How Gender Transition Changes the Skin — and How an LGBTQ+ Line Can Help

by Lauren Emily Whalen

EDGE Media Network Contributor

Thursday March 10, 2022

Many who medically transition turn to hormones, which can affect the mind and body in different ways. However, the effect of these hormones on the skin isn't often discussed. And it should be.

"We definitely do a disservice to transgender people when we do not discuss skincare in the context of hormone therapy," says Scott Nass, MD MPA FAAFP AAHIVS, who serves as Chief Medical Officer for Transgender Health & Wellness Center, a community-led and -focused organization in Southern California. Dr. Nass knows the effect of transition hormones on skin, are rarely covered in a healthcare setting. "Healthcare providers generally receive very little education on transgender health," he says. "Even providers who have been partnering with transgender patients for years are likely to be focused more on other body parts."

Dr. Nass knows for certain, however, that hormones do affect the oil and collagen production of a trans person's skin, and self-care practices may have to be reconsidered. "A skincare regimen that's 'good enough' now very likely will have to change drastically as one's skin changes in response to hormones," he says. For trans individuals looking to switch up their skincare, Jordan Samuel Skin — an LGBTQ+-founded line, may just be the solution.

How Transitioning Affects the Skin

Dr. Nass directs the Transgender Health & Wellness Center's health and wellness plan, which includes gender-affirming laser hair removal and electrolysis, social work assessments, and mental health counseling for transgender, gender nonconforming and intersex individuals. Though every patient is different, he sees patterns in skin changes depending on hormone regimen.

Those on testosterone, Dr. Nass says, will very quickly notice significant changes to their skin. "Usually within a matter of weeks to months, skin will become more coarse and begin to produce more oil," he says. "As a result, many individuals will see acne develop, especially on the face, upper back, and chest."

Because acne can worsen over the first two years on testosterone, Dr. Nass says, good skincare is essential. However, he cautions against aggressive routines. "[E]ven the oiliest, most acne-prone skin should be treated gently," he advises. "Too much scrubbing and rubbing is unhealthy for our skin, particularly on our face, and can actually worsen acne and other skin changes."

In contrast, the skin trans patients on estrogen and/or anti-androgen therapy will become less oily. These individuals, Dr. Nass says, "will start to notice an overall softening of their skin, particularly on the face, generally within a few weeks to months after being on a sufficient dose." Estrogen both stimulates the production of collagen, meaning the skin may feel more elastic, and slows the production of oil, which Dr. Nass "can really be a problem for folks who already had dry skin before starting estrogen."

A New 'Face' in LGBTQ+ Skincare

Though Jordan Samuel Pacitti is not trans himself, he is hyperaware of how skin can rapidly alter, for better and for worse. The founder of Jordan Samuel Skin didn't have many skin issues growing up. However, that quickly changed when he graduated from New York's School of American Ballet and signed with Pacific Northwest Ballet, a Seattle-based company.

"[W]hen I started... wearing stage makeup eight times a week, I had no idea how to care for my skin," Pacitti, now based in New York again, recalls. "Once my skin started acting up, I began seeking out professional advice and receiving regular facials... This, combined with the tips and tricks I learned from the company's established ballerinas, got me on a great skincare regimen."

This regimen, and the trial and error that went into it, eventually became another passion. Pacitti retired from dancing after 11 years with PNB and embarked on a second career as an esthetician. Twelve years of practice later, Jordan Samuel Skin was born: A brand that prides itself on welcoming every skin type.

"Skincare should not be confined by a gender," Pacitti says. "Our whole philosophy is being able to choreograph your own skincare routine and use multi-functional products that can be mixed and matched to help you achieve your daily skincare goals." Jordan Samuel Skin supports the trans community, Pacitti states, and adds, "we work to create gentle and effective products that'll help support skin through transitioning and beyond."

From conception to manufacturing, each Jordan Samuel Skin product goes through a months-long process. Pacitti also strives to be transparent. "As each customer will have different concerns, we try to keep information easily accessible on our site so they can find the best products for their skin," he says.

Skincare: Where to Start and Keep Going

While Pacitti encourages gentle cleansers, serums and moisturizers as potential parts of a skincare routine, he's aware that "the concerns that someone is transitioning may have will often go beyond the scope of an at-home regimen." If possible, he says, transitioning individuals should "seek out help from a dermatologist who will be able to put [them] on the right track."

For those medically transitioning — including nonbinary and gender-nonconforming patients who may be on a lower dose of hormones — Dr. Nass advises adaptability and communication. "One's skincare routine should continue to adapt in response to body changes," he says. "People starting HRT should discuss all their goals and concerns up front with their HRT provider, and the skin should be front and center in that discussion."

He adds, "[t]o avoid being frustrated by unexpected skin changes, folks should share their detailed gender goals with their HRT provider and have a frank discussion about changes they can expect — for better or for worse."

Lauren Emily Whalen is a writer, performer and aerialist living in Chicago. She's the author of four books for young adults. Learn more at laurenemilywrites.com.