Creatine supplements have not been established as a cause of acne, despite concerns that they may affect hormone levels and trigger skin breakouts.
The available evidence does not demonstrate a direct causal link between creatine and acne. However, research specifically investigating whether people who take creatine develop more acne remains limited.
The concern partly stems from claims that creatine increases dihydrotestosterone (DHT), a hormone derived from testosterone. DHT is involved in several bodily processes, while hormonal changes can contribute to acne by influencing oil production in the skin. But evidence linking creatine supplementation to increased DHT is inconsistent, and studies have not established that creatine causes acne through this mechanism.
What does the research say about creatine and acne?
The US National Institutes of Health (NIH), through its Office of Dietary Supplements, identifies creatine as a compound that helps supply energy to muscles. Its consumer guidance says creatine supplements can improve performance during repeated short bursts of intense activity, including weightlifting and sprinting.
The NIH also identifies water-related weight gain and occasional digestive discomfort among reported effects of creatine supplementation. Its guidance does not establish acne as a recognised side effect. However, the absence of acne from that guidance does not prove that the supplement cannot affect an individual’s skin.
No direct causal relationship between creatine supplementation and acne has been established by the evidence reviewed for this report.
Does creatine increase DHT?
DHT is produced when the body converts testosterone through the action of an enzyme. The hormone plays a role in the development and function of several tissues.
The concern about creatine and DHT partly originated from a small 2009 study involving rugby players. Researchers reported an increase in DHT following creatine supplementation, prompting questions about possible effects on hair loss and other hormone-related conditions.
However, the study did not investigate acne, and its findings have not been consistently reproduced.
A review published in 2021 in the Journal of the International Society of Sports Nutrition examined evidence surrounding creatine and several commonly reported safety concerns. The review found no convincing evidence that creatine supplementation consistently increases testosterone or causes dehydration or kidney damage in healthy people using recommended amounts.
More recently, a randomised controlled trial published in 2025 examined the effects of creatine supplementation on hormone levels and hair health in resistance-trained men.
The study, published in the Journal of the International Society of Sports Nutrition, included 45 men aged 18 to 40 who were assigned to receive either creatine monohydrate or a placebo. Thirty-eight participants completed the study.
After 12 weeks, researchers found no significant differences between the groups in DHT levels or the measured hair-related outcomes.
The trial did not investigate acne, however, so its findings cannot establish whether creatine affects the risk of developing breakouts.
Taken together, the findings do not support a conclusion that creatine routinely increases DHT. They also do not establish that the supplement causes acne.
What causes acne?
The UK’s National Health Service (NHS) explains that acne develops when hair follicles become blocked by excess oil and dead skin cells. Bacteria can grow within blocked follicles and contribute to inflammation.
Hormonal changes, including those that occur during puberty, can increase oil production and contribute to acne. Certain medicines and oily skin or hair products can also trigger or worsen breakouts.
The American Academy of Dermatology (AAD) says some research has associated high-glycaemic diets with more acne. Such diets include foods and drinks that raise blood sugar quickly. However, the evidence is not conclusive, and not everyone experiences the same dietary effects.
These established factors can help explain why acne develops, but they do not demonstrate that creatine causes breakouts.
People who notice acne after starting a supplement may also have experienced other changes, including changes in their routine, diet, skincare products or hormone levels. The timing alone cannot identify the cause.
Can dehydration cause acne when taking creatine?
The claim that creatine causes acne by dehydrating the body is not supported by convincing evidence.
According to the NIH Office of Dietary Supplements, creatine commonly increases water retention, which can contribute to weight gain. Research does not support the claim that creatine routinely causes dehydration when used appropriately by healthy adults.
People exercising intensely should replace fluids lost through sweating, particularly in hot conditions. However, dehydration is not an established explanation for acne associated with creatine use.
Drinking excessive amounts of water has also not been established as a way to prevent acne.
What are the side effects of creatine?
The NIH Office of Dietary Supplements reports that creatine is generally considered safe for healthy adults over periods of weeks or months, with evidence also supporting its safety over longer periods in studied populations.
Reported effects include weight gain associated with water retention and occasional digestive problems. Some people also report muscle stiffness or cramps, although such reports do not establish that creatine is responsible in every case.
Safety findings should not be interpreted as proof that every supplement, dose or pattern of use is harmless. People with kidney disease or other medical conditions should seek professional advice before using creatine.
The original claims that creatine routinely causes liver damage, high blood pressure or compartment syndrome are not supported by the sources reviewed for this report and should not be presented as established common side effects.
Creatine is also different from anabolic steroids. The two are not interchangeable, and evidence about the effects of steroids cannot automatically be applied to creatine.
What should you do if acne develops after starting a supplement?
Anyone who notices new or worsening acne after starting a supplement should consider whether other changes may have contributed. The timing may be relevant, but it does not prove that the supplement caused the problem.
The NHS advises seeking medical help if acne does not improve with self-care, becomes severe or painful, or begins causing scars. A healthcare professional or dermatologist can assess the condition and recommend appropriate treatment.
Anyone concerned about a supplement’s effects should discuss those concerns with a qualified healthcare professional, particularly if they have an existing medical condition or take medication.
What the evidence means
Current evidence does not establish creatine supplementation as a direct cause of acne. The proposed explanations involving DHT and dehydration have not been shown to cause breakouts in people taking the supplement.
However, a lack of evidence establishing a link is not the same as proof that no link exists. Research specifically designed to measure acne outcomes among creatine users would be needed to answer the question more definitively.
For now, acne developing during creatine use should not automatically be attributed to the supplement. Equally, claims that creatine prevents acne or has proven benefits for skin health should not be made without appropriate clinical evidence.
Sources
- US National Institutes of Health, Office of Dietary Supplements: Dietary Supplements for Exercise and Athletic Performance
- UK National Health Service: Acne
- American Academy of Dermatology: Can the right diet get rid of acne?
- Journal of the International Society of Sports Nutrition (2021): Common questions and misconceptions about creatine supplementation
- Journal of the International Society of Sports Nutrition (2025): Does creatine cause hair loss? A 12-week randomized controlled trial
