfoliating, even washing my back and shoulders immediately post-workout still doesn’t stop me from getting 2-3 new pimples a day (not to mention blackheads).

Enough of my sob story.

I’ve read about Accutane, and have some concerns about it (the same concerns everyone has about Accutane) but also that the skin on my calves is fucking DRY. No amount of moisturizer on earth will save them… So going through an Accutane treatment would likely make it even worse. Haven’t ruled it out, just curious if there’s other solutions - like a topical version of Accutane so I could control where it affects, instead of making it systemic.

Are there any alternative cures? If not, perhaps a low-cost, effective and SAFE treatment? This is just one of those things that everytime you google, it spams you with people trying to make money off you - instead of solutions to the problem. I’ve seen some stuff regarding Copper Peptides as well, but I assume those are treatments, not cures.

Anyways, this isn’t specific to TRT, I just want to manage my acne so I can blast if I choose to blast, or at least run a somewhat normal TRT dose without looking like a pubescent teenager… I don’t want to get into my 30s and still have acne troubles.

I suggest trying 100mgs a day of hyaluronic acid. Give it a couple months. It might not work, but I felt it helped my rosacea a few years back.

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the cure depends on if it is hormonal or bacterial.

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How would one determine this? I’d assume hormonal because the back acne got worse when I started TRT, but the facial acne is more or less the same as it always has been… still, I’ve kept on top of a good facial regimen for years and it only ever got slightly better.

No doubt that accutane has its share of horror stories, but for me it worked incredibly well. I was prescribed accutane by a dermatologist in my 20’s for acne on my back and shoulders. I took it for 3 months and haven’t had any acne, face or body, since.

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That sounds pretty rough.

I’ve never been there but I just recently bought several skincare products bc I upped my carb macros and caloric total…

It absolutely tore up my face, dried it out and now I have more acne…I can’t make this shit up.

I didn’t really have any acne (other than a pimple here and there every other week) prior but figured I needed to start to “improve hygiene” and keep my face clear of oils but I kind of regret it. The stuff I used is suppose to be for sensitive skin too…go figure…

The more I’m looking up “insulin resistance” on Google, reading research articles, studies and others personal experiences, I’m realizing that sugar is or was at one point THE PROBLEM.

Remember when we all were told that there’s no cure for male patern baldness and we don’t know why men get it…

Then we were told that MPB comes from fluctuating hormone levels like testosterone and estrogen…

Go upstream 1 more level and realize that sugar (alcohol counts) at one point or another has caused damage, toxicity or inflammation to either your liver, pancreas, kidneys or all 3. You can try mega dosing some liver, pancreas, kidney support, take fish oil and any other “skin happy” supliments…

Maybe…maybe…that’s all 100% grade A bullshit but when I look back, that’s exactly the reason for all my problems. Your liver is suppose to regenerate and repair but what if can’t bc something in your diet, lack of sleep, lack of potassium or your system won’t let it because it’s lost the ability to?

Why do kids get acne?

It’s because first thing in the morning right after they wake up is consume 80+ grams of sugar from cereal, toast, pancakes, syrup, waffles, juice, milk, Starbucks, poptarts, snacks, muffins, fake bacon, maple flavored sausage, etc…

It’s all bullshit “food”. None of that is good for anyone…period.

I don’t think anyone has NEVER had pizza, ice-cream, pie, cake, cookies, juice, quesadillas, cereals, Gatorade, energy drinks, ALCOHOL…you get my point.

So idk, I would start there. I’d be interested to know what your macros are percentage wise. How your digestive system is running, how you’re sleeping.

If you’re on gear / have any kind of acne, I’m assuming you’re eating super clean and not like a complete asshole…but hey, we don’t study this stuff in highschool and doctors today can be pretty f-ing pathetic.

Macros favoring protein and fats vs carbs ~20-25% may help. Also, eating fish like salmon for at least 15-20% of your meals throughout the week can help insilin resistance issues/symptoms. I hate to say it…but red meat only makes it worse… yes…even super lean red meat unfortunately.

The only other things I could recommend is finding a solid place for a steam & hot sauna and go to it as often as possible. I have an epic rec center right next to Armbrust Pro gym in CO that gives me a huge discount for living close so I get a pool (chlorine help with acne too), hot tub, gym, track, courts, 2 yoga rooms and 2 different saunas for $35/ month.

I guess you could work a little to get some sun to the affected areas, either outside or a quality tanning establishment with high pressure bulbs (or whatever is the best & healthiest set up). I think some places even have red light therapy beds which can help improve derma and sub-derma blood flow / health.

Maybe you can get some exfoliating gloves for the shower (usually sold just for women) but the ones I got at Target worked for me. You get a WAY better and more consistent exfoliation and clean with 2x 5 finger exfoliating gloves ( for $5) than a damn lufa or hand towel…if anyone’s even still using those anymore.

I wash my back and anywhere with acne sprouting potential with this product and the gloves. For heavy acne, I’d let it sit for a minute before rinsing it off. Saw a dermatologist recommend it for a skincare routine to address yeast or bacteria on skin.

It can dry out your skin so I use a soap that’s pretty moisturizing afterwards too.

I know there are oral medications to take but I’m not familiar with those enough to mention them.

Idk if any of that helps to think about and you prolly hate to hear it bc it’s WAY EASIER to just take a pill to solve your problem.

Short of an acid bath in Agent Orange…that’s all I’ve got…

I wish you the best though, good luck my man!

Post back when you’ve got a solution and everything’s all cleared up!!!

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An average day for me (when cutting):


^everything here is just trace sugars… not 0 sugar, but only those i can’t really avoid. Not entirely sold on it being sugar-related but it’s a valid point. I don’t do too much red meat either, most weeks it’s none, but occasionally (like once every two weeks) I’ll have a steak that’s ~800cals.

Have those, use them regularly.

Do this as well.

I also use hyaluronic acid about twice a week in the shoulders and face… not much help.

Have considered it being an estrogen problem, but I’m not sold on it enough to introduce an AI if not needed… which this is the only item that would warrant it’s introduction. I think it more likely to be test related as my levels are probably still at the top end of both TT and fT at 140mg/wk.

It’s worth noting that my cortisol levels are likely high 24/7 and there’s not much to be done about that… high stress job, full time school, finances and a young family mixed in with training and leaning out. FWIW, I’m a thibbs type 3 and secondary 1A, meaning my cortisol is going to be my downfall, but I’ve reduced what i can regarding stress.

Not trying to be a naysayer, I’m just saying that I’ve done about as much at I’m willing to do with lifestyle changes, and i don’t think adding in more is going to result in a significant change. Hence why I’m looking for a literal pill to solve my problem.

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I get it…

How’s your digestion?
Any digestion related symptom other than grade A+ perfect poops? lol serious questions tho
Also, how’s your hairline? Solid, receding, nonexistent?

At only 2000 calories per day, treat carbs as your “enemy” and put fats higher up on the pedestal. You can still eat lots of leafy vegies…like a lot and up your fiber intake to help keep carbs low while still getting a great volume of food, vitamins and minerals naturally (from food). That said, your body isn’t going to pull anything from the food you’re eating unless your pancreas is running in peak performance by outputting proper amounts of amylase, lipase and protease. If your pancreas IS NOT functioning (to help create solid brick fully formed perfect grade A+ poops w/ no wiping required) then you can supplement while things work themselves out. I personally like Vital Nutrients Pancreatic Enzymes with every meal.

Also, what program are you doing with those macro percentages? Correct me if my math is fucked but…

Protein: 233 grams 932 Calories 55%
Carbs: 147 grams 588 Calories 34%
Fats: 47 grams 423 Calories 11%

Sheesh…

I’ve never seen those macro numbers before for gaining, maintaining or cutting but again, I could be wrong.

With that much protein (percentage wise), without a decent amount of fat, you’re going to spike the shit out of your insulin and if done long enough, you could disrupt the feedback to your pancreas, forcing your pancreas to pump out 3-7 times the normal amount because your blood sugar is so high and staying high since your muscles refuse to allow proper/normal uptake…

When I was talking sugar numbers, I was talking blood test results. Generally, (and I’m no expert) you want to test the following for prediabetes (type 2) or insulin resistance:

  • A1C — 5.7 to 6.4 percent
  • FPG — 100 to 125 mg/dL (milligrams per deciliter)
  • OGTT — 140 to 199 mg/dL

aka

As long as your numbers are good here, it’ll help you determine how your macros are doing from the top down as high blood sugar directly and negatively correlates to poor hormone levels…but I think you’re going to find you currently have issues that will make your busy and stressful life more stressful, more expensive and fucking annoying.

With what you’ve got going on, I’d be worried about liver and kidneys (pancreas is prolly working overtime). Are you currently taking liver shield type supplements?

Here’s why I say that,

By “sugar” I mean carbs not “added sugar”, the type of carb matters too. In your situation,

1 cup of Green beans (G Index of 36) = 8 grams of carbs means you need 3 cups 5 times/day
vs
1 oz of White potato (G Index of 111) = 5 grams of carbs means you need 5 oz 5 times/day

Using the following macro percentages and eating 5 times a day:
Protein: 40%
Carbs: 25%
Fat: 35%
(Not counting “net carbs”)

Green beans will be a better carb for 3 reasons, more protein, more volume / more filling and lower insulin spike (meaning a lot of good things). I’m not recommending you ONLY eat green beans, I only mentioned it to keep things simple. You want to mix up your carbs simple/complex and mix them up for maximal nutritional (vitamin / mineral) benefits.

Currently, you’re at 34% which isn’t crazy at all and reasonable but your fats are super low. With low healthy fats and high protein, your insulin spikes are going to be high for extended periods of time causing your blood sugar to be high, muscles to start rejecting insulin, cortisol to be high, interrupted sleep and eventually load up your prostate with excess insulin once initial stages of NAFLD (non alcoholic fatty liver disease) kick in and then you’ll have to wake up in the middle of the night to piss multiple times (mentioning in case you already have symptoms). Then, insulin resistance leads to hormone imbalances and the creation of excess sebum which is responsible for acne. Don’t forget, insulin is a hormone too.

Taking vitamin D or tanning in your situation at the moment probably wont help until you get your insulin/blood sugar under control, your liver is allowed to recover/catch up and pancreas to chill TF out.


Source: The relationship of diet and acne - PMC

And hey, maybe you just started or changed to that macro split recently so I’m wrong but your skin is trying to tell you something…

I’d like someone else’s input but I’d swap up your macros because you’re not on a crazy amount of test for me to think the acne is a direct and solo result of taking test…but rather a bad situation made worst by the increase of the test. Again, the amount you increased by (in my opinion) is not a lot in the bigger scheme of things (assuming you have a solid, high quality, pharm grade test). If you were taking 100mg / day…then I’d be saying something completely different.

If it was me, I’d try the following for macro percentages or something in this ball park:

Higher fats will help you get insulin under control (because fats don’t spike insulin) working together with protein to prevent high spikes in insulin. (Lean protein ingested alone will result in spiked insulin despite it not being a sugar).

https://pescience.com/blogs/articles/whey-protein-insulin-spikes-and-how-to-avoid-them


I’d look at the following in your next blood tests as well to make sure you don’t have deficiencies in the following:

Vitamin A
Zinc
Selenium
Calcium
Vitamin D

Deficiencies in these will just make your acne worse. Supplement to correct as needed.

And lastly, nuts & oils to help with your fat consumption.

First, add your protein (proteins have fat as well) then bring up your macro meal total with fats in the form of:

Olive Oil
Macadamia nut oil
Brazil Nuts or
Macadamia Nuts

All other nuts (other than tiger nuts but they’re not common and have a weird macro profile) increase your SHBG) sex hormone binding globulin, thus, binding up your free test, causing other problems…

I’ve gone over and included a ton of shit in here for you to look at, think about and research on your own.

If I has some guy on T-Nation 10 years ago telling me my acne was due to me not eating enough healthy fats and too much protein, while also warning that I was headed down a dangerous path of insulin resistance I’d prolly say he’s full of shit…until I started to see the symptoms mentioned.

If I had to guess, you prolly already have a couple symptoms of insulin resistance but honestly, I don’t want to be right bc that would suck a lot. Personally, I didn’t know lean protein can cause insulin spikes until recently but I’m researching and learning more everyday.

From some articles I researched, high TT levels should keep the risk of actually getting insulin resistance low…but that doesn’t mean you wont see like symptoms of insulin resistance.

Let me know your thoughts, curious what your take is…

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I have a close family member on accutane at the moment. Nothing else has worked and this stuff legit gets it done. You can start on a lower dose like 10mg ED and if that works great, if not you ease into upping it. Either way, yes it dries you out like crazy. Mostly eyes, lips, and facial skin. I don’t know how it would affect your calves.

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I’m not. Look at the macro goals:
P: 200g (40%)
C: 175g (35%)
F: 56g (25%)

I need to keep my carbs higher than I used to because performance goes downhill hard if I don’t. I also don’t think I would extrapolate too much from my diet at this moment… I’ve had acne since I hit puberty and it has not let up since. I can definitively say that 13 y/o me had no idea what macros were. I think it’s much more likely that the increase in back acne is caused by the quadrupling of my TT and fT via TRT…

My fasted Hemoglobin A1C was 5.5 when I last checked.

The only cooking oil I use. Typically unmeasured, so my fats are likely a bit higher than recorded - but unsure to what degree. I also eat like 10 almonds in the mornings but I get lazy with tracking.

The insulin resistance certainly is a possibility, I’ve suspected I may be insulin resistant to an extent - but I’ve not overeaten carbs in quite some time (literal years) so I’m not entirely sold on that. At any rate, I’m aware this is something I may need to correct at some point.

Stool is consistent, typically firm but could be better I guess… haven’t gone into poo-diagnoses yet but it could be time. Hairline is fine, receded a bit in the military but seems to have held the line since - even once TRT was introduced about 5 months ago.

I hope this doesn’t come off as dismissive, I appreciate the level of effort you put into your post, I just think the most likely scenario here is my test levels causing increased sebum secretion - and increased acne. I always had relatively little back acne until starting TRT, and it has never been as bad as it’s been since starting. I think that’s too strong a coincidence to ignore.

Ah! I was confused with the Total being higher and completely missed that. Good deal!

Instead of higher carbs (especially since you’re cutting) what about a solid carb free electrolyte?

My bad, I missed that too, I was trying to figure out if that’s what that was.

It’s not going to make that big a difference if at all but I’d swap to brazil nut’s at some point to keep your SHBG low. Mine was high for years until I got off earing 5 lbs of almonds every month and using almond oil in my protein shakes and meals.

Not at all buddy. I wouldn’t try if I didn’t care and I dont know all the details / history of your situation.

I just hope you get it figured out!

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Do you have any advice to give regarding acne inhibition, or did you come here to argue?

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Just my two cents here on the hormones and acne. I think it’s reasonable to think both estrogen and dht can cause acne.

Women prone to acne seem to have differing severity depending on the time of the month. I guess that could be from estrogen, being high or low, or something else completely.

That example doesn’t show estrogen to be a causal factor, just that it seems possible for me.

Use of drugs like finasteride (which lowers dht) usually lowers acne. Some guys use it on cycle mostly for hair loss prevention, but notice less acne.

Not proof again, but enough for me to think it’s possible.

For treatments benzoyl peroxide seems to be the strongest thing otc.

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Please don’t beat me with a stick…

What if you just went on a high protein and high fat diet or fasted for a few days?

It may be the 1 thing you haven’t tried but high protein and fat diets are known to clear up chronic skin conditions among other chronic health issues. Fats in general, should be more important than carbs due to the very small amount of carbs required to build protein and cortisol response.

I know you’re frustrated; I know you want a magic bullet…this might be it.

I’m 5 days in on a water/electrolyte and bone broth (day 4) fast and I don’t have ANY of the prediabetic symptoms I was having, my skin is cleaner, less greasy and more clear, I sleep better, more flexibility (less inflammation) etc. My knee joints hurt day 3 (and only day 3) which is interesting bc I don’t normally have knee pain but when looking at oxalate excretion mentioned in the video below this makes A LOT of sense.

I was done with this post on your topic (I wasn’t going to bother you anymore about food)…But when chronically high cortisol levels were mentioned in this video, I thought about you and this thread…

Here’s another video on fats in the blood

And maybe I was wrong earlier but I’d check out this video too

Maybe try these macros?

P: (40%)
C: (15%)
F: (45%)

Or cut carbs out completely to 0% for faster better results but I don’t know what those macro percentages would look like…

I’ll be honest, these macro numbers seem stupid. But I don’t think you’re in a “standard situation,” I get it, me either. Your liver will monitor your blood sugar and make what you need so your concern about “needing carbs” might not be as important as you think.

All in all, if I was in your situation, I’d try it for 2 solid weeks and eat some fatty protein, some more red meat, steaks, salmon, chicken thighs, chicken / turkey drums, pork ribs, beef ribs, etc.

Give me that option over eating carbs and I’d def try it for 2-3 or 4 weeks. I was at the same exact macros that you’re currently on for the first time in a long time and ended up with unbearable prediabetic symptoms within 2-3 weeks of 35% carb macros (I’ve been eating clean and strict macros for over 6 months now…month 7 was the reason I’m seeing prediabetic symptoms in the first place…my fault…).

I don’t think you’ll have any issues cutting (swapping your macros for higher Protein & Fat) because your caloric requirements will remain until you lose weight (and have to reconfigure to prevent plateau).

So idk, 5 days in fasting, I don’t miss carbs and with solid electrolytes, I don’t miss eating/food as much in general. Low sodium/salt diets increase appetite and I’m experiencing this now supplementing with this powder. I feel a lot better and I feel a lot different. This is talked about towards the end of the CATO video (like a Ted Talk) below.

So idk, I feel like (in a way) I’m fighting with you more on your thought process vs helping you find a solution but I guess I’m still trying bc I care and genuinely believe this crazy idea might help your specific situation AND I want you to find the root of the problem so you’re not on a problematic drug that creates dependance.

You said you had acne for a long time…

So the root of this issue can go back decades (like me) when you weren’t eating clean…just a thought in a “critical thinking exercise”

YOU already know that taking higher amounts of test worsens this already persistent acne problem…but you’re not willing to make changes in that department (lowering dose or cutting it out all together) even though you know it will help…(I’m not blaming you btw, I wouldn’t either, I think the root of the issue is elsewhere as proven by your early age acne).

You want a pill or solution to the problem, RT_Nomad suggested hyaluronic acid (I’d try it more than 2x/wk), antimadder & blshaw suggested accutane, asmonius suggested head and shoulders, mnben87 suggested finasteride and benzoyl peroxide, more will come. There are hundreds of dermatologists on youtube and TikTok with solutions of this type.

With all the above, you have to understand or at least open to the possibility that there’s something else at play causing this issue if it requires involving a hard-hitting chemicals.

Carbs (in general) (low fat) can negatively impact bacteria, internal gut bacteria, hormones, cortisol levels, insulin levels, blood sugar levels, etc…

Another “outside of the box thought” maybe blood tests “in range” for everyone else isn’t “in range” for what is optimal for you. The BIGGEST problem with blood test is that no one gets them BEFORE they encounter issues so no one really has a solid baseline for their own “optimum levels.”

All in all, I would try giving carbs a break for 2-3 solid weeks. And maybe that’s not a long enough time to run a trial…but it’s not a long enough time to negatively impact you either.

I think a test like this with someone with your background and details would be fascinating and I think this community would be better, more optimum and better educated with a solidly documented test like this out there.

So, it’s all obviously up to you. I personally HATE the idea of all the KETO crap…I hate it…but it’s because they think protein should be low (15%) and I don’t agree with that, nor do I agree that all vegetables are bad…but that’s assuming that none of the fruits and vegetables are engineered or contain things that prevent our bodies from working properly. The apples on my counter (almost 2 weeks) should have gone bad by now…but they haven’t yet…interesting…I don’t think that’s not exactly natural (sound like McD’s fries anyone?) I’m not saying meat is “super clean either”, just flipping what we’ve been told to think about food on it’s head. SO many people who only eat meat end up with MUCH better digestion, cleaner skin, less illness, less auto-immune related issues, etc…

I would try something different diet wise, drink filtered water (watched a pro bodybuilder who installed a water filtration system in his house and it improved sleep, skin, digestion, energy etc.), get better sleep, etc…

Feel free to try one or 2 different types of suggested meds tho, I hope they can actually help. Where I’m coming from is the possibility that your dependance on those drugs may decrease if you change what you eat since we can establish that injecting testosterone was not THE cause of your acne.

From one of your previous post, I’m definitely not here to argue either, I put too much time into this to “argue” (I should be at the gym but…I’m going in 10 minutes), I hope someone “if not you” can read through this, watch the video’s I linked, learn or at least “hear” something new, think a bit more critically and try something different…something new and maybe find a solution to this brutal acne issue.

Best of luck buddy! Lots of respect for you and all here!

12/25/2022 Edit:

I thought it might be worth mentioning that fasting for 6 solid day’s no food, working out as heavy as possible everyday and using the steam/dry sauna, I didn’t notice much as far as face/body oils go so I have to assume it was a “normal” amount which was expected without eating.

After only eating meat/high fat for 2 days, I thought it was weird that my face feels “different” and it’s a little hard to explain because it’s not “dry” but it’s not greasy either for how much fat I’ve eaten. I’ve had bacon, sausage (0 carb), eggs, pork ribs, chicken thighs/legs, oils, butter in stupid amounts, etc.

After eating foods literally dripping in grease, I thought my face / temples would feel greasy but that was simply not the case. In the past, after eating, say, a cookie (food made of mostly carbs & some fat), my cheeks, temples and forehead would become greasy and I could feel it pouring out of the skin in my face in the most gross way prompting me to want to wash my face / take a shower no less than 4 minutes after consumption.

If this feeling is related directly to excess dirty AF carbs or just carbs in general, then it makes sense why the leading cause of male pattern baldness is insulin resistance; caused by the consumption of excess sugar.

This is what I found:


Source: Correlation between sweat glucose and blood glucose in subjects with diabetes - PubMed

There is an inverse relationship between insulin resistance and high levels of DHT, meaning there’s likely another mechanism at play that I’ll research later.

Thanks!

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If you haven’t tried large doses of Resveratrol, that is one option, the other is anastrozole.
What were your last E2, SHBG, free T and Total T numbers?
I am one of those Men that easily convert T to E2, so I always take Anastrozole, I do like the positive effect of Resveratrol, but during the last few years if I don’t take capsules either store bought or hand made. My ADHD really screws with my memory…

did this clear up acne for you personally?

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Just curious. Define “large doses” if you will.

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@Andrewgen_Receptors

I’m intrigued. Now I need to know how much and speak to someone who used it with success.

resveratrol-for-acne-Google-Search

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On 182mg/wk:
E2: 46.2
SHBG: 15.9
fT: 30
TT: 1264

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I presume you do not have any high or low e2 symptoms.

Would you take ai for acne?

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