Yes, acne is caused by testosterone (putting it simply), and many factors contribute to your levels of testosterone such as stress, diet, and exercise.A blood test that measures low or in range testosterone does not mean your testosterone is not causing your acne, it’s much more complicated than that. People who suffer from acne will have an increased follicle sensitivity due to an increased level of 5 alpha-reductase in the skin. What is 5 alpha-reductase? It’s an enzyme which regulates testosterone converting it into dihydrotestosterone (DHT). What is dihydrotestosterone (DHT)? It’s a different form of testosterone, found in both men and woman, and responsible for: in men – formation of external genitalia, development of facial hair, deepening of the voice and muscle growth, in excess for men can cause balding, and for females – determines the onset of puberty and sex drive and in excess can cause polycystic ovarian syndrome (PCOS), facial hair, balding and acne. So what’s the point? “Well” everyone wants blood tests to check their sex hormones, but what are those result actually telling you. A blood result showing low or in range, testosterone doesn’t mean your testosterone isn’t causing your acne. Your acne will depend on many more factors such as, do you have increased levels of 5 alpha-reductase? do you have follicle sensitivities? Are your hormones being regulated sufficiently? Do you have a good ratio of progesterone, estrogens and testosterone? How does your stress levels fluctuate from week to week? Do you have insulin sensitivity? and many other factors. In every acne case, the 4 pinnacle points that have to be addressed is diet, stress management, gut health and liver function. By addressing these 4 points you regulate sex hormones normalising the ratios, increase liver function enabling better metabolism of hormones, reducing inflammation by addressing your gut health and reducing the conversion of testosterone to DHT which stops the negative attributes of testosterone such as acne. Acne is complicated when looking at it from a top-down approach yet simple if you can understand it from a bottom-up approach.