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Testosterone Topical Cream
Applying testosterone to the skin is a convenient and cost-effective method of replacement therapy.



Men's Health


Testosterone Replacement Therapy


Testosterone Topical Cream

Testosterone Topical Cream
Applying testosterone to the skin is a convenient and cost-effective method of replacement therapy.
Testosterone Replacement Therapy Defy Medical 04

Defy Medical offers a variety of options for personalized replacement therapy, including custom testosterone creams and gels designed for maximum absorption with predictable results.

Topical creams and transdermal delivery systems have long been used to introduce hormones into the bloodstream without the need for injections.

Topical testosterone is one option available to patients who prefer the daily application of a topical cream.  Testosterone is available as a topical cream or gel applied to the skin to deliver a steady supply of hormone over 24 hours. Testosterone cream is typically applied once daily, using an applicator that dispenses a measured dose directly to the skin.

Ask your doctor about topical options during your consultation. 

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Learn More About Topical Testosterone Creams and Gels

Testosterone is available as a transdermal delivery system (TDS) in various concentrations for topical application.

The patient applies the prescribed amount of gel or cream to the skin, and a small amount of the hormone penetrates through the skin, absorbing into circulation. When applied daily, topical testosterone gel or cream typically provides a 24-hour window of effectiveness, which naturally mimics the rise and fall of testosterone throughout the day.

Types of transdermal delivery systems

Transdermal delivery systems work by diffusion. The drug diffuses from the “carrier” through the skin to circulate throughout the body.

The most common types of carriers used for hormone therapy include:

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Although each type of delivery system has a different appearance and texture, all are designed to deliver the highest concentration of active ingredient.

There are transdermal creams and gels designed to deliver multiple active ingredients at once. A compounded hormone combination cream is an example of a multi-drug transdermal delivery system (i.e. a topical cream including 10% testosterone and 5% Nandrolone).

Compounding pharmacies can compound testosterone using the delivery system that is best for the patient. Manufactured brand-name transdermal testosterone products are available only as either a gel or transdermal patch.

Common transdermal testosterone delivery systems (TDS)

Compounding pharmacies usually carry a variety of TDS bases that can be used to make a transdermal hormone. Many pharmacies manufacture their own TDS formulas and even make improvements to existing base formulas available at the pharmacy supplier.

Here is a list of common TDS bases used in transdermal hormone products including testosterone:

Transdermal cream base designed to deliver multiple medications or hormones through the skin.

An oil-in-water emulsion developed for topical or vaginal delivery in Hormone Replacement Therapy.

Primarily used for women, this versatile base can also be used for men as it is highly absorbent and specially designed with an emollient to help soften skin. Alternatively, this base can be used in a wide variety of other medicated topical applications.

This is a cosmetic transdermal cream base that is designed to deliver fast absorption of medication. Due to its moisturizing effects on the skin, Versabase® can be used for both cosmetic and pharmaceutical application.

Alcohol is used to solubilize the skin to allow for diffusion of the hormone. Hydro-alcohol gels dry faster than transdermal creams, but can also be drying to the skin and may irritate the application site.

All types of TDS listed are available at compounding pharmacies.

Transdermal Testosterone Absorption
transdermal application

Absorption can vary between individuals who apply transdermal testosterone to the skin.

The standard measurement of predicted absorption used by compounding pharmacists is 10% - meaning roughly 10% of the total dosage of topically applied hormone will penetrate the skin.

For example, for every 100 mg of testosterone applied, only 10 mg will actually be absorbed through the skin. Because the absorption rate will vary based on the individual, it is important to do follow-up blood tests to determine the right dosage based on your unique absorption rate.

Men typically require 7 mg-10 mg of testosterone daily to reach the upper quartile of optimized testosterone levels and gain relief from hypogonadism symptoms.

The Benefits of Compounded Medications

Using compounded transdermal testosterone appears to be more effective than brand name (manufactured) transdermal testosterone products (Androgel, Testim, etc.) for a few reasons.

  • Higher concentrations of testosterone can be achieved in a compounded transdermal.
  • Most male patients respond best to dosages between 5% - 20% applied topically to reach 5mg-10mg absorption.
    • Common strengths found in compounded topical testosterone products range between 5%-20% testosterone. 5% equals a 50mg/ml concentration of testosterone; 7% equals 70mg/ml; 10% equals 100mg/ml; etc.
    • The highest concentration available for most transdermal hormone creams and gels is 20%, or 200mg/ml. More than 20% concentration may result in poor distribution of the testosterone, ‘clumping’ of the ingredients, and reduced absorption of the medication.
  • Patients can select the transdermal delivery system that works best for them through compounding.
    • 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 areas can irritate the skin, therefore using a compounded cream is preferred.
    • Some patients who do not experience skin irritation may like the consistency and faster rate of absorption found in gels. Compounding pharmacies can compound either a gel or cream depending on what the prescription calls for. If the type of delivery system is not specified on the prescription, the pharmacy will usually default to either a cream or gel base.
Available Transdermal Delivery Systems for Testosterone
Compounded Medications

Testosterone is available at compounding pharmacies who specialize in hormone preparations.

Compounding pharmacies have the ability customize topically applied testosterone into different strengths and combinations using a variety of transdermal delivery systems (Lipoderm, HRT, Versabase, alcohol gel).

Compounding pharmacies can be used to prescribe a higher concentrated transdermal testosterone which will allow enough of the hormone to be absorbed to maintain a good physiologic level of total testosterone.

In addition, testosterone can be compounded using a custom delivery system which will result in minimal skin reactions. Lipoderm, Versabase, and HRT base are delivery systems that can provide maximum bioavailability and penetration of active ingredients while minimizing skin irritation that can occur with alcohol-based gels or transdermal patches.

The higher dose compounded testosterone creams containing 5% to 20% testosterone have been available by physician’s prescription from any compounding pharmacy specializing in hormone preparations.

The cost for compounded testosterone creams is less than 1% AndroGel® and less expensive generic alternatives can be compounded by many pharmacists. A low dose dihydrotestosterone, DHT gel, labeled Andactrim™, also from Solvay, has been available in Europe for almost a decade. Doctors who specialize in bio-identical hormone replacement therapy have been using cream and gel delivery of female hormones for decades.

Compounded testosterone creams create more physiologic testosterone levels, skin reactions are minimal, and short-term discontinuation of therapy is possible due to the longer half-life of up to 25 hours.

Scrotal application is also convenient and discrete while theoretically producing more DHT than when applied to other locations on the body.


Brand Name Delivery Systems

Common brand name testosterone products on the market include:

AndroGel® is a low dose 1% (10 mg/ml), testosterone product. On the market since July 2000, it provides a safe, alcohol-based gel containing testosterone in low physiologic doses.

Due to the low concentration, larger amounts are required for adequate testosterone replacement in men.

Testim®, released in 2004, seems to have slightly better absorption rate than AndroGel, making it more efficient, but it also has a low concentration of testosterone (1%). Therefore, the increased absorption rate may not provide significant elevation of total testosterone.

Patients have also reported a slight musky odor after applying Testim®.

Clinical trials have also proven that testosterone patch called Androderm®, developed by Watson Pharmaceuticals in 1985, is another safe form of testosterone replacement.

Clinical trials have also proven that testosterone patch called Androderm®, developed by Watson Pharmaceuticals in 1985, is another safe form of testosterone replacement.

Androderm® is available in two strengths, as either a 2mg or 4mg transdermal patch. Due to the low strength, two patches are often needed to adequately restore testosterone.

Patients who use testosterone patches have reported problems with the patch falling off, particularly when they are physically active. Patients have also reported skin irritation including a rash at the site where the patch is applied.

Transdermal Testosterone Options: Compounded Testosterone cream, Testim®, Androderm® (patch), Androgel®

Transdermal containers

Dispensing Syringes


Dispensing syringes of various sizes are commonly used for hormone gels and creams. The hormone is dispensed by depressing the plunger until a measured dose releases from the syringe.

Plastic or Glass Jars


Plastic or glass jars can also be used to store medicated transdermal gels and creams. The jar may come with a measuring spoon or the patient can use their finger to apply an estimated amount of hormone.

Topi-Click Containers


Another common dispensing container is called “Topi-Click”, similar to 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 or click of the dial equals 1/4ml of medication.

Other containers might be available depending on the pharmacy. If the prescription does not request a specific type of container, then the compounding pharmacy will usually default to one of the more commonly used containers.