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  • Writer's pictureTrans Field Guide

Pore Problems: Acne

Updated: Aug 5, 2019

(Originally Aired on 7/20/19)

Acne is annoying, we can all agree on that. Most of the time we experience it at its worst during puberty. Well, guess what you’re doing a second time! With the changing of the hormones in your body, especially for trans masculine individuals on testosterone, you’re going to be very likely to have the teenage pox that you thought you were done with (presuming you’re well into your adulthood).

Causes of acne:

Part of the issue with acne is that it can be caused by a wide variety of things, such as oily skin, clogged pores, changing hair follicles, and even mild allergies to foods. Because of this, it’s hard to know if or when your acne will clear up, and how much. There is a lot of anecdotal evidence from trans men that the acne will calm down if not completely clear up after the first few years on hormone replacement therapy. However, this is not guaranteed, and there are some men who continue to battle acne well into their process.

Based on the anecdotal evidence, it seems that if the acne is primarily caused by the changing of hair follicles in order to produce thicker, darker hair, then once this change is complete the acne will mostly go away. However, this is rarely the only cause of acne, and treatment should still be considered into in order to prevent any worsening of symptoms.

Acne can usually be partially kept at bay by a consistent skin care regimen that focuses on exfoliating to remove dead skin cells and using a good quality cleanser to clear dirt and oil from pores. The trick to this part, though, is finding the right product or combination of products that works for your skin. Since no two people have the exact same skin, this usually comes down to trial and error.

You can also give yourself a leg up by having a properly balanced diet and avoiding overly greasy foods and foods that you may have any mild allergies to.

For acne on your chest and back, if you are wearing a binder every day, please remember to WASH YOUR BINDER regularly. If you can afford it, try to have multiple binders to rotate through so that you’re not constantly re-introducing the sweat and oil from previous days onto the skin.

Let’s take a look at some options for treatment, starting with those you can get over the counter:

Benzoyl Peroxide

A large amount of acne-focused cleansers use Benzoyl Peroxide in order to kill the bacteria that is the direct cause of acne, as in it’s the bacteria that’s thriving on the gunk in your pores. Since it has peroxide in it, it can also dry out your skin, which can actually cause your skin to produce more oil to compensate, so it’s recommended to use a good moisturizer. You can check out for an example regimen.

Salicylic Acid

Salicylic acid causes your body to let got of dead skin cells easier, which helps prevent them from clogging up your pores. This is more preventative than treating, but when used in tandem with benzoyl peroxide, it can keep your skin clear.

Resorcinol and Sulfur

These two together help to break down and peel away any rough skin, which helps to get rid of existing tough acne like blackheads.

Tea Tree Oil

This is a more natural approach that kills off bacteria, calms down irritated skin, and clears out pores. The biggest trade off compared to the previous options is that it can take longer to be super effective, as it’s not as potent as the others. However, for those with more sensitive skin, it could be the best option to avoid any irritation caused by more harsh treatments.


Activated charcoal is the hot thing right now. The biggest claims are its ability to clear out pores, which can help prevent acne.

Coconut Oil

Coconut Oil is also a huge thing right now on the topic of more natural remedies for skin ailments. Its antibacterial properties make it some people’s go-to moisturizer for everything from acne to scar tissue. While there have been studies to provide preliminary support for this, it is still important to make sure to combine it with a good pore cleansing regimen to make sure you don’t overload your skin with any particular oil.

Other essential oils

Continuing down the path of natural remedies, some other essential oils that can help to clear up the skin are: lemon and lavender

according to Cristophe Valentini, my resident herbalism person,

You can also use washes made with thyme, oregano or sage tea.

Herbs and foods that promote liver health and function can help control acne, as “Liver function clears toxins from the body and helps to clear the skin. Though it does accelerate metabolism of pharmaceuticals.” So things like dandelion tea can be useful.

Other topical treatments, according to Christophe, are rose water, chamomile tea and witch hazel. However, witch hazel can be excessively drying if not used for spot treatment.

It’s always a good idea to keep a good quality moisturizer as part of your skin care regimen.

Prescription treatments:

Prescription treatments fall under two categories: topical and oral. Let’s look at the topical treatments first:

Azelaic acid

This acid increases the rate of skin renewal, prevents buildup in pores, and kills the bacteria that causes acne.

Topical Retinoids

These help clear out pores and keep them clear, and is usually used alongside either a topical or oral antibiotic. However it could cause dry, red, or irritated skin.

Prescription-grade oral treatments

Some doctors may prescribe an oral antibiotic that is focused on killing the specific bacteria that causes acne. I would recommend that if any oral antibiotics are being used, to supplement vitamin C and a probiotic, as antibiotics can throw off your gut biome, and potentially affect your immune system.

Isotretinoin- "Accutane"

According to Hudson’s Guide

“Isotretinoin is a retinoid (a derivative of vitamin A) that is prescribed in pill form, usually for 15-20 weeks. Because of its potential for serious side effects, it is considered a last resort in acne treatment, used when all other approaches have failed. Isotretinoin works by shrinking the oil glands, thus greatly reducing the amount of oil produced.

Isotretinoin is a very effective medicine that can help prevent scarring. However, there is a risk of serious side effects which should be thoroughly discussed with your doctor before considering Accutane.”

With this treatment specifically, there is a risk of serious birth defects if the person on the treatment becomes pregnant. Because of this, doctors are required to discuss this side effect and register the patient as the gender assigned at birth, which can trigger dysphoria. Please mentally and emotionally prepare yourself if you are considering this course of action.


Herbalism advice from Christophe Valentini

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