Testogel (testosterone gel) is a hormone replacement therapy prescribed for men with confirmed testosterone deficiency. Proper application technique is crucial for optimal absorption and safety. Many patients wonder how long they should rub Testogel into their skin during application. The answer is straightforward: spread the gel thinly and evenly over the approved area without prolonged rubbing. The gel is designed to absorb gradually through passive diffusion, and excessive rubbing does not improve effectiveness. This article explains correct application technique, common mistakes to avoid, and what to expect from your treatment.

How to Apply Testogel Correctly

Testogel (testosterone gel) is a hormone replacement therapy prescribed for men with confirmed testosterone deficiency (hypogonadism). Proper application technique is essential to ensure optimal absorption and therapeutic effect whilst minimising the risk of transfer to others.

Before applying Testogel, ensure your skin is clean, dry, and intact. The gel should be applied once daily, preferably at the same time each morning after showering. The recommended application sites depend on your specific Testogel formulation:

• Testogel 50mg/5g (1% sachets): Apply to shoulders, upper arms, or abdomen

• Testogel 16.2 mg/g (pump): Apply only to shoulders or upper arms

Never apply to the genital area or broken skin, as this can cause irritation and unpredictable absorption.

Step-by-step application process:

• Wash and dry your hands thoroughly before opening the sachet or using the pump

• Tear open the sachet completely or dispense the prescribed dose from the pump

• Apply the gel directly to the approved application site

• Spread the gel thinly and evenly across the area in a single layer

• Allow the gel to dry completely before dressing (typically 3–5 minutes)

• Wash your hands thoroughly with soap and water immediately after application

Important safety considerations:

• Avoid washing or swimming after application: For Testogel 1% sachets, wait at least 6 hours; for Testogel 16.2 mg/g pump, wait at least 2 hours

• Flammability warning: The gel contains alcohol and is flammable until dry—avoid naked flames, smoking, or sources of ignition

• Prevent transfer: Cover the application site with clothing once dry. Before any skin-to-skin contact, wash the application site thoroughly with soap and water

• Sunscreen: If you need to apply sunscreen, wait at least 1 hour after Testogel application, as sunscreen can increase testosterone absorption

Always follow your prescriber's specific instructions and refer to the Patient Information Leaflet for your specific Testogel formulation.

How Long Should You Rub Testogel Into Your Skin?

When applying Testogel, you should spread the gel in a thin, even layer over the approved application site. The SmPC (Summary of Product Characteristics) does not specify a required rubbing time—the key is to ensure even distribution rather than focusing on a specific duration of rubbing.

Testogel is formulated as a hydroalcoholic gel designed for transdermal absorption. The alcohol component acts as a penetration enhancer and evaporates quickly, leaving the testosterone to absorb through the stratum corneum (outer skin layer) over several hours. Excessive or prolonged rubbing does not significantly improve absorption and may actually cause unnecessary skin irritation.

The correct application technique involves:

• Using gentle motions to spread the gel thinly and evenly

• Covering the entire designated application area without concentrating the product in one spot

• Avoiding vigorous massage or friction that could irritate the skin

• Stopping once the gel appears evenly distributed as a thin, translucent layer

After application, simply allow the gel to air-dry naturally for 3–5 minutes before getting dressed. You should not continue rubbing during the drying phase. The gel will feel slightly tacky initially but should dry to an invisible film. There is no evidence that longer rubbing times improve testosterone absorption—the medication is designed to penetrate the skin gradually through passive diffusion.

Do not cover the application site with occlusive dressings or bandages, as this may alter absorption. Once dry, the area should be covered with clothing to prevent transfer to others.

If you experience persistent skin irritation, redness, or discomfort at application sites, contact your GP or prescribing clinician. They may recommend rotating application sites more frequently or investigating alternative testosterone replacement formulations.

What Happens If Testogel Isn't Rubbed In Properly?

Inadequate application technique can compromise the therapeutic effectiveness of Testogel and increase the risk of adverse effects or accidental transfer to others. Understanding these potential consequences emphasises the importance of correct application.

If Testogel is not spread evenly or remains concentrated in small areas, uneven absorption may occur. This can result in suboptimal testosterone levels in the bloodstream, potentially leading to persistent symptoms of hypogonadism such as fatigue, reduced libido, mood changes, and decreased muscle mass. Conversely, concentrated application may cause localised skin reactions including erythema (redness), pruritus (itching), or contact dermatitis.

Key risks of improper application include:

• Transfer to others: If the gel remains on the skin surface rather than being spread and allowed to dry, it can transfer to partners, children, or household members through direct skin contact. This is particularly concerning for women and children, who may develop signs of virilisation (unwanted male characteristics) such as increased body hair, voice deepening, or menstrual irregularities

• Reduced efficacy: Pooling of gel or application to inappropriate sites (such as areas with thick hair or poor blood supply) may result in inadequate testosterone absorption

• Clothing staining: Gel that hasn't been properly spread may transfer to clothing before absorption is complete

• Skin irritation: Concentrated application increases the likelihood of local adverse reactions

If you suspect inadequate absorption due to application errors, do not apply additional doses on the same day, as this may lead to excessive testosterone levels. Instead, continue with your regular dosing schedule and discuss your concerns with your healthcare provider.

To prevent transfer to others, always wash your hands after application, ensure the gel is completely dry before dressing, cover the application site with clothing, and wash the application site thoroughly with soap and water before any anticipated skin-to-skin contact. If accidental contact occurs, the exposed person should wash the area immediately with soap and water. Contact a healthcare professional promptly if a woman or child shows signs of androgen exposure.

The MHRA advises that proper application technique and precautions to prevent transfer are essential components of safe Testogel use.

When Testogel Starts Working and What to Expect

Understanding the timeline of Testogel's effects helps set realistic expectations and ensures appropriate monitoring of your treatment response. Testosterone replacement therapy works gradually, with different symptoms improving at varying rates.

Pharmacokinetics and initial absorption:

Following proper application, testosterone begins absorbing through the skin immediately, with measurable increases in serum testosterone levels occurring within hours. Steady-state testosterone levels in the bloodstream are typically achieved within 2–3 days of consistent daily application. However, your clinician will usually arrange blood tests after 2–3 months of treatment to assess whether therapeutic testosterone levels have been achieved and to make any necessary dose adjustments.

Timeline of symptomatic improvement:

• Energy and mood (2–6 weeks): Many men report improved energy levels, mood, and sense of wellbeing within the first month of treatment

• Libido and sexual function (3–6 weeks): Improvements in sexual desire and erectile function typically emerge within 4–6 weeks, though maximum benefit may take 3–6 months

• Body composition (3–6 months): Changes in muscle mass, strength, and fat distribution occur more gradually, becoming noticeable after several months of consistent treatment

• Bone density (6–12 months): Improvements in bone mineral density require longer-term treatment, typically assessed after at least 12 months

Monitoring during treatment:

Your prescriber will monitor your response through regular assessments, typically including:

• Blood tests for testosterone levels

• Full blood count (to check haematocrit levels, which can rise with testosterone treatment)

• PSA (prostate-specific antigen) and prostate assessment as appropriate

• Clinical assessment of symptoms and potential side effects

These assessments are usually conducted at 3, 6, and 12 months initially, then annually. According to NICE Clinical Knowledge Summary guidance, testosterone therapy should only continue if there is clear symptomatic benefit and no significant adverse effects.

When to contact your GP:

Seek medical advice if you experience no improvement after 3 months, develop troublesome side effects (such as significant mood changes, breast tenderness, ankle swelling, or breathing difficulties during sleep), or have concerns about your treatment response. If you experience side effects, consider reporting them through the MHRA Yellow Card scheme (yellowcard.mhra.gov.uk).

Common Mistakes When Applying Testogel

Avoiding frequent application errors ensures optimal therapeutic benefit and minimises safety risks associated with testosterone replacement therapy. Many of these mistakes are easily corrected with proper education and awareness.

Application site errors:

• Applying to inappropriate areas: Use only the sites recommended for your specific formulation—Testogel 1% sachets can be applied to shoulders, upper arms, or abdomen, while Testogel 16.2 mg/g pump should only be applied to shoulders or upper arms. Never apply to the genital area, scrotum, or breasts

• Applying to broken or irritated skin: Always check that the application site is intact, without cuts, abrasions, or active dermatitis

• Insufficient rotation of sites: Using the same small area repeatedly can cause cumulative irritation. Rotate between approved application sites

• Applying to excessively hairy areas: Dense body hair may impede absorption; consider trimming (not shaving) very hairy application sites

Timing and hygiene mistakes:

• Showering too soon: For Testogel 1% sachets, avoid washing for at least 6 hours; for Testogel 16.2 mg/g pump, wait at least 2 hours after application

• Forgetting to wash hands: This is the most critical step to prevent accidental transfer. Always wash hands thoroughly with soap and water immediately after application

• Inconsistent application times: Applying at different times each day can lead to fluctuating testosterone levels. Establish a consistent morning routine

• Using occlusive dressings: Do not cover the application site with plastic wrap, bandages or occlusive dressings

Safety oversights:

• Ignoring flammability: The alcohol in the gel is flammable until completely dry—avoid naked flames, smoking, or sources of ignition

• Applying sunscreen incorrectly: Wait at least 1 hour after Testogel application before applying sunscreen to avoid increased testosterone absorption

Dosing errors:

• Applying extra doses: If you miss a dose, apply it as soon as you remember on the same day, but never double up the next day

• Self-adjusting the dose: Only change your Testogel dose under medical supervision, as this requires monitoring of testosterone levels

• Sharing medication: Testogel is prescribed specifically for you based on confirmed testosterone deficiency; never share with others

Transfer prevention oversights:

Many men underestimate the risk of testosterone transfer to household members. Always ensure the application site is completely dry and covered with clothing before close physical contact. Before anticipated skin-to-skin contact, wash the application site thoroughly with soap and water. If accidental contact occurs, the affected person should wash the area immediately with soap and water. Women who are pregnant or may become pregnant should avoid any contact with Testogel application sites, as testosterone exposure can affect foetal development.

If you have questions about proper application technique or concerns about potential mistakes, discuss these with your GP, practice nurse, or pharmacist. They can provide practical advice to optimise your treatment outcomes whilst maintaining safety for you and your household.

Frequently Asked Questions