What are the effects of Testosterone Replacement Therapy (TRT) on the face?

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From the Guidelines

Testosterone Replacement Therapy (TRT) has no established effects on the face.

Effects of TRT on the Face

  • There is no mention of facial effects in the provided evidence, which focuses on the efficacy and safety of testosterone treatment in men with low testosterone levels, particularly in relation to sexual functioning, quality of life, and physical functioning 1.
  • The evidence primarily discusses the benefits and harms of testosterone therapy in men without underlying organic causes of hypogonadism, with no specific reference to facial effects 1.
  • While the evidence reports on various symptoms and outcomes, such as erectile dysfunction, decreased sex drive, and loss of energy, it does not address the effects of TRT on the face 1.
  • The lack of information on facial effects suggests that TRT may not have a significant impact on the face, but this cannot be conclusively determined based on the available evidence.

Limitations of the Evidence

  • The evidence is limited by the lack of long-term follow-up and the exclusion of men at increased risk for certain conditions, such as cardiovascular events or prostate cancer 1.
  • The studies varied in their definitions of low testosterone and study entry criteria, which may affect the generalizability of the findings 1.

From the Research

Effects of Testosterone Replacement Therapy on the Face

There is no direct evidence in the provided studies regarding the effects of Testosterone Replacement Therapy (TRT) on the face.

General Effects of TRT

  • The aim of TRT is to improve symptoms and signs of testosterone deficiency, including decreased libido, erectile dysfunction, and loss of muscle and bone mass, by increasing serum testosterone levels to a physiologic range 2.
  • TRT has been associated with multiple benefits, but the recommendations given in different guidelines on TRT are based on limited data from randomized controlled trials and non-randomized clinical studies 2.
  • The effects of TRT on bones, cardiac function, sexuality, gynecomastia, fertility, and contraception have been highlighted, as well as areas of concern regarding prostate carcinoma and testosterone replacement therapy 3.
  • The estimated likelihood of adverse effects of long-term TRT is still unknown, and evidence to suggest that TRT increases cardiovascular morbidity and mortality risks is poor 4.
  • TRT may result in erythrocytosis in some men, but long-term studies have not reported significant adverse events 4.
  • TRT is contraindicated in men with untreated prostate and breast cancer, and men on TRT should be monitored for side-effects such as polycythemia, peripheral edema, cardiac and hepatic dysfunction 5.
  • The risk of adverse cardiovascular events and mortality associated with TRT is controversial, and a retrospective cohort study found no difference in the risk of the combined cardiovascular endpoint between the treatment group and the comparison group 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Testosterone replacement therapy.

Andrology, 2020

Research

[Testosterone replacement therapy and possible side effects].

Urologie (Heidelberg, Germany), 2024

Research

Risks of testosterone replacement therapy in men.

Indian journal of urology : IJU : journal of the Urological Society of India, 2014

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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