Facial hair growth typically occurs within 6-12 months of therapy and has the potential for continued growth up to 4-5 years. You may notice some “peach fuzz” develop over the first year. During this stage, the hair on your face is transitioning from vellus hair to terminal hair. Over the course of therapy, it develops into terminal hair quite rapidly.

Terminal hair growth is permanent, even if you if stop testosterone.


Vellus hair is the light, translucent hair that covers your body except for your palms, soles of your feet, and lips. It gives your skin a softer appearance.

Terminal hair is pigmented hair that is coarse and textured. Prior to therapy, you can observe terminal hair in your armpits, pubic area, and on your scalp and eyebrows.

Hair Types

Vellus vs. Terminal Hair Anatomy

Terminal Hair

Vellus Hair


Blood Vessels


Hair Bulb

The illustration to the right shows a cut section of skin revealing terminal and vellus hair anatomy. Notice that terminal hair is thicker and runs deeper to the skin than vellus hair. Terminal hair also has a more developed root and hair bulb with more nerves and vessels reaching it. This is why terminal hair is a permanent transformation; you will not be able to reverse back to vellus hair after this change has occurred. 

The illustrations below reveal the differences of terminal and vellus hair as you see it on the surface of your skin. Notice here that terminal hair is much thicker and darker than vellus.

Vellus Hair

Terminal Hair

Face & Skin Changes Along a Timeline 

Surface Anatomy

6-12 Months

1-2 Years

3-4 Years

  • Hairline Recession Onset

  • Facial hair around chin & lips

  • Increased oil production

  • Onset of Acne

  • Continued Hairline Recession 

  • Increased Stubble

  • Enlarged Pore Size

  • Acne Progression

  • Continued Hairline Recession 

  • Beard Thickening

  • Acne Begins to Resolve

Before Therapy

The pattern and extent of your facial hair growth depends primarily on genetics. Some individuals may develop a fully thickened beard. Others may only experience hair growth on their chin, around their lips, and along the jawline. The time in which it takes for your beard to fully develop varies, depending on your genetic makeup. To determine which is more likely for you, take a look at the facial hair patterns of the men in your family.

Your skin should also take on a rougher texture and the surrounding cheek fat may become noticeably thinner. Decreased fat concentration in the cheeks and face creates a more masculine facial structure, and gives the appearance of having a more pronounced jaw line. However, the actual jaw bone is not enlarging, but rather becoming more pronounced as fat percentage declines.



During your transition, you will be experiencing what is sometimes called a “second puberty”, and your skin will produce more oil during this phase. Due to increased oil production, coupled with the enlargement of your pores, you will most likely experience moderate to severe acne. While this is normal, a more vigilant skin care regimen can counteract many of these effects.


It is important to ask your doctor about a recommended skin regimen when starting testosterone therapy. Over time, as your body matures from its “second puberty”, acne should begin to clear.

Be sure to look for the word “non-comedogenic” on any facial care products to ensure that it is formulated to not clog your pores.


Skeletal changes typically do not occur with therapy, unless started prior to the completion of puberty.

In contrast to body and facial hair growth, over the first 12 months you may also experience a receding hairline near your temples, giving you a hairline consistent with a “widow’s peak”. This is normal, and although it is a sign of male pattern baldness, it does not mean you will completely lose your hair. Male pattern baldness is determined upon genetics and would occur over a longer period of time. If there is any sign of this progressing beyond a typical widow’s peak, discuss this with your physician about treatments available to counteract these effects. Any balding or hairline recession that occurs while on therapy may be reversed if testosterone is stopped, but this is not true in all cases.

4-5+ Years

Hairline Recession

Receding Hairline

Body Hair Growth

Before Therapy

4-5+ Years

Terminal body hair growth typically occurs along the same timeline as facial hair. You may find an increase of terminal hair growth along your arms, from your wrists to your upper arm, as well as on your legs from the ankle up through the inner groin region.

The hair on your chest will also transition from vellus to terminal hair, extending from the center of your chest to your breasts and around the nipple area. Your hair growth may extend down the midline of your abdomen and across your back. Once again, its pattern and appearance are determined primarily upon genetics.

© 2019 Sam Nigro, Augusta University

Hormone therapy is not required for any transition or queer experience. Changes from hormone therapy that are outlined in this website are not guaranteed. All changes from hormone therapy are dependent on genetic makeup and can be different for everyone. 

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