7 Special Skincare Concerns for the LGBTQIA+ Community

Everyone struggles with their personal cocktail of skin concerns, whether it’s acne, blemished skin, uneven tone, sun damage, or scars. While environmental damage from the sun (and tanning) and even blue light from our phones are definitely to blame for some skin woes, our skin’s appearance and texture is not determined solely by the environment—it is also a reflection of what’s going on inside our bodies.

As an LGBTQ patient, it’s key to find an in-the-know dermatologist or cosmetic surgeon who will treat your skin with an understanding of your particular medical history, gender identity, and sexual orientation. Wonder why this matters? Here are 7 special skin concerns that bring LGBTQ individuals to the dermatologist or cosmetic surgeon, and the factors we consider when treating LGBTQ patients at Anderson Sobel Cosmetic Surgery.

1. The importance of skin cancer prevention

Research shows that self-identified gay and bisexual men are at a greater risk for developing skin cancer in their lifetime. We already know that excessive sun exposure, tanning beds, and having fair skin are risk factors for developing skin cancer, and for this specific population, there is a greater risk of developing both skin cancer and other forms of cancer if you carry other risk factors, including:

• HIV positive status
• A family history of cancer
• Infection with the human papillomavirus (HPV)

These data indicate that much work is needed from healthcare providers and researchers to better meet the needs of the LGBTQ population. Your dermatologist, cosmetic surgeon, and other physicians should both learn about you and work together to provide you with excellent care.

Still, knowing your risk factors can encourage you to take preventative measures by scheduling annual skin screenings with your dermatologist and wearing a broad-spectrum, mineral-based sunscreen of at least SPF 30. The ingredients titanium dioxide and/or zinc oxide best protect against oxidation in the skin. Because these products are often a little harder to apply and maintain, they are challenging to find outside of a cosmetic surgeon or dermatologist’s office, but essential for safe and perfectly-performing skin protection.

2. Acne treatment during T-therapy

Also known as MHT or T therapy, masculinizing hormone therapy leads to a number of dermatologic changes that your physician should take into account. One of the most frustrating and common issues is acne—also called “T acne”—that forms during the first year of treatment. It is important to treat it early since acne is known to exacerbate depression, and transgender individuals are already at a statistically higher risk of depression and suicide.

While this type of acne may be treated in some of the same ways as other forms of acne, some common treatments are not suitable for those undergoing hormone therapy. Isoretinoin (Accutane) is a common treatment for severe acne that may be effective for patients undergoing MHT; however, it comes with a number of drawbacks, including:

• Hormonal birth control can interfere with the effects of MHT, yet there are a number of strict regulations around Accutane regarding pregnancy prevention. Your prescriber should be fluent in discussing sexuality in order to treat you both appropriately and with sensitivity.
• If you are planning surgery, your surgeon may ask that you stop taking Accutane ahead of the procedure.
• It is unknown what effect Accutane may have on depression.
• Accutane can be liver toxic and enhance toxicity of medications, alcohol, and recreational drugs.
• Accutane may cause permanent changes to moisture production in the skin.

Because of the nuance of hormone therapy and gender affirming care, your hormones and overall health should be taken into consideration at every turn of your acne treatment plan.

Worried about acne scars? Luckily, acne scar treatment is more straightforward. We can resurface your skin and diminish acne scars—even discoloration or spots—with dermal fillers (particularly Belotero), chemical peels, and laser resurfacing treatments. There is a peel and a laser treatment for most skin types, ranging from gentler to more powerful for severe blemishes and uneven tone.

3. MHT and hormone-related hair loss

Testosterone-related hair loss, also called androgenetic alopecia or male pattern hair loss, results in the loss of hair from the top of the head, in the temples, back to the crown of the head in those transgender patients who undergo masculinizing hormone therapy. This may affect some and not others; and for some patients, this change is desirable as part of their transition.

Those trans men who desire treatment for this hair loss require that their hormones be taken into account in their hair loss treatment, as some treatments should wait until after you have fully developed the masculine characteristics desired. At Anderson Sobel Cosmetic, we offer NeoGraft® minimally-invasive hair transplants, in which the resilient hair follicles from the back of the head are used to replace those affected by testosterone. This procedure can be completed under local anesthesia in the office, and it gives you natural results that are permanent, short of continued natural hair loss.

4. Treating folliculitis after MHT

With testosterone therapy, you’ll see new hair growth—but sometimes, new hairs become ingrown or inflamed, a condition called folliculitis. The combined effects of developing acne can make the condition doubly frustrating. Treatment with laser skin resurfacing at your cosmetic surgeon’s office or prescription ointment and oral antibiotics from your dermatologist are typically safe treatments, allowing you to proudly enjoy your features.

5. Laser hair removal to fully feminize the face

Lasers are the gold standard for not just smoothing and resurfacing the skin, but for eliminating unwanted hair follicles. Feminizing hormone therapy may not stop facial hair from growing completely (or show changes quickly), so facial laser hair removal can be incredibly helpful for trans women, who may experience pseudofolliculitis barbae (PFB)—a fancy term for bumps caused by shaving. Over time, PFB can lead to scarring, hyperpigmentation, and affect your self-image as transfeminine. A series of laser hair removal treatments, preferably used before a shaving regimen to prevent the risk of PFB, can eliminate facial hair for good.

6. Melasma prevention and treatment

The risk of developing melasma is also exacerbated for transfeminine patients taking estrogen hormones. This pigmentary concern is already quite common in those with melanin-rich skin and those who live in sunny areas, and sun protection is the first line of defense. Should melasma occur, dermatologists can also prescribe topical creams or your cosmetic surgeon can treat it with medical facials, such as chemical peels and laser treatment.

7. Laser hair removal before gender-affirming bottom surgery

For those undergoing genital gender affirmation surgery, permanent hair removal is crucial pre-surgery to prepare areas to be used as surgical flaps, as well as in areas that may be used as grafts in construction of your genitalia. If your surgeon does not also perform permanent hair removal with electrolysis or lasers, a transgender-friendly hair removal specialist can work with both you and your surgeon to ensure you have the result you want from your gender confirmation procedure.

While there are numerous providers who offer laser hair removal, be cautious when you choose your provider for any kind of laser therapy: lasers are powerful devices, each with its own settings and applications. Choose a cosmetic surgeon who knows how to treat your skin tone with lasers, and is knowledgeable about hair removal for transgender patients.

Find a knowledgeable provider for your Seattle/Bellevue LGBTQ skin care

Who you are, your pronouns, and your experiences are relevant to your skincare and dermatologic concerns, and you deserve a cosmetic provider who approaches your care accordingly and provides a safe space for treating your cosmetic concerns. Choosing a physician who will treat your whole self will go a long way to helping you look and feel your best at every phase of your life.

At Anderson Sobel Cosmetic Surgery, we welcome LGBTQIA+ patients in search of aesthetic procedures, professional skin treatments, and medical-grade skincare. In your consultation, Dr. Sobel will work with you (and your other doctors) to understand your unique circumstances and fully customize your treatment plan. To learn more and schedule a consultation, call our office at (425) 453-9060 or fill out our online contact form and one of our caring staff will reach out to you.