APPLICATIONS AND SAFETY OF TESTOSTERONE CREAMS: A SYSTEMATIC REVIEW OF TOPICAL FORMULATIONS, CLINICAL EFFICACY, AND POTENTIAL RISKS

Abstract

Testosterone creams and gels have been widely used in clinical practice for hormone replacement and for use without formal clinical indication, mainly among middle-aged and elderly men. This study aims to systematically review the evidence on the composition, mechanisms of action, efficacy, safety, and risks associated with the use of topical testosterone formulations, including creams, gels, ointments, and transdermal patches. Studies indexed in PubMed, Scopus, and SciELO databases between 2010 and 2025 were included. Comparative analysis shows that creams exhibit variable absorption depending on the area applied, the vehicle, and the contact time, while gels offer more stable bioavailability, and transdermal patches maintain continuous release. Although effective in raising serum testosterone levels, these products can cause adverse events, including acne, gynecomastia, alopecia, and possible stimulation of prostate or breast cells. It is concluded that, even with topical use, the systemic risk is significant, and they should be prescribed under rigorous medical evaluation.