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You get that from Michael Schellenberger, Matt Taibbi, Glenn Greenwald

Most evidence comes from animal studies or small preclinical trials

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Ozog DM, Rkein AM, Fabi SG, Gold MH, Goldman MP, Lowe NJ, et al

Yes, testosterone therapy can cause acne even with proper skin care because it increases sebum production and stimulates oil glands, making pores more likely to clog regardless of hygiene