WEDNESDAY, Jan. 21, 2026 (HealthDay News) -- Transgender individuals have distinct acne incidence patterns compared with matched cisgender male and cisgender female individuals, according to a study published online Jan. 21 in JAMA Dermatology.

Courtney A. Smith, from the Emory University School of Medicine in Atlanta, and colleagues compared the incidence of acne and moderate-to-severe acne in transgender individuals in a retrospective matched cohort study. Participants included individuals without baseline acne: 11,234 transmasculine individuals and 9,486 transfeminine individuals matched with 132,462 cisgender male and 127,815 cisgender female individuals. Overall, 12,156 of the transgender individuals initiated gender-affirming therapy.

The researchers found that the cumulative incidence of acne at five years was 15.8, 3.8, and 10.5 percent in transmasculine individuals, matched cisgender male individuals, and matched cisgender female individuals, respectively, and 6.0, 2.9, and 8.4 percent in transfeminine individuals, matched cisgender men, and matched cisgender women, respectively. Transmasculine individuals had the highest acne risk in the first year after initiation of testosterone (hazard ratios, 8.29 and 2.63 versus matched cisgender male individuals and matched cisgender female individuals, respectively); in subsequent years, the risk remained higher than among cisgender men and cisgender women (hazard ratios, 5.29 and 1.69, respectively). Transfeminine individuals had higher acne risk after starting estradiol compared with cisgender men (hazard ratio, 1.56), but had a lower risk compared with cisgender women (hazard ratio, 0.53). Similar patterns were seen for moderate-to-severe acne incidence.

"Future studies should evaluate potential dermatologic care barriers in transgender health settings, given high rates of moderate-to-severe acne in transmasculine individuals during the first year after testosterone initiation," the authors write.

One author disclosed ties to Amgen; a second author disclosed ties to the dermatology and pharmaceutical industries.

Abstract/Full Text