Clobetasol

Your boobs have glucocorticoids (GCs) in them with unique response to stimulation. where most places shrink fat depots in response to GC stimulation, in boobs it causes rapid adipocyte hyperplasia. the current protocol is a week of one day on one day off application of clobetasol cream directly to boobs, followed by 7 weeks off. it seems to work better on pio. this is a very new and developing thing so theres not much info on it yet

background

Glucocorticoids seem to produce substantial adipocyte hyperplasia in women. There are multiple accounts of cis women taking these medications developing macromastia and requiring surgical reduction of their breasts. In theory any GC will do, but because GCs have a number of undesireable effects including suppression of the HPA axis, immune system compromise, reduction of peripheral fat depots, promotion of visceral fat, and lots of other undesirable things, those of us who are trying them are mostly using topicals.

directions

• due to aforementioned general GC use risks these medications are best cycled
• for full receptor reset you need around 6 weeks off
• unless youre underweight it seems safe to use this cream daily for a period of 2 weeks for your on cycle
• it seems to promote significant mammary fat increases in that time, particularly intramammary fat, like prog is known to do but much much faster
• growth is permanent, and effects are known to continue for up to after cessation due to buffering effect in skin and residual action
• they seem to be made significantly more effective when combined with at least 30mg pioglitazone a day
• skin thinning is possible with topicals, so it may be wise to use topical tretinoin on them in your off time
• reasonably large dose will be between 4 and 6g of cream total, which if topical to systemic numbers are to be trusted puts this at 1/10th the typical circulating levels for the lowest dose of oral corticosteroids

familliarise yourself with GC side effects before using and do not attempt to use them while ill or over compromised skin, including ingrown hairs. it would also be wise to apply this using rubber gloves so none absorbs via your hands. clobetasol is cheap and easy to acquire from many of the sources that will sell you pioglitazone.

In short

• glucocorticoids strongly promote preadipocyte differentiation specifically
• their expression in terms of adipogenesis is hormonally constrained, premenopausal conditions reduce abdominal fat tissue growth vs postmenopausal and male tissue conditions, presumably applicable systemically
• use of topical concentrates GCs where we want them, minimising systemic circulation and off target adipogenesis
• PPARy agonists cause full maturation of progenitor cells produced by glucocorticoids
• estrogen and progesterone drive lipid uptake of new adipocytes

evidence

current evidence and working theory for glucocorticoid induced breast growth: existing cases in medicine: 10.1097/MAJ.0b013e3182277a09 10.1016/j.ijscr.2019.04.042 Troccola A, Maruccia M, Dessy LA, Onesti MG. Cortisone-induced gigantomastia during chemotherapy. Giornale di Chirurgia. 2011;32(5):266-269 here we have 3 cases of people who experienced macromastia specifically associated with corticosteroid use. obviously this isnt evidence that its useful to us, but its reason enough to look into it.

hypothetical mechanism of action: 10.1038/labinvest.2010.170 investigates glucocorticoid effects on adipocytes, establishes that it upregulates KLF15, an important factor in adipogenesis. blocking of GR via antagonist also prevented differentiation of mesenchymal stem cells from differentiating into adipocytes and fibroblasts, meaning GR activity is required for creation of adipocytes.

10.1091/mbc.e08-04-0420 investigates glucocorticoids, specifically dexamethasone, for their specific role in adipose development. finds that glucocorticoids are required for a key stage in preadipocyte differentiation into adipose tissue that cannot be performed by other components of the standard adipocyte culturing cocktail.

10.1016/j.lfs.2020.118363 confirms that it drives PPARy expression in differentiating preadipocyte cells, implying use of PPARy agonists can drive complete differentiation here if used in conjunction.

10.3389/fendo.2022.889923 tells us that estrogen has a constraining effect on adipogenesis. estrogen facilitates adipocyte hyperplasia, and its absence both in postmenopausal and male hormonal conditions results in hypertrophy instead of hyperplasia in fat stores. ERa density is a key factor in this. PPARy agonists drive full maturation from now committed adipocyte progenitor cells.

betamethasone

betamethasone may be preferable to clobetasol due to increased proportion of adipogenesis to fibrosis, but its a less tested option and we dont know how the valerate ester affects absorbtion into breast