Where should testosterone gel be applied?

Where to Apply Testosterone Gel

Apply testosterone gel to the upper arms and shoulders as the primary application site, as this location provides superior testosterone absorption compared to other body sites. 1, 2, 3

Recommended Application Sites by Formulation

AndroGel 1.62% (FDA-Approved Sites)

• Apply exclusively to the upper arms and shoulders 3
• The FDA label explicitly states: "Do not apply testosterone gel 1.62% to any other parts of the body, including the abdomen, genitals, chest, armpits (axillae), or knees" 3
• Limit the application area to what would be covered by a short-sleeve t-shirt 3

AndroGel 1% and Other Formulations

• Approved sites include: shoulders, upper arms, abdomen, back, and upper thighs 1
• However, upper arms/shoulders provide 30-40% higher bioavailability compared to abdominal application 4

Evidence Supporting Upper Arm/Shoulder Application

The upper arms and shoulders are the optimal application sites based on absorption studies:

• Application to arms/shoulders achieves significantly higher testosterone levels than chest/abdomen or legs/calves (A > C ≥ L, P = 0.011) 5
• Abdominal application results in approximately 30-40% lower bioavailability compared to upper arms/shoulders 4
• Both application sites achieve eugonadal testosterone levels, but arms/shoulders require less dose adjustment 4

Application Technique

Follow these specific steps to maximize absorption and minimize transfer risk:

• Apply to clean, dry, intact skin only 3
• Use the palm of your hand to spread the gel across the maximum surface area 3
• For doses requiring bilateral application, divide between right and left upper arms/shoulders 3
• Allow the gel to dry completely (approximately 5 minutes) before covering with clothing 3, 6
• Cover the application site with a t-shirt once dry 3

Critical Safety Precautions to Prevent Transfer

Testosterone gel transfer to partners and children is the primary safety concern with topical formulations:

• Wash hands immediately with soap and water after application 3, 7
• Cover the application site with clothing after the gel dries 3, 7
• Avoid skin-to-skin contact with others for at least 2 hours after application 7
• If direct contact occurs before 2 hours, wearing a t-shirt prevents transfer (for 2.5g doses) 7
• Washing the application site with soap and water before anticipated skin contact reduces residual testosterone by at least 81% and prevents transfer 8
• Washing as early as 2 hours post-application decreases bioavailability by only 10-14% but effectively prevents secondary exposure 8

Common Pitfalls to Avoid

Do not apply to the following sites despite older product labeling:

• Avoid the abdomen if using upper arms/shoulders is feasible, as this reduces bioavailability by 30-40% 4
• Never apply to genitals, chest, armpits, or knees with 1.62% formulations 3
• Do not apply to broken or irritated skin 3
• Avoid swimming or showering for at least 2 hours after application to ensure adequate absorption 3

Application Site Surface Area Considerations

Spreading the gel over a larger surface area has minimal impact on absorption:

• Applying gel to four different sites (both arms/shoulders and both sides of abdomen) versus one site increases testosterone levels by only 23% despite four times the surface area 6
• This means you should spread the gel thinly over the recommended area rather than applying it thickly to a small spot 6