Incidence and Factors Associated With Acne in Transgender Adolescents on Testosterone: A Retrospective Cohort Study |
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| Affiliation: | 1. Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia;2. Division of Endocrinology, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia;3. Division of Endocrinology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia;4. Division of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia;5. Clinical Resource Hub Veterans Integrated Service Network VISN 7, Atlanta, Georgia;1. Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore;2. Yong Loo Lin School of Medicine, National University Singapore, Singapore;3. Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University Singapore, Singapore;4. Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore;5. National University Centre for Organ Transplantation, National University Health System, Singapore;6. Department of Biosciences, School of Science, Indrashil University, Rajpur, Mehsana, Gujarat, India;7. Center for Biomedicine and Community Health, International School, Vietnam National University, Hanoi, Vietnam;8. Department of Natural Science and Technology, International School, Vietnam National University, Hanoi, Vietnam;9. Department of Endocrinology, National University Hospital, Singapore;10. Department of Cardiology, National University Heart Centre, National University Health System, Singapore;11. Faculty of Life Sciences and Medicine, School of Life Course Sciences, King''s College London, London, United Kingdom;12. Department of Endocrinology ASO/EASO COM, King''s College Hospital NHS Foundation Trust, Denmark Hill, London, United Kingdom;1. Division of Pediatric Endocrine, Cincinnati Children’s Hospital Medical Center and the University of Cincinnati, Cincinnati, Ohio;2. Division of Pediatric Gastroenterology, Cincinnati Children’s Hospital Medical Center and the University of Cincinnati, Cincinnati, Ohio;3. Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center and the University of Cincinnati, Cincinnati, Ohio;4. Xavier University, College of Arts and Sciences, Cincinnati, Ohio;1. The Department of General Surgery, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China;2. Department of Ultrasonography, Yuhang Third People’s Hospital, Hangzhou, China;3. Department of Ultrasonography, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China;1. Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, China;2. Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China;1. Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China;2. The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu, China;1. Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Houston Methodist Hospital, Weill Cornell Medicine, Houston, Texas;2. Center for Health Data Science and Analytics, Houston Methodist Hospital Research Institute and Weill Cornell Medicine, Houston, Texas |
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| Abstract: | ObjectiveThis retrospective cohort study aimed to assess incidence and predictors of acne among transgender adolescents receiving testosterone.MethodsWe analyzed records of patients aged <18 years, assigned female at birth, seen at Children’s Healthcare of Atlanta Pediatric Endocrinology clinic for testosterone initiation between January 1, 2016, and January 1, 2019, with at least 1-year follow-up documented. Bivariable analyses to determine the association of clinical and demographic factors with new acne diagnosis were performed.ResultsOf 60 patients, 46 (77%) did not have baseline acne, but of those 46 patients, 25 (54%) developed acne within 1 year of testosterone initiation. Overall incidence proportion was 70% at 2 years; patients who used progestin prior to or during follow-up were more likely to develop acne than nonusers (92% vs 33%, P <.001).ConclusionTransgender adolescents starting testosterone, particularly those taking progestin, should be monitored for acne development and treated proactively by hormone providers and dermatologists. |
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| Keywords: | epidemiology acne testosterone transgender pediatric dermatology masculinizing hormone therapy |
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