Topical Androgen Transfer

Discussion in 'Men's Health Forum' started by Michael Scally MD, Jun 5, 2013.

  1. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    With topical formulations, there is a risk of person-to-person transmission if appropriate precautions are not taken. We describe two cases of virilization in pre-pubertal children following passive transfer of paternal topical testosterone.

    A 21 month old male was referred with a 6 week history of pubic hair, phallic growth, and linear growth spurt. Genital examination revealed Tanner stage 2 pubic hair and Tanner stage 3 phallic development, which was discordant with the pre-pubertal testicular size (2 mL bilaterally).

    A 3 year 8 month old girl was referred for a 2 month history of increasing pubic hair development. Examination revealed Tanner stage 2 pubic hair and Tanner stage 1 breast development.

    Both of these patients had fathers who had been diagnosed with hypogonadism and were being treated with topical androgen gel therapy, which they applied to their arms and chest before bed. In addition, both patients often slept with their parents resulting in skin-to-skin contact.

    Investigations were consistent with gonadotropin independent virilization with both patients demonstrating elevated testosterone levels. Testosterone levels returned to normal pre-pubertal levels with no further development of secondary sexual characteristics following discontinuation of exposure to topical testosterone.

    Precautions must be taken to prevent person-to-person transfer of topical steroids. With the increasing popularity of topical steroids for the treatment of low testosterone, it is imperative that these therapies be prescribed and utilized judiciously to prevent harm, specifically gonadotropin-independent virilization.

    Nelson D, Ho J, Pacaud D, Stephure D. Virilization in two pre-pubertal children exposed to topical androgen. J Pediatr Endocrinol Metab 2013:1-5. Virilization in two pre-pubertal children exposed to topical androgen : Journal of Pediatric Endocrinology and Metabolism
    BBC3 likes this.
  2. BBC3

    BBC3 Member

    The REAL QUESTION is going to be - Under WHAT CONDITIONS are these topical testosterone creams and gels POTENT, and the WHAT DEGREEs..!!?? The long and short is as I have made clear, I believe the new Axiron is an attempt at heading this off at the pass, as it appears to be more of a plain old "alcohol/test" mixture, thus greatly limiting viable potency TIME. BUT IS THAT RIGHT AT ALL??!! Whereas compared to Testoderm or the more typical gels, they appear to have some longer term "emulsifiers/potentiators", that I speculate could leave a glob dropped on the bathroom floor potent for days... Thats a layman's interpretation anyway.


    1. What value does synthetically manufactured testosterone as not esterfied have on the skin just alone and with no additives?
    I recall first learning about testosterone supplementation, and as AAS. The general consensus was the testosterone as a steroid has very little value on at the digestive tract, and even less on the skin. But come to think of it, that was pertaining to cypionate as discussed really. I also believe that "raw testosterone as synthetic" was also included in the context of the discussion, but not sure. I dont think any documentation was ever produced.

    2. What are the ingredients in the various common testosterone gels and creams as marketed today? What are the differences? What is the intention precisely of each ingredient of these testosterone concoctions? And how do they work
    Can we really conclude the time that a gel may remain effective based on the time it says to leave the application area unwashed? (For example the new Axiron citing about two hours I think)

    3. Does synthetic testosterone as a cream or gel interact with common ORGANIC or INORGANIC components in our daily lives? Does gel spilled on a hard tile floor retain potency better than gel spilled in carpet? Could gel placed on wool, synthetic fibers, or even cotton involve itself in a molecular way creating a "potent depot" as an incidental supply source long term?. Do the chemical potentiators in gels intended to help saturate the skin happen to perhaps also coincidentally involve the hormone in PLASTICS long term (cups, dishes)? ETC. ETC. ETC....? Does it even wash out of clothes? Or is it being spread throughout the wash (I suspect)? Have these principles been tested? SHOULD THERE BE A SPECIAL CLOTHES WASHING PROTOCOL FOR MEN USING CREAMS WITH KIDS IN THE HOUSE ( re: Detergent, time, water temp, dont mix clothes in same wash, etc..)?? And really, if the stuff still has a potent value after all solvents and emulsifiers have evaporated, DOES TESTOSTERONE FLOAT IN WATER?!?!?? Do standard vertical drum washers allow the testosterone to simply float on top thus creating a building "ring" of hormones at the top of the washer tub, just creating an ever building supply in the washer.?? Should there be a washing machine maintenance and cleaning protocol for those using hormones?

    4. How do factors like HEAT involve? Does cold preserve?

    5. How do these creams interact with common household cleaners and other common chemicals that come on furniture? The fire preventions chemicals in couches? The stain preventers in carpet? Wood polish? Windex? BODY OILS ON REMOTE CONTROLS..?!?!?!! What else was in that body oil other than the gel from the hand of the dad that just applied it?? How often is dad scratching his ass and pits in between changing channels, then the kid taking the remote?(big one). Logically, gels are going to even irritate the skin causing the person to touch it MORE>.. Personally, I like to stroke and caress the application area like its a big ol third nut I am so proud of... How impregnated can a household become...?!

    6. Most importantly. What is the difference between an INFANT or CHILD's skin vs. and adult's skin? Clearly the manufacturers are not going to be running trials on children's skin with regard to hormones, but what does medical science know about the properties of a young infants skin. REALLY DO THEY GIVE A SHIT WITH REGARD TO HORMONES!!!! Clearly, we recall that our skin was a lot softer and less worn all the way up to at least 10,11, even 16 depending on genetics. But just how susceptible is an infant's skin to things they may come into contact with???!!!! Is anyone paying attention at all??
    Last edited: Jun 7, 2013
  3. Nemesis RR

    Nemesis RR Member

    I workout with my kid and help him with grappling. When the doc said gel I said hell no.
  4. BBC3

    BBC3 Member

    I suspect gels are going to prove to be a socio-medical CATASTROPHE...!

    And again, ALL empowered by the past demonization. Here we are in this day and age and just how many children do you REALLY think are being accidentally POISONED by their fathers and lazy sorry ass docs who dont even bother to tell them...!
  5. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    [OA] Transfer of Topical testosterone to Subcutaneous Microdialysate, Blood and Saliva

    OBJECTIVE: We evaluated percutaneous penetration of topical testosterone and subsequent transfer to subcutaneous tissue, blood and saliva.

    METHODS: This microdialysis trial involved eight healthy male volunteers. Five participants received a single dose of 50 mg testosterone gel on the abdominal skin and three untreated participants served as controls. Two microdialysis probes were inserted percutaneously into the abdominal subcutaneous adipose tissue. On the skin above one probe, testosterone gel was applied (ipsilateral side). A second control probe was inserted on the contralateral side. For the determination of total and free testosterone, samples of subcutaneous microdialysate, serum, and saliva were collected over six hours, frozen, and analysed using ELISA procedures.

    RESULTS: Testosterone values in the ipsilateral microdialysate of treated subjects increased significantly within 6 h after gel application compared to controls. Salivary testosterone levels showed a rapid increase within 20 min after transdermal application followed by a plateau phase with tenfold increased testosterone levels. Microdialysate testosterone of the contralateral site started to rise moderately within the normal range 1 h after administration of testosterone gel whereas total and free testosterone serum concentrations increased within 2 h in each case followed by a plateau phase.

    SUMMARY AND CONCLUSION: Single topical administration of testosterone gel leads to a continuous increase of testosterone in the subcutaneous ipsilateral microdialysate. Rapid salivary testosterone increase happens after gel administration followed by tenfold increased testosterone plateau values. Despite continuous influx, testosterone concentrations in serum, saliva, and contralateral microdialysate show a plateau formation thus avoiding testosterone excess.

    Krebs A, Clement HW, Zimmerer J, et al. Transfer of Topical Testosterone to Subcutaneous Microdialysate, Blood and Saliva in Healthy Young Men. Experimental and clinical endocrinology & diabetes: official journal, German Society of Endocrinology [and] German Diabetes Association 2018. Thieme E-Journals - Experimental and Clinical Endocrinology & Diabetes / Abstract