If you have questions, please PM me, do not respond to this post.
Introduction
You thought you would "grow out" of your acne and didn't? You're not alone. Many men and women suffer adult acne in their 20s, 30s, 40s, and beyond. Adults with acne often have hormonal imbalances that linger after puberty, and these imbalances create disfiguring acne.
Quick Review on Hormones
The main sex hormones are testosterone, estrogen, and progesterone. Men and women have all three hormones in the body at different proportions. A more general term for testosterones is androgens. When you see "androgens" just remember that it means testosterone hormones in general.
The Culprit: DHT
DHT, or Dihydrotestosterone, is a type of testosterone that is one of most potent androgens in the body. DHT is 2-3x more powerful than "regular" testosterone and 15-30x more powerful than other adrenal androgens. This means that small fluctuations in DHT can have enormous effects on the body.
DHT synthesizes in the skin, hair follicles, testes, prostate, ovaries, and adrenal glands. Excess DHT and/or DHT sensitivity has been linked to:
- acne (men and women)
- balding, hair loss, hair thinning (men and women)
- excessive sex drive (men and women)
- facial hair or excess body hair (women)
- Polycystic Ovary Syndrome PCOS and endometriosis (women)
- prostate problems (men)
- low sperm count (men)
Why am I sensitive to DHT?
There is a lot of evidence to suggest that sensitivity to DHT is largely caused by genetics and the hormonal conditions of the womb while you were still a fetus. Genetics and prenatal hormone conditions work together to mold your adult hormonal state. Both are very powerful influences that a little ProActive is not going to fix.
But the real answer is: I don't know. Neither does your doctor. The fact is that treating a DHT sensitivity often clears acne. So I focus more on what can be done rather than why it happens.
Can I get a test that will tell me if DHT is causing my acne?
No. Medical testing for a sensitivity to DHT does not exist. You can get a test on your testosterone levels. Some people with acne actually have higher levels of androgens. But some have "normal" levels of androgens, yet still manifest symptoms.
Well then why should I treat my acne as if it's hormonal?
- You can completely prevent acne from occurring through hormonal treatment.
- Antibiotics are only a short-term fix.
- Accutane users find their acne coming back a few years later because the sebaceous glands grow back.
- Benzoyl peroxide and retinoids can't prevent deeper cystic acne, and the redness and peeling caused by these products are almost as bad as the acne itself.
How to reduce DHT
Reducing DHT involves avoiding DHT triggers in the food you consume, providing your body with the pre-hormone D3 so it can metabolize hormones efficiently, and using a DHT inhibitor to fight your built-in DHT sensitivity.
1. Eliminate dairy (milk, cheese, yogurt).
Dairy is naturally loaded with hormones (even organic dairy). Remember that cow's milk is made for baby calves to help them grow to maturity. It contains all sorts of growth hormones that only "grow acne" in adult humans. Most commercial dairy manufacturers also add synthetic hormones to keep the cows lactating constantly.
2. Eliminate sugar, refined carbs, and high loads of simple carbohydrates.
Both increase insulin levels which directly stimulate bad hormonal activity that leads to acne. What is a refined carb? Fruit juice. Soda. Candy. Chocolate bars. Crackers. Pretzels. Potato chips. Maple syrup. Sweet tea. Anything made with white flour (most breads and pastas). Anything with sugar added (many frozen or pre-packaged foods). You may be thinking, well what do I eat? Vegetables. Meats. Eggs. Whole grains in moderation. Whole fruits in moderation. Google the "paleo diet" for more ideas.
3. Eliminate coffee, energy drinks, soda, teas, and caffeine in general.
Study upon study has shown that caffeine, even in small amounts, stimulate bad insulin and hormonal activity that exacerbate acne, just like dairy and sugar. Kick the caffeine habit!!!
And what about tea? Many blends have a significant amount of caffeine. Many people on these forums tout green tea but I would stay away from it. Its negative hormonal activities outweigh its good features in my opinion. One recent study shows green tea increasing DHT by 194% and testosterone by 74%.
4. Reduce or eliminate alcohol.
Just google alcohol and acne. Not only can the chemicals in alcohol create acne, but alcohol is a huge stress on your liver, and when your liver suffers, it purges itself through your skin.
4. Get adequate sun exposure.
Vitamin D3 is not really a vitamin, it is a pre-hormone. Your body cannot regulate hormones without D3.
Many acne sufferers are in a habit of avoiding the sun, slathering on sunscreen, or simply live indoor lifestyles. Important facts about vitamin D3:
- Dairy is fortified with vitamin D2, which is not the vitamin D3 you need for hormone regulation.
- You cannot get D3 when you are blocking UVB light with sunscreen or makeup.
- Glass blocks the UVB rays required to produce D3 (so sitting in the car or by a sunny window don't count)
- The prescription shots are vitamin D2.
I either recommend a lot of outdoor sun exposure, or if you must take a pill:
- 5,000 to 15,000 IU of vitamin D3 a day
- Take it with an omega-3 supplement (fish oil), because D3 is not absorbed from a pill without good fats taken at the same time
5. Stop using "workout" supplements.
Many workout supplements and protein powders (especially whey protein, which is dairy!) are designed to stimulate androgenic activity, which supposedly helps you build muscle faster. Unfortunately too much androgenic activity = acne. If you don't want acne, you may have to accept that professional bodybuilding is not in your future.
6. Women: Pay attention to the type of birth control you are using.
With birth control you are putting hormones directly into your body. This has HUGE effects on acne. All pills/implants contain some type of progestin (a synthetic form of progesterone). If that progestin is highly androgenic, you may as well be throwing gasoline on the acne fire. I have made a separate post on this topic:
7. Take anti-androgen drugs or herbal supplements.
This is ESSENTIAL to clearing hormonal acne. Even if you fix everything else, you need to attack the DHT directly.
An anti-androgen mutes some of the DHT activity in your body so that it stops creating acne. If you have a DHT sensitivity problem, your body is freaking out every time your DHT spikes a little bit. SO many things spike DHT on a daily basis. Eating. Exercise. Sex. Stress. Basically LIFE spikes your DHT! This means...you guessed it...you have acne all the time. You have to mute some of this activity so your body stops having "acne freak outs".
The key to this step is PATIENCE and remembering that it is PREVENTION. Anti-androgens prevent new acne. They don't make existing zits disappear any faster.
PRESCRIPTION ROUTE
Women.
The most effective anti-androgen is prescription oral spironolactone. Most women succeed on a daily dose of 50mg - 100mg. It is hard to find a doctor that will prescribe spiro for acne. I recommend printing this website out and bringing it into your appointment. It describes how spiro is used for acne and cites medical journals. If your dermatologist still will not prescribe it, I recommend switching to an endocrinologist or ob-gyn, who tend to be more educated in hormonal issues.
Men. Your prescription options are:
- Topical spironolactone. You cannot get oral spiro for acne because it is too strong for males. However, you can get spiro cream for acne with a prescription. (You can also order the over-the-counter hairloss version of the cream, which is perfectly safe to use on your face.)
- Finasteride (also known as Propecia or Proscar) is commonly prescribed to treat balding (which is also caused by DHT). If you already have a balding problem, a nice side effect of this medication is it can clear up acne.
HERBAL ROUTE
There are several plants that have anti-androgenic effects. You will get better results and less side effects when you combine two or more different plant types. I cannot stress this enough. Taking large doses of saw palmetto will not help nearly as much as taking moderate doses of multiple plants.
You must use standardized extract supplements ("whole herb" supplements are not potent enough).
- Saw palmetto
- Stinging nettle
- Pygeum
- Pumpkin seed oil
- Beta sitosterol
Men: Total dosage of all anti-DHT herbs combined should range between 320mg - 1000mg daily.
Women: You should only be taking herbs if you are NOT taking spironolactone. Total dosage of all anti-DHT herbs combined should range between 640mg - 1500mg daily.
I will say this again. You need to combine different plant types and customize your dosages to work with your body. Many people give up on herbal anti-androgens because they do not combine plant types, take too small of a total dose, or take too large of a dose of one plant.
Okay, I'm doing everything. How long do I have to wait?
It depends on how severe your acne is, how messed up your hormones are, and how strictly you follow all of the recommendations. I had severe nodular/cystic acne that took 8 months on 100mg of spironolactone to resolve. For the first 4-5 months, my skin looked EXACTLY THE SAME as when I started. If that's not discouraging, I don't know what is.
Hormones are SLOW. Do not expect that you can be "tweaking" your regimen every week. Basically start from a good place, and slog through. If you don't see any improvements at about 4 months, then consider making changes.
Can I speed this along?
There really is not a quick fix for hormonal issues. For various reasons that I will not go into here because it would take far too much time, I DO NOT recommend combining hormonal treatment with antibiotics, retinoids, or benzoyl peroxide products.
How should I wash my face?
Less is more. The short version is that your skin needs an ideal pH level of 5.5 to fight off infection and heal itself. Get above or below that and your skin suffers.
Most of you wash your face with alkaline city or well water, then you use an alkaline cleanser, then you slather on some acne product that is too alkaline or too acidic. Some of you do this 2-3 times a day. What you are really doing is leaving your skin in a disrupted state...all the time.
(By the way, the marketing term "pH balanced" is crap. It's not regulated. It doesn't mean anything. Companies can slap this on whatever they want.)
When I was going through hormonal treatment, this is the exact regimen I followed:
- Cleanse skin once a day with distilled water (this has a neutral pH) and CeraVe cleanser
- Moisturize once a day with CeraVe Hydrating Lotion
- Wear makeup/sunscreen as little as possible
- 30 minutes of sun exposure daily
- No caffeine, alcohol, dairy, or sugar. Diet low in refined carbs.
How did it work for you?
How long did it take you to have clear skin?
I went from severe acne to zero zits after 8 months of following all of the steps above. It can be a very discouraging process. At month 4, my skin looked about the same as at month 1. But between month 4 and month 8, I saw zits slowly disappear. Expect this. The changes are slow. It is worth it in the end.
How bad was your acne?
My acne was graded by several dermatologists as severe. On the Leeds scale I was an 8 (out of 10), on the Cooks scale a 7 (out of 8), and on the Pillsbury scale a 4 (out or 4). After 8 months following the steps above, my skin was completely clear of active lesions. My exact regimen is as follows:
- 100mg of spironolactone daily
- Washing face once a day with distilled water and CeraVe Hydrating Cleanser
- Moisturizing with CeraVe Moisturizing Lotion
- NO caffeine, dairy, and sugar. Diet generally low in refined carbs.
- 30 minutes sun exposure daily (no sunscreen)
What treatments failed you?
- Oral and topical antibiotics: Cephalexin, Amoxicillin, Tetracycline, Doxycycline, Clindamyacin, Minocycyline, Azithromycin
- Topical retinoids: Differin, Retin-A Micro, Retin-A
- Benzoyl peroxide
- Acids: salicylic acid (BHA), glycolic acid (AHA), mandelic acid, lactic acid
- Light therapy: blue light, red light, infrared light
- Exfoliation regimens: Clarisonic, dry brushing, scrubs
- Washing regimens: Oil Cleansing Method, water-only method
- Vitamin regimens: zinc, vitamin A, vitamin B5, MSM, probiotics, digestive enzymes, fish oils, omega fats, iodine
Will I have to take an anti-androgen long-term?
I have to. I experimented with not taking mine on vacations and have broken out again.
How is everything going now?
My skin remains clear. I currently follow the same simple cleansing regimen, take my anti-androgen daily, and get adequate sun exposure. I never drink caffeine, however I now allow myself some dairy products and occasional desserts. I only wish I had known about the hormonal causes of acne sooner.
Outside reading:
Do Milk and Sugar Cause Acne? By Dr. Mark Hyman in the Huffington Post
Female Acne and Hormones By Dr. Geoffrey Redmond and the Hormone Help Center of New York
Progesterone: The Almost Forgotten Hormone By Energetic Nutrition and citing Dr. John Lee
Saw palmetto reduced DHT levels by 32% in this study.
If you have questions, please PM me, do not respond to this post.
Gosh this is amazing. Thanks for putting all of this information into one post. The one I always forget is caffeine! I drink too much tea, which could be why I've started to get a little bit of acne on my chin again. I'm so glad I cut out dairy, but I still have to make a conscious effort to minimize my sugar intake. Sugar definitely has a dramatic effect on my skin. I don't know if I can go without makeup yet though. 
Thank you for posting all this info in one thread and making it easy to read and understand.
Sugar , dairy and caffine are gone for me now. Am supplementing with multi vit , plus pumpkin and sunflower seeds. Drinking spearmint tea, with nettle and nettle tea.
Trying to get a good half hour a day sunlight (whilst we still have some in the UK) don't eat processed food anyhow. Don't eat any bread or any white pasta/ rice. Handfull of nuts a day and fresh green leaves.
Feeling better and noticed improvement in active acne.
(I also extra supp with zinc. Its working for me)
So do you believe we have too much DHT, and not a sensitivity to it? Do you think we have too much DHT in the skin or too much free DHT in the body?
I lean towards the sensitivity idea, such as the hypothesis that androgen receptors can be more sensitive in some people due to
1. genetic sensitivity (many of the genetic markers for male pattern baldness have now been linked to DHT issues)
2. long-term overexposure to androgens during formative years (I think there is a reason acne is worst in cultures that feed kids dairy and sugar constantly during their formative years when their cells are developing)
It makes more sense to me that the sensitivity is concentrated in the skin and hair follicles, since this is where DHT primarily synthesizes.
But that's just speculation. Research is too scarce for me to form a solid opinion on why.
This information is very useful and undoubtedly holds some merit. The real question, however, is who has the time and patience to follow every single bit of such advice without promise of guaranteed results? There's always a concern about ability - some people cannot really afford to limit their diet drastically. I haven't even begun to address the fact that the prices of purely organic products make any middle-American cringe.
I actually don't advocate eating organically anywhere in here. My diet consists of meat, eggs, vegetables, whole fruits, and whole grains. I do not buy organic because, like many of you, I cannot afford it.
I'm not sure what you think has the "promise" of guaranteed results? I don't recall any acne treatment having the promise of guaranteed results. Doctors thought that was Accutane for a while...which has been proven wrong many, many times.
2. long-term overexposure to androgens during formative years (I think there is a reason acne is worst in cultures that feed kids dairy and sugar constantly during their formative years when their cells are developing)
Never heard this one before. Based on no research whatsoever, I would assume that overexposure to something would cause insensitivity to it, like with insulin. But I agree that our western diet has a huge role in acne and oily skin.
2. long-term overexposure to androgens during formative years (I think there is a reason acne is worst in cultures that feed kids dairy and sugar constantly during their formative years when their cells are developing)
Never heard this one before. Based on no research whatsoever, I would assume that overexposure to something would cause insensitivity to it, like with insulin. But I agree that our western diet has a huge role in acne and oily skin.
I should clarify that when I mean overexposure to androgens during formative years, a huge chunk of this is in the womb. Mom's hormones (affected by her own genetics, as well as diet and environment) directly contribute to the prenatal environment, which has huge effects on a kid's eventual adult stage hormones.
Polycystic ovary syndrome (PCOS) is a common endocrine disorder of premenopausal women, characterized by hyperandrogenism, polycystic ovaries, and chronic anovulation along with insulin resistance and abdominal obesity as frequent metabolic traits. Although PCOS manifests clinically during adolescence, emerging data suggest that the natural history of PCOS may originate in intrauterine life.
Implications for PCOS: The pancreas is altered by in-utero androgen exposure
Early-Life Exposure to Testosterone Programs the Hypothalamic Melanocortin System
Thank you Green Gables for your helpful information. Please, if anyone has tried Saw Palmetto tell me your experience, I would like to give this a try. I am currently taking Diane35 ( Ciproterone acetate) but I am not cured,but I don't know if there is an interaction with saw palmetto.
I wish I could take Spironolactone, but I tried it and I fainted in the first week because I have low blood pressure.
I was inclined to believe that excess DHT rather than androgen sensitivity is the issue, however I am starting to wonder if this is the case. I have lower than normal serum androgen levels, yet I have extra facial hair, acne around the chin and a very high sex drive. I assumed this meant excess DHT at the skin level and in the peripheral tissue. However, I recently learned that sometimes this can be measured by the hormone 3a-androstanediol glucuronide (mouthful), as it is a bi-product of skin level DHT. This hormone tests normal for me also. My endo says androgen sensitivity would be a genetic fluke, but I'm starting to believe that if my androgens and DHT are not high anywhere in my body, androgen sensitivity would be the only possible conclusion. This is the worst scenario, because Spiro requires high, or at least normal, androgens in order to have it's antagonistic effects on the androgen receptor.
I have also read the theory that fetal androgen exposure can have a lifelong negative effect. I remember my mom telling me that she ate nothing but sugar when she was pregnant with me. It's probably a reach - but this is a loose theory I have floating around in the back of my mind.
It is all quite complicated and no one knows the exact mechanisms by which androgens display their effects on the skin - my Harvard educated endo admits to this. He also doesn't believe in the estrogen dominance theory (it's hard to find a website on this issue that isn't selling something). I know for me progesterone has androgenic effects and is no good, but when my estrogen was highest late pregnancy I was the clearest I've ever been. Yet the opposite is true for some people. It's all a mystery. Quite unfortunate that more research has not been done.
HERBAL ROUTE
Take at least two different DHT herbal inhibitors. You will get better results and less side effects when you combine two or more different plant types. You must use standardized extract supplements ("whole herb" supplements are not potent enough). The most effective anti-DHT herbs are:
- Saw palmetto
- Stinging nettle
- Pygeum
- Pumpkin seed oil
So how effective are herbs vs. spiro? It has been difficult for me to get a prescription for spiro because doctors don't know much about it treating acne/they don't want to prescribe something 'off label'. I'm still going to try for spiro but how effective are these herbs in comparison?
Green Gables, if you are to provide a post like this you need to show the side effects of messing with DHT. The supplements you mention are usually harmless for women, but can cause some serious problems for men. Like anything, you have to weigh the risks and benefits of a treatment, and your initial post makes it seem like there are no potential dangers to the "self-correcting" of perceived hormonal imbalances. There are (85% pertain to men only though), and it would be great if you'd address them so the readers can make an informed decision. Or, I could post them if you'd like later on in the week.
Green Gables, if you are to provide a post like this you need to show the side effects of messing with DHT. The supplements you mention are usually harmless for women, but can cause some serious problems for men. Like anything, you have to weigh the risks and benefits of a treatment, and your initial post makes it seem like there are no potential dangers to the "self-correcting" of perceived hormonal imbalances. There are (85% pertain to men only though), and it would be great if you'd address them so the readers can make an informed decision. Or, I could post them if you'd like later on in the week.
Agreed. As a male, I would love to get the scoop on possible side effects of all the natural supplements mentioned. Thanks.
About the DHT and men stuff...
Make a separate post if you like. I made one about spironolactone that specifically addresses the side effects (and timeline of those side effects) for females. That side-effects post was based on my own experience, extensive talks with my endocrinologist (I actually made an appointment and asked him to help me write that post accurately), and hours of medical journal research.
Whoever does make such a post, I would really hope that you actually have extensive experience supplementing with anti-DHT herbs and/or prescription anti-DHT medications such as spironolactone (it was prescribed to males once upon a time, and still is sometimes in low doses) or Propecia. I mean, I don't like Accutane, and I know the documented risks for it, but I try to hold my tongue when it comes to "warning people about Accutane" because I didn't experience it. Therefore my opinion holds far less weight than someone who actually went through with it. I'd love to see a "warnings and side effects post" for saw palmetto, but it's much more valuable from someone who went through months and months of using those herbs and who recorded their experience. Not just someone who tried it for a month or two, got headaches and quit, and then used Google to write a post. Which may or may not apply to anyone here, just saying. Stepping off the soapbox now...
If you're just looking for more info from the male side, search for spironolactone male, or saw palmetto male (on the forum search), there are some users who have talked about their experiences.
thank you for all the info. do you know if its safe to take spiro with DIM/calcium d glucarate? i'm currently taking DIM+CdG right now and i just got prescribed spiro.. not sure if i should stop.
Yes, DIM is safe with spiro. In the simplest terms, DIM reduces the bad metabolites of estrogens and keeps the progesterone/estrogen balance in check. Some people find it helpful along with the spiro. Some people don't notice a difference either way. Very few report bad effects from it, though.
HERBAL ROUTE
Take at least two different DHT herbal inhibitors. You will get better results and less side effects when you combine two or more different plant types. You must use standardized extract supplements ("whole herb" supplements are not potent enough). The most effective anti-DHT herbs are:
- Saw palmetto
- Stinging nettle
- Pygeum
- Pumpkin seed oil
So how effective are herbs vs. spiro? It has been difficult for me to get a prescription for spiro because doctors don't know much about it treating acne/they don't want to prescribe something 'off label'. I'm still going to try for spiro but how effective are these herbs in comparison?
A lot of people PM me about their experiences, so I went through my PMs and counted. This is what I found from the recent conversations about non-spiro regimens. These are more recent conversations, every few months I go through and delete everything in my inbox.
Trying to make these vague as possible to protect privacy...
3 males who are 90%-100% clear from saw palmetto + stinging nettle (dosage 600-800mg daily)
2 males who have had moderate success on just saw palmetto (dosage 300-500mg daily)
1 male who only had minor success on just saw palmetto and then decided to go on Accutane (dosage 300mg daily)
2 females who are 80%-90% clear on just saw palmetto (dosage 1000+ daily)
1 female who is 100% clear on saw palmetto and no dairy diet (dosage 600mg daily upping to 1000mg on the highest testosterone week in the menstrual cycle)
1 female is 90% clear on saw palmetto + stinging nettle + vitamin B5 (not sure on her dosage)
1 female who is 80-90% clear on saw palmetto + stinging nettle + DIM + vitex (not sure on her dosage)
1 female who successfully cleared her acne and regulated her irregular period with over the counter USP progesterone (not sure on her dosage)
1 female who went on really high doses of saw palmetto only for 2 months, started seeing some clearing but didn't like the headaches and dehydration, and quit
So that's completely anecdotal and a really small sample, but that's what I've seen.
I had some clearing personally on saw palmetto + stinging nettle + vitamin B5 + vitamin A, but my saw palmetto/stinging nettle dosage was rather low for a female. It was during that time when I suddenly learned about spironolactone and got that prescribed. Because I wanted to see how well spiro worked, I quit everything except the spiro.
Please, Greengable, do you know if you can take this herbal suplement with Diane35? I would like to try saw palmetto, but I am scary because I don't know if there is an interaction with diane35. I know Diane35 is very strong pill, and It's forbiden in US and France, but not here in Spain.
Please, Greengable, do you know if you can take this herbal suplement with Diane35? I would like to try saw palmetto, but I am scary because I don't know if there is an interaction with diane35. I know Diane35 is very strong pill, and It's forbiden in US and France, but not here in Spain.
Spiro is prescribed with birth control all the time. Saw palmetto is not as strong as spiro and should not have any negative effects on your Diane-35. Go for it.
Thank you, Green Gables. I'll try saw palmetto and I'll report my experience. I am 43 years old, and sometimes I think I will have acne for ever, and I feel so desperate. I am currently upping my dose of zinc 50 mg ( 30 mg before), and I have notice some improvement but I realised It's not a cure.
I want to follow a paleo diet to help my acne.My college is soon going to begin and so i'll be away from my home living in an apartment with my buddies.I know paleo diet consists of:Meat,eggs,fruits and vegetables because in the paleolithic era grains weren't discovered.The question is :How should i survive ? i mean can someone suggest easy to cook things for a college guy who has never cooked before lol.I'll perhaps thrive on eggs like 30 egg whites [Edited image out]...But where will the vitamins come from?
Also ,since i lift weights,my protein requirement is tremendous.I need like at least 120 grams of it everyday.Given the fact that i'm from India where meat is not as readily available as is in the Western countries,are there any quick fixes?
It's an irony that the monster which is making my life not worth living (testosterone) is the reason why i'm a man and without which i won't be able to have pride in my masculinity .
Testosterone is a double edged sword.
Yes, Aanabill, I've been taking 50 mg zinc chelated for a month. Last month I was taking 30 mg zinc gluconate. It's suposed to inhibit enzyme 5 reductasa and I am upping the dose from 30 to 50 mg to know what happen if you inhibit more enzyme 5 reductasa.
When I was taking 30 mg gluconate zinc, I noticed that scars healed better, and less keratinitation, it helped but definetely not a cure.
Regarding the dosage, I know that many people in this forum are taking that dosage, and I take it after the meal, and I haven't noticed any adverse side effect and I take copper from a natural way (peanuts, almonds...).
I don't really want to get into what I call "The Great Man Debate". This is what boils down to. Both men and women have testosterone, progesterone, and estrogen. Different proportions of those hormones in the womb and as we are going through puberty form the significant internal and external differences between men and women. Yes, if you completely suck yourself dry of testosterone you won't feel so great...but this applies to anyone. Both men and women need testosterone for muscle-building, sex drive, etc. However, there is that line where there is always TOO MUCH of a good thing.
DHT is one of the most potent forms of testosterone. Yet, too much of it causes BALDING, ACNE, EXCESSIVE LIBIDO, and here's the kicker LOW SPERM COUNT. Good lord, people, please tell me how low sperm, men who act like salivating dogs, and balding is manly. I don't care if you're pumping iron every day and have a sixteen pack...pus-filled cysts on your face, a Donald Trump combover in your early thirties, the inability to ever father children yet humping everything in sight....none of these things are hot. Or manly.
Hormone regulation is about finding a balance of hormones. If you are a man, yes, you don't want to take your testosterone down to zero. But you also don't want to be a horny horndog with acne who can't attract anyone. Sometimes a little less testosterone puts your body in an IDEAL hormone range and actually makes you more attractive. More testosterone does not equal more manly. IDEAL LEVELS of testosterone = manly. Acne is a sign those testosterone levels are NOT ideal.
Different strokes for different folks, but I know A LOT of women who are completely grossed out by little hygiene things. You know, not flossing your teeth. A little bad breath. A little body odor. Not washing your junk. Guess what ranks really high on the gross list? ACNE. SOMETHING THAT LOOKS LIKE A RAGING INFECTION ON YOUR FACE. If bodybuilding is that important to you...just realize...having a six pack and bulging arms doesn't compensate for a disease on your FACE which is what people have to look at 99% of the time!!!
Even as a woman who has (obviously) struggled with acne, in my completely hypocritical double standard, I'd take clear skin and a little flab over AcneManWithWashboardAbs any day of the week.
P.S. Accutane reduces testosterone.