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How should we counsel our #transgender patients receiving masculinizing hormone therapy about their risk for #acne? A new 988 patient cohort study in @JAMADerm led by Nick Thoreson and @EricaDommasch. A quick thread 
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https://jamanetwork.com/journals/jamadermatology/article-abstract/2775154#:~:text=Findings%20In%20this%20cohort%20study,year%20incidence%20proportion%20of%2025.1%25.
1/5https://jamanetwork.com/journals/jamadermatology/article-abstract/2775154#:~:text=Findings%20In%20this%20cohort%20study,year%20incidence%20proportion%20of%2025.1%25.
In this cohort (mean age 26 years-old), the prevalence of acne was 31% after initiation of masculinizing hormone therapy (compared to 6.3% prior). As might be expected, the prevalence of acne was higher among younger individuals. 2/5
Most acne developed within the first 6-12 months after initiation of masculinizing hormone therapy, with very few new cases of acne developing a year after starting. Helpful data to provide anticipatory guidance with respect to the timing of acne development. 3/5
Although they had hypothesized that mode of delivery may influence the development of acne, in their multivariable analyses, they did not identify an association between mode of delivery (e.g. injection vs transdermal), BMI, or smoking with acne. 4/5
Among this cohort, only 7.1% had a dermatology visit. While it is not clear why more patients did not see a dermatologist, given the negative psychosocial impacts of acne, there may be an opportunity to improve access to acne care in this population. 5/5 https://jamanetwork.com/journals/jamadermatology/article-abstract/2775152
