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Local Hair Growth at the Site of Subcutaneous Testosterone Injections in Two Transmen

Ron S Newfield1,2* and Maja Marinkovic1,2
1Department of Pediatric Endocrinology, University of California San Diego, USA
2Department of Pediatric Endocrinology, Rady Children's Hospital San Diego, USA


*Corresponding author: Ron S Newfield, Department of Pediatric Endocrinology, University of California, Rady Children's Hospital, San Diego, USA


Published: 21 Sep, 2018
Cite this article as: Newfield RS, Marinkovic M. Local Hair Growth at the Site of Subcutaneous Testosterone Injections in Two Transmen. Ann Clin Case Rep. 2018; 3: 1545.

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We report for the first time of terminal hair growth at the testosterone injection sites in two transmen. Patients’ readiness for masculinizing treatment was confirmed by therapist and they were appropriately consented/assented. 17y old Caucasian transmale receiving Depot-Lupron™ for pubertal suppression, was started on Depot-testosterone cypionate 50mg every two weeks, administered subcutaneously (SC) using 25G-needle. Testosterone was increased after 2.5 months to 40mg weekly and Lupron™ was discontinued. He injected exclusively lateral to the umbilicus and after 8 months two patches of coarse terminal hair were noted (Figure 1). Total and free testosterone troughs were appropriate for adult males: 495 ng/dL and 60.1 pg/mL, respectively. Another transmale (14.5 yr Mexican American), receiving Depot-testosterone cypionate 50mg weekly, also injecting solely lateral to the umbilicus, developed mild terminal hair and hyperpigmentation at injection sites. Recent publications of SC testosterone [1], or IM versus SC testosterone [2] didn’t describe localized hair growth, however it was noted in 4/5 postmenopausal cis-women receiving 10mg Depot-testosterone cyclopentylproprionate SC every 5-6 weeks [3].
This rare event may be avoided in transmales by injection-site rotation.


Figure 1

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Figure 1
Local hair growth at the site of subcutaneous testosterone injections.

References

  1. McFarland J, Craig W, Clarke NJ, Spratt DI. Serum testosterone concentrations remain stable between injections in patients receiving subcutaneous testosterone. J Endocr Soc. 2017;1(8):1095-103.
  2. Spratt DI, Stewart II, Savage C, Craig W, Spack NP, Chandler DW, at al. Subcutaneous injection of testosterone is an effective and preferred alternative to intramuscular injection: Demonstration in female-tomale transgender patients. J Clin Endocrinol Metab. 2017;102(7):2349-55.
  3. Maguire HC Jr. Facial hair growth over the site of testosterone injection in women. Lancet. 1964;1(7338):864.