TRT injection technique videos: what the science says about proper administration

What did @trt__np actually say?

The creator, presenting as a nurse practitioner offering TRT services, recommends two grocery store products to manage acne: a loofah (called a "luffus bunch" throughout) with antibacterial Dial liquid soap, and optionally a tea tree oil soap. The pitch is simple: scrub with the loofah, let the soap sit to kill bacteria, rinse off. They also describe tea tree oil as "an antifungal" that will "stop the poor from being infected." No mention of hormonal causes, sebum production, or why TRT patients are specifically vulnerable to acne in the first place.

The advice is delivered from what appears to be a grocery store aisle, which is a creative setting, but the clinical framing is loose. Calling it a method to "get rid of your acne" sets an expectation that a loofah and bar soap cannot consistently meet, especially in a TRT population where acne is driven by androgen-induced changes in sebaceous gland activity, not just surface bacteria.

Does the science back this up?

Partially. Mechanical exfoliation and cleansing do reduce surface bacteria and dead skin buildup, but they address symptoms rather than the hormonal mechanism driving TRT-related acne. The evidence for scrubbing as a primary treatment is weak at best.

Acne in the context of exogenous testosterone is largely driven by dihydrotestosterone (DHT) stimulating sebaceous glands to overproduce sebum. Propionibacterium acnes (now reclassified as Cutibacterium acnes) thrives in that environment. Removing surface bacteria with antibacterial soap can reduce colonization temporarily, but multiple studies confirm that topical antibacterials alone are insufficient for moderate-to-severe acne. A 2020 review in the Journal of the American Academy of Dermatology (Thiboutot et al.) emphasizes that combination therapy, including retinoids and sometimes systemic agents, is standard for inflammatory acne. Scrubbing with a loofah can actually worsen inflammatory lesions by causing micro-trauma. The American Academy of Dermatology explicitly advises against harsh scrubbing for active acne.

What did they get wrong (or right)?

They got the tea tree oil claim partially wrong and the framing mostly wrong. Tea tree oil (Melaleuca alternifolia) does have antimicrobial AND antifungal properties, but calling it simply "an antifungal" in the context of treating acne is misleading. Acne vulgaris is a bacterial and inflammatory condition, not a fungal one. Fungal acne (Malassezia folliculitis) is a separate diagnosis that looks similar but requires different treatment. Conflating the two on a TikTok aimed at TRT patients who may already have inflamed skin is a real problem.

What they got right: tea tree oil does have legitimate evidence for mild acne. A 1990 RCT by Bassett et al. in the Medical Journal of Australia found 5% tea tree oil gel comparable to 5% benzoyl peroxide for mild-to-moderate acne, though slower. Cleansing with a gentle antibacterial soap is not wrong as an adjunct. Exfoliation helps clear follicles. The advice is not dangerous. It is just dramatically oversold as an acne solution for a population with a hormonal root cause.

The word "poor" was used repeatedly when they meant "pore." Minor, but if you are a clinician advising patients, terminology matters.

What should you actually know?

TRT-related acne is a known, documented side effect of testosterone therapy. It is not a hygiene problem. That framing is where this video does real harm: it implies that patients who develop acne on TRT are just not scrubbing hard enough. They are not. Their sebaceous glands are responding to elevated androgens.

Effective management of TRT acne typically involves dose adjustment or injection frequency changes, topical retinoids (tretinoin is first-line), topical or oral antibiotics in some cases, and dermatologist referral for persistent or cystic presentations. A 2018 paper by Traish et al. in the Journal of Sexual Medicine documents acne and oily skin as consistent adverse effects of testosterone therapy requiring clinical management, not grocery store workarounds.

A loofah and Dial soap can be part of a hygiene routine. They should not be presented as the solution to a hormonally driven skin condition to 20,000 viewers who may be starting or already on TRT.

• Use a gentle, non-comedogenic cleanser twice daily. Harsh scrubbing with a loofah on inflamed skin can rupture pustules and worsen scarring.
• If you develop acne on TRT, talk to your prescribing provider about dose, ester, and administration route before buying a loofah.
• Tea tree oil is a reasonable adjunct for mild acne. It is not an antifungal treatment for standard acne vulgaris.
• Fungal acne and bacterial acne require different treatments. Do not assume a TikTok tip covers both.