How to Apply Testosterone Cream

Testosterone topical cream (which is actually more gel-like) is used to treat people whose bodies don't make enough natural testosterone—a condition called hypogonadism—and as hormone replacement therapy (HRT) for transgender men and non-binary people. Testosterone is a hormone that triggers the growth and development of male sex organs and maintains masculine secondary sex characteristics, such as a deep voice, muscle mass, and a relatively hairy body. Testosterone cream/gel is available only via a doctor's prescription and precautions need to be taken while applying it.

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Applying Testosterone Cream

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1
Choose your product. Once your doctor has established that you’d benefit from testosterone gel, talk with them about what product (and strength) is most appropriate for you. Androgel and Fortesta are both available in individual packets and multi-dose pumps.^{[1]XTrustworthy SourceCleveland ClinicEducational website from one of the world's leading hospitalsGo to source} Vogelxo is available as individual packets, multi-dose pumps and tubes.
- Prime the applicator before using it for the first time by holding it over a sink and pushing the pump until it releases full doses of gel. If you’re using an Androgel of Vogelxo, pump it three times.^{[2]XResearch source} If you’re using Fortesta, pump it 8 times.^{[3]XResearch source}
  - Wash the extra gel down the drain or prime the pump over a waste bin that pets and children can’t access.
- Individual packets (AndroGel, Fortesta, and Vogelxo) are pre-portioned and don’t need any priming—you just tear the packet open.
- If you’re using testosterone for gender-affirming care, talk to your doctor about what results you want from HRT. It can take longer for your secondary sex characteristics to develop with topical testosterone compared to injections.
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Measure out the correct dose. Once you've primed the applicator, wash your hands and pump the prescribed amount of testosterone gel into your palm.^{[4]XTrustworthy SourceCleveland ClinicEducational website from one of the world's leading hospitalsGo to source} If you’re using individual foil packets or the Vogelxo single-unit tube, squeeze the entire contents into the palm of your hand or directly to the area your doctor recommended applying it.^{[5]XResearch source}
- AndroGel is available in two dosage strengths: 1% and 1.62% concentrations. Both are applied to the skin, but in different amounts.
  - The recommended starting dose of AndroGel 1% is 50mg (4 pumps) applied once daily to your skin.^{[6]XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source} AndroGel 1.62% prescriptions start at 20.25 mg (1 pump) daily.
- The strength of the gel and number of pumps you need are based on your base testosterone levels and how large a person you are.
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Apply the cream/gel to your body. Apply the testosterone cream/gel to clean, dry skin on your shoulders, upper arms, or abdomen (stomach) — unless your doctor recommends a different location.^{[7]XExpert SourceScott Tobis, MD
Board Certified UrologistExpert Interview. 26 August 2021.} In general, put the gel on areas that can be covered by clothes easily to prevent other people and animals from coming into contact with it.^{[8]XExpert SourceScott Tobis, MD
Board Certified UrologistExpert Interview. 26 August 2021.}
- The stronger concentration of AndroGel (1.62%) is usually only applied to the shoulders and upper arms.
- Fortesta gel/cream is typically applied to the front or inner skin of the thighs (upper legs).
- Only apply Vogelxo gel/cream to your shoulders or upper arms—not your abdomen or stomach.^{[9]XResearch source}
- Never apply Testosterone cream/gel to your genitals or skin that has cuts or scrapes.
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Wash your hands before and after applying the testosterone. Wash your hands with warm water and soap immediately after applying your cream.^{[10]XExpert SourceScott Tobis, MD
Board Certified UrologistExpert Interview. 26 August 2021.} Don’t touch anything or anyone else—while testosterone cream can be beneficial for people who need HRT, it can disrupt the hormone balance in people or animals who don’t.
- If another person accidentally gets the gel on their skin, have them wash the area with soap and water as soon as possible.
- If you have to have skin contact with someone, like during sex, thoroughly wash the area you applied the gel to beforehand.
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Cover the application area with clothes. After washing and drying your hands, put on clothes over the area with the gel.^{[11]XResearch source} Allow the testosterone cream/gel at least 10 minutes to absorb into your skin before putting on your clothes—this is for the protection of other people (and pets) more than anything else.^{[12]XExpert SourceScott Tobis, MD
Board Certified UrologistExpert Interview. 26 August 2021.}
- Depending on the health and hydration of your skin, absorption can take less than 10 or up to 20 minutes.
- Wear breathable cotton garments so your skin can keep absorbing testosterone after your clothes are on.
- Keep dirty clothes, towels, and bed linens away from pets, children, and people who are pregnant or breastfeeding.^{[13]XResearch source}
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Wait at least two hours to bathe after applying the gel. After applying AndroGel 1.62%, Fortesta, or Vogelxo, wait at least two hours to shower, swim, or do any vigorous exercise. If you’re using AndroGel 1%, wait five hours. Getting your skin wet too soon can wash off the cream.^{[14]XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source}
- Although the gel/cream may look like it's completely absorbed after 10 minutes, it actually takes longer for it to penetrate all the layers of your skin and reach your bloodstream.

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Taking Precautions with Testosterone Cream

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Get your testosterone levels checked at regular intervals. Schedule regular visits with your doctor (every few months or so) so they can check your progress, take blood samples, and see if the testosterone medication is working as expected.^{[15]XTrustworthy SourceNational Institutes of HealthU.S. government agency for biomedical and public health researchGo to source} If your serum testosterone levels are off your doctor can make changes to your dosage.
- Signs and symptoms that your testosterone levels may be too low include low sex drive, trouble getting an erection, hair loss, lack of energy, loss of muscle mass, increase in body fat, and mood changes (depression).
- It can take three to six months of daily application of testosterone gel to counteract hypogonadism—sometimes longer.
- Don’t use this medicine if you’re treating the symptoms of a natural decline in testosterone due to aging.^{[16]XResearch source}
2
Keep the gel from touching other people and animals. When not prescribed, testosterone can cause a hormonal imbalance and negative health effects. If someone is pregnant, it can cause birth defects in their fetus. It can trigger masculine secondary sex characteristics in women and over-stimulate the sexual development of children.^{[17]XTrustworthy SourceNational Institutes of HealthU.S. government agency for biomedical and public health researchGo to source}
- Secondary sex characteristics include a deep voice and increased body hair growth.
- Rubbing up against the skin of someone who's just applied the gel once or twice isn’t especially dangerous, but repeated exposure to testosterone can cause problems in other adults, fetuses, and children—as well as pets.
- Have other people avoid touching anything that comes directly in contact with your skin, like clothes, towels, and sheets.
3
Recognize the negative side effects. Applying testosterone cream to your skin for months or years increases the risk of negative side effects. You may experience bloating and swelling, acne, blurred vision, dizziness, flush, headaches, hair loss, sweating, or urinary tract problems.^{[18]XTrustworthy SourceCleveland ClinicEducational website from one of the world's leading hospitalsGo to source} Let your doctor know about new side effects immediately.
- If you have a prostate you’re more likely to experience blood in your urine, difficulty urinating, or frequent urination.
- If you have sleep apnea, testosterone cream could worsen your condition. Speak to your doctor about treatment with a CPAP machine.
- People using testosterone cream are also at risk for deep vein thrombosis and pulmonary embolism due to the increased red blood cell count that results from testosterone therapy. Talk to your doctor if you want to be screened for this and keep an eye out for leg/calf pain or shortness of breath.
- Taking testosterone medication typically causes your testicles to shrink due to atrophy (not working as hard producing natural testosterone). On the other hand, testosterone gel therapy can enlarge the penis or clitoris.

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Where is the best place for testosterone cream?
Scott Tobis, MD
Board Certified Urologist
Dr. Scott Tobis is a board certified Urologist. With more than seven years of experience, he specializes in treating patients for urologic conditions such as urologic cancers, prostate enlargement, vasectomy, kidney stones, frequent/urgent urination, erectile dysfunction, incontinence, and blood in the urine. Dr. Tobis holds a BS in Cellular and Developmental Biology from The University of California, Santa Barbara, and an MD from Dartmouth Medical School. He completed his internship in General Surgery and residency in Urologic Surgery at the University of Rochester School of Medicine and Dentistry and his fellowship in Urologic Oncology and Robotic Surgery at The City of Hope National Medical Center. Dr. Tobis is a diplomat of the American Board of Urology.
Scott Tobis, MD
Board Certified Urologist
Expert Answer
Generally, testosterone cream works best when placed on the upper arms and chest, after the skin has been cleaned and thoroughly dried first. These areas tend to have good absorption of the medication through the skin.
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Tips

Store your testosterone gel in a closed container at room temperature away from any heat source, moisture, and direct light. Never freeze it.
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If your skin starts to get irritated and itchy from applying the testosterone gel, change locations. Make sure to clear it with your doctor first.
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Switch the sides you put the gel on. For example, alternate days putting the testosterone on your right and left shoulders.
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