Does Creatine Cause Acne? A Detailed Look at the Evidence
Creatine is one of the most popular and widely studied supplements used by athletes, bodybuilders, and fitness enthusiasts to improve strength, muscle mass, and exercise performance. While it is well-documented as a safe and effective supplement, some individuals express concerns about potential side effects, including a possible link between creatine and acne.
In this article, we will explore whether creatine truly causes acne by reviewing the available research, discussing potential mechanisms, and considering how lifestyle factors might influence both acne and creatine use.
What Is Creatine?
Creatine is a naturally occurring compound found in small amounts in certain foods (like red meat and fish) and produced by the liver, kidneys, and pancreas. It is stored in muscle cells and used to produce energy during short bursts of intense physical activity. When taken as a supplement, creatine increases the amount of creatine phosphate in the muscles, allowing for greater energy production, which can improve performance during strength training and high-intensity exercise.
The Science Behind Acne Development
Acne is a common skin condition that occurs when hair follicles become clogged with oil (sebum) and dead skin cells. This creates an environment where Propionibacterium acnes (now called Cutibacterium acnes) bacteria can grow, leading to inflammation and the formation of pimples, blackheads, whiteheads, or even cysts.
Acne is influenced by several factors, including:
Excess oil production: When the sebaceous glands produce too much oil, it can clog the pores and lead to breakouts.
Hormonal fluctuations: Androgens (male hormones) like testosterone can increase sebum production, which is why acne is often linked to puberty, menstrual cycles, and hormonal imbalances.
Bacteria: The growth of C. acnes bacteria in clogged pores can trigger inflammation, resulting in pimples.
Diet and lifestyle: Certain dietary factors, stress, and lifestyle habits may exacerbate acne in some individuals.
Does Creatine Affect Hormones and Acne?
One of the primary concerns about creatine and acne revolves around the supplement’s potential effect on hormones, particularly testosterone and other androgens. Since elevated androgen levels can increase sebum production, there’s a belief that creatine might exacerbate acne by boosting hormone levels. Let’s break down the evidence:
1. Creatine and Testosterone Levels
Some early studies suggested that creatine might increase testosterone levels, but the research findings on this are mixed. Most scientific studies show that creatine supplementation does not significantly alter testosterone or androgen levels in healthy individuals. For example:
A 2000 study in Medicine & Science in Sports & Exercise found that creatine did not raise testosterone levels in men after several weeks of supplementation.
Another study published in European Journal of Applied Physiology in 2006 similarly found no significant increase in testosterone among athletes taking creatine.
While there is limited evidence that creatine directly affects hormone levels, it’s important to note that high-intensity exercise itself can temporarily increase testosterone. Thus, it’s possible that any perceived increase in acne could be due to changes in lifestyle (such as intense exercise) rather than the creatine itself.
2. Creatine and DHT
A 2009 study from Clinical Journal of Sports Medicine found a potential link between creatine and dihydrotestosterone (DHT), a potent androgen derived from testosterone. In this study, participants who took creatine showed a 56% increase in DHT levels after one week of creatine loading. Elevated DHT levels can influence sebum production, potentially contributing to acne.
However, it’s crucial to understand that this was a small study, and the increase in DHT did not result in any reported increase in acne among participants. More research is needed to determine whether creatine consistently raises DHT and whether this increase is enough to trigger acne in most people.
Other Factors to Consider
While the research on creatine’s direct role in causing acne is limited, other factors related to creatine use may influence skin health:
1. Exercise and Sweat
People who take creatine are often engaging in high-intensity workouts and strength training, which can lead to sweating and increased oil production on the skin. If sweat and oil are not properly managed (e.g., by showering after workouts), this could increase the risk of clogged pores and breakouts.
2. Dehydration
Creatine can cause muscles to retain water, leading to concerns about dehydration if users don’t drink enough fluids. Dehydrated skin may produce more oil as a compensatory mechanism, which could increase the risk of acne for some individuals. Staying well-hydrated is essential when using creatine, not only for performance but also for maintaining healthy skin.
3. Diet and Supplement Intake
Creatine is often consumed as part of a larger fitness and nutrition regimen, which may include high-protein diets, pre-workout supplements, and other performance-enhancing products. Diets rich in dairy and high-glycemic foods (which cause spikes in blood sugar) have been associated with increased acne risk in some individuals. Thus, any increase in acne might be related to dietary changes rather than creatine itself.
Personal Sensitivity to Acne
Acne triggers can vary greatly from person to person, meaning some individuals may be more prone to developing acne when using creatine due to personal sensitivity. If someone already has acne-prone skin, they may notice a correlation between creatine and breakouts, even if the scientific evidence doesn’t clearly support a direct link.
How to Manage Acne While Taking Creatine
If you’re concerned about acne but want to continue using creatine for its performance benefits, there are several strategies to minimize potential breakouts:
Maintain proper skincare: Cleanse your face regularly, especially after workouts, to remove sweat, oil, and dirt that can clog pores. Use non-comedogenic (non-pore-clogging) skincare products.
Stay hydrated: Drink plenty of water to keep your skin hydrated and healthy. This can help prevent the skin from overproducing oil as a response to dehydration.
Watch your diet: Monitor how your skin reacts to dietary changes, such as increased protein intake or supplement use. Avoid foods that trigger breakouts, like high-glycemic or dairy-heavy foods, if you notice a correlation.
Conclusion
The current scientific evidence does not strongly support the idea that creatine directly causes acne. Most studies show that creatine does not significantly alter testosterone levels, and while one study suggested an increase in DHT, the overall impact on acne remains unclear. It’s more likely that factors like increased exercise, sweat, or changes in diet associated with creatine use may contribute to acne in some individuals.
If you are acne-prone, it’s important to focus on good skincare practices, staying hydrated, and avoiding known acne triggers. Creatine is a safe and effective supplement for most people, but as with any supplement, it’s essential to listen to your body and adjust your routine accordingly.
References
Antonio, J., & Ciccone, V. (2013). The effects of pre versus post workout supplementation of creatine monohydrate on body composition and strength. Journal of the International Society of Sports Nutrition, 10(1), 36.
Rosenbloom, C., & Coleman, E. (2012). Sports Nutrition: A Practice Manual for Professionals. 5th edition. Chicago: Academy of Nutrition and Dietetics.
van Zuuren, E. J., Fedorowicz, Z., & Carter, B. (2017). Interventions for rosacea: abridged Cochrane systematic review including GRADE assessments. British Journal of Dermatology, 176(1), 122-129.
van der Merwe, J., & Brooks, N. (2009). Effect of creatine supplementation on dihydrotestosterone levels in college-aged rugby players. Clinical Journal of Sport Medicine, 19(5), 399-404.
Author: Dr. Yesser Falk