Creatine and acne: what the research shows

Creatine is one of the most studied sports supplements there is, and one of the most searched questions about it has almost no research behind it. People want to know whether creatine causes acne. Nobody has tested it.

That sounds like a dodge, so here is what actually exists. Researchers have measured creatine's effect on hormones many times. They have measured its effect on muscle, on kidney function, and on hair. In all of that work, nobody has counted spots on anyone's face. So the honest starting point is that there is no study showing creatine causes acne, and no study showing it does not.

What there is, instead, is a chain of reasoning. Some people worry that creatine raises a hormone, that the hormone acts on oil glands, and that more oil means more acne. Each link in that chain is worth looking at on its own, because the first link is weaker than most people assume.

Where the worry came from

In 2009, researchers gave creatine to a group of male rugby players and measured their hormones. They used a loading dose of 25 grams a day for 7 days, then 5 grams a day for 14 days. Sixteen men completed the study.

The result that spread widely was this one. DHT rose 56 percent above the starting level after the loading week, and stayed 40 percent above it after the two maintenance weeks. This is reported in the 2021 review in the Journal of the International Society of Sports Nutrition.

DHT stands for dihydrotestosterone. It is made from testosterone by an enzyme, and it acts on hair follicles and on the oil glands attached to them. The American Academy of Dermatology explains that during puberty, hormones called androgens increase the size of the skin's oil glands, and those glands then make more oil, which can clog pores. DHT is one of those androgens, best known as the main hormone behind male pattern hair loss. The DHT and acne guide explains how it differs from testosterone and what finasteride's label says about the skin. So a hormone with a real link to oil production went up in a creatine study, and the worry about acne grew from there.

Two limits matter. The study ran 3 weeks and included 16 people. And it measured hormones in blood, not acne on skin. No participant was examined for spots.

What the larger, longer trial found

In 2025, a randomised controlled trial set out to test the DHT claim properly. Published in the same journal, it followed 38 resistance-trained men aged 18 to 40, split into two groups of 19. One group took 5 grams of creatine monohydrate a day. The other took 5 grams of maltodextrin, a placebo powder. Both groups continued for 12 weeks, four times longer than the 2009 study.

The researchers measured total testosterone, free testosterone and DHT in blood, and assessed hair follicles with two methods.

The results: no difference between the groups in DHT, and none in the ratio of DHT to testosterone. Total testosterone rose in both groups, and the placebo group's rise was the larger of the two. Free testosterone fell by a near-identical amount in both groups. The paper reports no group-by-time interactions for any hormone.

The trial also reported no side effects in either group across the full 12 weeks, and no change in creatinine or eGFR, two blood measures of kidney function.

This does not prove creatine is harmless for skin, because the trial did not grade anyone's acne either. What it does is remove the hormone step from the chain of reasoning. If creatine does not change DHT over 12 weeks at a normal maintenance dose, then the explanation people give for creatine acne has nothing holding it up.

The wider hormone picture

The 2021 review looked at this question across the whole literature. It found 12 other studies that tested creatine's effect on testosterone, at doses from 3 to 25 grams a day, over periods from 6 days to 12 weeks.

Of those 12, ten reported no change in testosterone. Two found small increases after six and seven days, which the review describes as physiologically insignificant. Five of the studies also measured free testosterone, and none found an increase.

On hair, the review's conclusion is direct: while it is possible that creatine raised 5-alpha-reductase activity in the 2009 rugby players, no study has reported hair loss or baldness in humans. The same gap applies to skin, with less attention paid to it.

What has been measured	What the evidence shows
Testosterone	10 of 12 studies found no change
Free testosterone	No increase in 5 studies that measured it
DHT	Up in one 3-week study of 16 men; unchanged in a 12-week trial of 38 men
Hair loss	No study has reported it in humans
Acne	Never measured in any study

What is more likely behind gym acne

If your skin changed when you started training, several things changed at once. Some of them do have evidence behind them.

Whey protein is the clearest example. Case reports describe teenage boys and young men whose acne started soon after they began whey shakes and improved after stopping, though a 2024 controlled trial found whey made acne no worse than a shake without it. The whey protein and acne guide goes through that evidence in full.

Sweat left on the skin after a workout, and friction from equipment, straps and tight clothing, both affect the areas where gym acne usually appears: the back, shoulders and chest. Sweat, gym gear and back acne covers what to change about showering and washing clothes.

Sugar is the other one. A 2022 systematic review in JAAD International found that a high glycemic index, high glycemic load and high carbohydrate intake have a modest but real acne-worsening effect, and that 77 percent of observational studies supported a link between the glycemic content of the diet and acne. Many gym supplements, including flavoured creatine blends and mass-gainer powders, carry a lot of added sugar. A plain creatine monohydrate powder does not.

The American Academy of Dermatology also lists oily hair and skin care products among the things that worsen acne, which includes hair pomade that transfers to the forehead and back during a workout.

How to test creatine on your own skin

If you still suspect your supplement, you can test it, but the test only works if you do one thing at a time.

The AAD's suggestion for food triggers is to ask yourself whether something causes breakouts, then watch what happens when you go without it for a day, a week or a month. For acne, the longer window is the one that tells you anything, because skin takes weeks to respond to any change.

Here is a workable version:

1. Take photos of the affected areas first, in the same light and from the same distance each time. The progress photo guide covers how to make them comparable.
2. Stop the creatine, and change nothing else. Keep the same cleanser, the same treatment, the same training and the same diet.
3. Wait 8 weeks. Skinli's guidance across the site is to judge any acne change over 8 to 12 weeks, because that is how long skin takes to turn over and respond.
4. Compare the photos, not your memory of how your skin looked.

If the photos look the same, creatine was not the cause, and you have ruled out one thing properly rather than guessing. If they improved, you have your answer for your own skin, which is the only skin that matters to you.

One thing to avoid is stopping your acne treatment at the same time. That is the most common way these experiments produce a confusing result.

When the supplement question is the wrong question

Some acne does not respond to anything you buy. The NHS says to see a GP if you have tried treating it yourself and it is not getting better, if you have lots of spots, or if the spots are deep, painful or causing scars.

Deep lumps under the skin, spots that leave marks or dents, and acne that keeps coming back across the back and chest all fall into that group. A doctor has prescription options, and the earlier they start, the less chance there is of permanent scarring. The cystic acne guide explains what those treatments look like.

Skinli gives education, not medical advice, and no supplement decision replaces a diagnosis.

For the foods and supplements that do have research behind them, including milk, sugar, zinc and fish oil, the diet and acne guide collects what each study actually found.

The short version on creatine: the hormone worry rests on one 3-week study of 16 men that counted no spots, a 12-week trial found no hormone change at all, and nobody has yet run the study that would answer the question directly.