Before you are to test your hormones and start introducing any pharmaceutical compounds in your regimen you would be better off making several adjustments in your daily life, make sure your diet is clean and probably check out whether you fall into the category of people how are genetically prone to acne. All of this you can read in the previous article where we discussed what are the main reasons why people get non-hormone related acne (link).

However today the narrative of the story will go into details on why your hormones might not be okay, how they can potentially influence your skin and what measures can be taken to counter such scenarios.

Fist of all we have to remember that injectable testosterone can go a long way through many enzymatic conversions and many of its effects on our physiology has to do with the molecules which are metabolites from it.

It’s a material for a whole lecture on what is happening to testosterone and where it can end up through hormonal cascade(it’s also interring to note that endogenous testosterone comes from pregnenolone via the cholesterol-pregnenolone-progesterone-testosterone pathway,- this is also what supports the necessity of HCG on a long cycle because otherwise you are not getting these hormones) but in this article we would mostly focus on testosterone conversion to estrogens via aromatize enzyme and it’s conversion to dehydro-testosterone(DHT) via 5α-Reductase.

Let’s start with estrogen(specifically it’s estradiol(E2) which is the potent “slice” of it but we can generalize it whilst speaking of acne). If you do have high estrogen you might notice that your skin is getting more and more oily over time. The same thing happens to women who happened to be unlucky enough and now talking birth control pills which contain oestrogen.

Excessive estrogen makes your skin produce more sebum and this is why you might gain that undesirable oily look. The solution is indeed quite simple: you should control your estrogen level and make sure it doesn’t get too high and fall off the reference range(anything above 50pg/ml is indeed undesirable). This could done through utilizing aromatize inhibitors(AI).

It’s safe to say that letrozole is probably not the best choice since it’s extremely high potency in hindering our bodies ability to aromatize testosterone. At the same time exemestane or anastrozole(also known as arimidex) are really good options which would definitely work. It’s likely hard to guess the exact dose since the aromatize enzyme actively heavily depends on individual genetics and body fat percentage, but if we assume that you are using anything around 500mgs of test per week,- 0.5mgs of anastrozole per day or EOD and 12.5mgs of exemestane per day or EOD are good starting points. Once again this should be prescribed individually and the only good indicator is your blood work.

What about DHT? Well DHT indeed can cause cause irritation and dryness of the skin which would leave us with a different type of acne. Keep in mind that crushing your estrogen while you are having high DHT levels will make situation way worse. This is why you are always better off having a blood test before you try to intervene in any enzymatic sequence in your body.

As we have already discussed above high DHT can also dramatically worsen your skin quality not even speaking about its ability to induce prostate hyperplasia(another topic which requires a long discussion), so what shall be done if we are dealing with a 5-10 fold increase in DHT levels? By the way this is common during heavy steroid cycles especially if DHT derivatives are involved.

You are to use anti DHT agents. However once again not all of them are sustainable long term. I personally wouldn’t recommend finasteride or dutasteride as for this medications not only partly chemically poison your libido but are also able to induce clinical depression and overall turn you into a very unmotivated person.

5α-Reductase is not only responsible for converting testosterone into DHT but also does convert pregnenolone into allopregnenolone. This second metabolite could easily be described as an important mood enhancing neurotransmitter. It’s undesirable to switch it off.

So what shall we do with DHT then? Look for a milder solution. Luckily is exists and its called saw palmetto. I personally recommend looking for the extract and taking it in dosages around 300-1000mgs daily adjusting it via bloodwork and your personal well-being. Most people do just fine with these dosages. 

To sum up its safe to say that this is probably it: we covered most of the topic. Remember that skin is also an organ(some professors state that it is) and it should also receive good care. Make sure you digest this message and continue to strive towards a healthier, stronger and prettier version of yourself(what else is there if not to be pretty). 

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