Since the skin and its appendages are androgen-dependent, male hypogonadism can be associated with dermatologically relevant lesions. The skin surface of hypogonadal patients is thin and shows increased wrinkles. In cases of prepubertal hypogonadism, severe acne does not occur. In contrast, patients may suffer from sebostasis due to missing stimulation of the sebaceous glands. The genital skin does not show pigmentation, which normally develops during puberty; the integument is pale. Hair growth on breast, pubia, axilla, face and integument is reduced; patients do not present with typical androgenetic alopecia. In addition to these features, dermatological diseases caused by treatment of the hypogonadism or drug-induced skin reactions have to be considered. While drug reactions to oral or intramuscular androgens or gonadotropins are rare, irritative or allergic skin lesions are observed frequently, especially in cases of non-scrotal transdermal therapeutic systems with testosterone. A variety of syndromes include dermatological symptoms associated with male hypogonadism; however, the prevalence of these syndromes is low.