Ciclosporin-Induced Generalised Hypertrichosis in a Transgender Woman Receiving Testosterone Blockers

TL;DR

A transgender woman on testosterone blockers developed unwanted hair growth from ciclosporin, highlighting a rare side effect in this population.

Contribution

This is the first reported case of ciclosporin-induced hypertrichosis in a transgender woman on testosterone suppression.

Findings

Ciclosporin can cause generalized hypertrichosis even in the presence of androgen suppression.

Switching to adalimumab resolved psoriasis without recurrence of hypertrichosis.

The case highlights the psychological impact and need for awareness in prescribing ciclosporin to transgender patients.

Abstract

Hypertrichosis is a well-documented side effect of ciclosporin, yet it is rarely encountered in dermatological practice. We present a case of hypertrichosis in a transgender woman on testosterone-blocking therapy, illustrating that ciclosporin can induce hypertrichosis even in the context of androgen suppression.

A 25-year-old transgender woman with severe plaque psoriasis developed generalised hypertrichosis after commencing ciclosporin. She was concurrently taking estradiol and triptorelin as part of gender-affirming therapy. Hypertrichosis involved the arms, fingers, and face, leading to distress and subsequent discontinuation of ciclosporin. The patient was transitioned to adalimumab, which achieved good disease control without recurrence of hypertrichosis.

This appears to be the first documented case of ciclosporin-induced hypertrichosis in a transgender woman receiving testosterone blockers. Clinicians should remain mindful of this potential adverse effect and its psychological impact when prescribing ciclosporin to transgender individuals. Further research is warranted to clarify the role of sex hormones in susceptibility to this side effect.