Testosterone affects the skin via androgen receptors: it can increase sebum production and promote acne, but also modulate collagen synthesis and wound healing. However, therapeutic use for skin improvement is not supported by robust clinical trials. In men with confirmed testosterone deficiency, hormone replacement therapy may improve skin thickness and elasticity, while in women excess testosterone often causes skin issues. Direct-to-consumer DNA tests claiming a link between testosterone and skin health are based on weak associations or mechanistic hypotheses. The evidence is mostly mechanistic and insufficient for general recommendations. Without a medical diagnosis of hormone deficiency, testosterone treatment for skin optimization is not indicated and may cause side effects like worsened acne or hair loss. In summary: testosterone has complex effects on skin, but its benefit as a targeted therapy is unclear and should not be inferred from genetic tests.
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