Extreme jawline acne

[ZoomerSpicoid415]

Started Test 250mg just to test a year ago (early aprill 2024) ran for 6 months -> 1-2 extra pimples, face is oily, nothing to care about seeing as I didn't even try with my skin care. -> Been on 500mg for the past 4-6 months and I have insane jaw line acne and 5 pimples on each cheek

My skin care was garbage this entire time and for the past 2 weeks I went down back to 250mg and It is starting to clear up, but what is the mechanism of action behind this?

Estrogen out of wack (I see women get similar acne during their period etc) ? or is it oilyness/sweat from testosterone? or a combo of both

 

[WeiWei]

It’s likely a combination of factors, but the main culprits behind your acne worsening at 500mg vs. 250mg are:

1. Increased Androgenic Activity (DHT & Sebum Production)​

• Higher testosterone doses lead to more dihydrotestosterone (DHT) conversion.
• DHT increases sebaceous gland activity, making your skin more oily.
• More oil = more clogged pores = more acne.

2. Estrogen Fluctuations​

• Higher test = more aromatization to estrogen.
• Estrogen plays a role in skin health and inflammation.
• If estrogen is too high or fluctuating wildly, it can contribute to acne (similar to women during their cycle).
• If your estrogen is too low (e.g., from AI use), you can also get breakouts due to dryness and irritation.

3. Inflammation & Bacterial Overgrowth​

• More oil = C. acnes (bacteria) proliferation, which leads to inflammatory acne.
• Sweat from increased metabolism can also irritate pores.
• Poor skin care and clogged pores worsen the issue.

Why It’s Improving at 250mg:​

• Lower DHT = Less Sebum & Oiliness
• More Stable Estrogen Levels
• Less Systemic Inflammation

What to Do:​

• Dial in Skincare: Use a gentle benzoyl peroxide wash, salicylic acid toner, and moisturizer.
• Check Estrogen: If symptoms (sensitive nipples, bloating, mood swings) suggest high E2, you may need to adjust your protocol.
• Consider DHT Blockers: Something mild like topical finasteride (if you tolerate it).
• Keep Diet & Hygiene in Check: Avoid dairy, eat low-inflammatory foods, and wash pillowcases frequently.

TL;DR: Higher test = more DHT + more estrogen fluctuations + more oil = acne. Lowering to 250mg is helping because these factors are stabilizing.