Topical Testosterone: What Bases are Available?
Topical Testosterone is a popular form of Testosterone Replacement Therapy (TRT).
When you place a hormone cream on the skin and the medication is absorbed into the bloodstream, that’s known as transdermal absorption.
Typically, a small amount of the applied hormone reaches the blood, so dosages are created with this in mind. Topical Testosterone is also called a transdermal delivery system (TDS).
There are many types of topical Testosterone, including commercial and compounded options. These are made by taking Testosterone in its raw form and adding it to various creams, lotions, gels, and patches for topical application.
Each type of topical Testosterone has a different texture and appearance, but they are all designed to deliver the maximum amount of Testosterone possible to the skin.
When applied on a daily basis, topical Testosterone typically provides 24-hour duration of action. This naturally mimics the rise and fall of Testosterone levels throughout the day.
Types of Topical Testosterone/Transdermal Bases
Pharmacies usually carry a variety of topical Testosterone bases that can be used to make a transdermal hormone. Many pharmacies manufacture their own formulas and even make improvements to existing base formulas.
Here are common topical Testosterone bases used in transdermal hormone products, including Testosterone. Hormones like Estrogen and Progesterone are also available topically.
Lipoderm® is a transdermal cream base created by the compounding industry to maximize absorption. This deep-penetrating topical base is shown to effectively deliver hormones through the skin.
This formula does not separate when refrigerated, making it easier to use, and it has a creamy, non-sticky application for increased comfort.
Versabase® is a transdermal cream that also has cosmetic and moisturizing effects. This base typically works well for patients who like the benefits of lotion along with their topical hormone dose.
Versabase® is formulated to have a smooth, non-sticky application with fast absorption. It is non-irritating for most patients, hypoallergenic, and scentless. The base has been shown to mimic the skin’s natural moisture barrier.
HRT Cream Base
This versatile cream base is highly absorbent and designed to soften and moisturize skin. While it’s often used by female patients, men can also use this base.
The HRT cream is an oil-in-water emulsion, meaning it includes oil dispersed within the water base. This helps with its moisturizing effects.
This topical HRT base is designed in two formulations: heavy cream base and light cream base. The lighter formula works well when delivering one medication, while the heavy base work well for multiple hormones/medications.
This alcohol-based gel is designed to absorb quickly to limit transference.
Transference is something that can happen with most topical delivery systems. A family or friend may accidentally pick up the hormone cream from skin-to-skin contact.
It’s extremely important to avoid transference, both because it limits the effects of your TRT, and because it gives dosages to people who don’t need it.
An alcohol-based gel dries more quickly, making it an effective option for patients with children or other families/friends whom they want to avoid transferring to. The alcohol also solubilizes the skin (makes it more able to absorb the medication).
While there are many benefits, Hydro-Alcohol gel can potentially dry out and irritate the application site, especially if you have sensitive skin.
Topical Testosterone can also be applied via transdermal patches that contain the medication.
Similar to a smoking cessation patch, these patches stay on your skin throughout the day and deliver the medication over time. Transdermal patches are only available as brand-name medications like Androderm®.
Many patients dislike patches because they can be uncomfortable, fail to stay on oily skin, peel away during activity, and stick to body hair.
Commercial Topical Testosterone: Androgel and Testim
There are brand name TRT medications available to men, as well. Androgel and Testim are two types of commercial topical medications.
These typically have a fixed concentration and utilize gel as the base. The percentage of Testosterone in these medications is typically less than compounded alternatives.
How Well Does Transdermal Testosterone Absorb?
Absorption varies from patient to patient.
According to compounding pharmacists, the average amount of absorption is 10%. So, roughly 10% of the total dosage of topically applied hormone will penetrate the skin.
This means that for every 100 mg of Testosterone applied, an estimated 10 mg will actually be absorbed. Depending on the individual, sometimes less is absorbed, and sometimes more.
This is why it’s important to follow up with your provider and regularly test your levels to ensure your protocol is optimized and working for you.
Topical Testosterone Dosages
Men typically require 7 mg to 10 mg of Testosterone absorbed per day to optimize hormone levels.
To reach these levels, male patients often need their medication to be between 5% to 20% Testosterone. Five percent equals a 50 mg/ML concentration of Testosterone; 7% equals 70 mg/ML; 10% equals 100 mg/ML; and so on. The highest concentration available for most transdermal hormone creams and gels is 20%, or 200 mg/ML.
More than 20% concentration may result in poor distribution of the Testosterone, clumping of the ingredients, and reduced absorption of the medication.
Which Transdermal Base Should I Use?
The right transdermal base depends on many factors. That’s why it’s important to work with an experienced TRT provider who can explain your options and help you choose the best one for you.
For example, cream-based delivery systems apply better to skin in sensitive areas, such as the scrotum or inner thighs. Using an alcohol-based gel in these delicate areas can irritate the skin.
On the other hand, patients who don’t experience skin irritation may like the consistency and faster rate of absorption found in gels.
Containers for Topical Testosterone
There are different containers that can be used to dispense transdermal hormones.
- Topi-Click is a common dispensing container that looks like a deodorant container. The patient twists the dial at the bottom of the container to dispense a measured dose of transdermal hormone out of the opening at the top. One twist (click) of the dial typically equals 1/4 ML of medication. You can apply the Testosterone directly from the Topi-Click container, which helps avoid wasting or transferring the medication.
- Dispensing syringes are also commonly used for hormone gels and creams. Patients are provided pre-filled syringes (with no needle) that have the correct dosage inside. The hormone is dispensed by pressing the plunger.
- Plastic or glass jars are used to store Testosterone gels and creams, as well. The jar may come with a measuring spoon, or the patient can use their finger to apply an estimated amount of hormone.
- Other containers might be available depending on the pharmacy.
If the prescription does not request a specific type of container, then the pharmacy will usually default to one of the more commonly used containers.
Topical Testosterone Replacement Therapy at Defy Medical
Defy Medical provides hormone restoration to patients who are struggling from hormone imbalance. Our providers have more than 10 years of experience helping patients optimize their levels and lead happier, healthier lives.
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