The use of creams and gels are very common, requiring daily application once or twice a day. There are FDA approved topical testosterone and testosterone patches. We can also have testosterone cream and gels compounded to a specific dose for a particular patient. The upside to topical testosterone there is no injection. However, there are a few important concerns when it comes to topical testosterone.
Topical testosterone sounds quick and easy, but there are some important concerns which we have to take into account prior to prescribing. Topical testosterone can be transferred through the clothes for up to 12 hours after application. What does this means for patients? We do not recommend topical to men with small children because they can transfer it to the kids. Once testosterone is transferred to the kids they will start developing masculinization symptoms.
Not only does testosterone transfer occur up to 12 hours after application, if you are not careful with your hygiene after application will also inadvertently transfer testosterone to others. For instance, lets say you apply your testosterone gel a with your right hand and then you use that hand to open the faucet, you will leave some residual testosterone on the tap and some who comes along and opens that faucet later will inadvertently absorb testosterone.
Men who are married or involved in a relationship should really consider not using topical testosterone because it can be transferred during intimacy.
On another note, testosterone applied on the skin is quickly converted to DHT because most of the enzymes which convert testosterone to DHT is located in the skin. While on testosterone therapy the DHT levels will monitored on a regular basis.