Adult Male Acne Explained: Testosterone, Medications & Hidden Causes

Adult acne in men is more common than many people realize. In this in depth, evidence based video, board certified dermatologist Dr. Dray explains why breakouts persist well beyond the teenage years and how hormones, medications, and underlying skin conditions contribute to adult male acne. This comprehensive discussion covers the biology of the pilosebaceous unit, the role of testosterone and DHT in driving sebum production, and why excess oil can trigger not only acne, but also seborrheic dermatitis, pityrosporum folliculitis, and tinea versicolor. Dr. Dray also breaks down acne mimickers such as rosacea, bacterial and fungal folliculitis, and pseudofolliculitis barbae, helping viewers understand why accurate diagnosis is critical for effective treatment. She takes a deep dive into the follicular occlusion tetrad, including acne conglobata, hidradenitis suppurativa, dissecting cellulitis of the scalp, and pilonidal disease, and explains why these severe inflammatory conditions require medical management rather than over the counter products. Medication induced acne is also discussed, including testosterone replacement therapy, anabolic steroids, lithium, and the newer JAK inhibitor class, sometimes referred to as JAK induced acne or JAK ne. Finally, Dr. Dray reviews evidence based treatment options for adult male acne, from topical retinoids and benzoyl peroxide to oral antibiotics and isotretinoin, along with practical lifestyle tips and guidance on when to see a derma