What we searched
On October 26, 2026 we searched PubMed for creatine supplementation and acne, and we searched Europe PMC for creatine titles that also mentioned acne. The hits that look relevant at a glance are mostly creatine kinase, the enzyme dermatologists watch in people taking isotretinoin. That enzyme is not the powder in the tub. A paper about a blood test during acne treatment is not a test of creatine monohydrate.
Two PubMed records matched the broader supplementation-and-acne wording and still were not creatine-powder trials: one was a berberine study in women with PCOS, and one was a case series on supplements, isotretinoin, and liver tests in adolescents. We are not using either paper as an acne result for creatine. If a randomized trial with a lesion count exists outside those indexes, we have not read it, and this page should be corrected when it is in front of us.
The 685-trial skin row
Kreider and colleagues, 2025, inventoried side effects across 685 human creatine trials and 652 placebo comparisons. The word acne does not appear in the full text. Skin does, as one category among many.
Counted by study, skin was reported in 1 placebo study out of 652 (0.15%) and 1 creatine study out of 685 (0.15%). The p-value on that comparison is 0.972. Counted by participant, 222 of 13,452 placebo participants (1.65%) and 226 of 12,839 creatine participants (1.76%) had a skin report, a difference of 0.11 percentage points (p = 0.983). The paper does not say those reports were pimples, cysts, or a dermatology score. A checkbox labeled skin is a wide net. It can include a rash, itching, or a note a trialist bothered to write down.
The same paper found study-level differences for gastrointestinal issues and muscle cramping that were not significant when counted by participant. Those complaints are written up on creatine side effects. The decades view is on creatine long-term safety.
The DHT study did not count blemishes
The hormone paper that gets dragged into acne arguments is van der Merwe, Brooks, and Myburgh, 2009. Twenty college-aged male rugby players completed a double-blind crossover during the competitive season, with a six-week washout. They loaded with 25 grams of creatine plus 25 grams of glucose a day for seven days, then 5 grams of creatine plus 25 grams of glucose for 14 days, or a glucose placebo. Serum testosterone did not change. DHT rose 56 percent after the loading week and was still 40 percent above baseline after the maintenance fortnight (p < 0.001). The DHT-to-testosterone ratio rose 36 percent, then stayed 22 percent up (p < 0.01).
The outcomes were blood androgens and body composition. The paper did not count acne, and it did not count hair. The participants were young men in a rugby season, on a loading dose with a large glucose add-on. A rise in a blood androgen ratio, in that group, is not a measurement of a woman's jawline in week two of 5 grams. The hair write-up of the same study, including the later trial that did measure hair in men, is does creatine cause hair loss.
Why the tub gets blamed anyway
People start creatine in the same month they start a harder program, a higher-calorie bulk, a new pre-workout, or more dairy protein. Any of those can line up with a breakout. The creatine trials above do not separate those exposures, because they were not designed as dermatology studies. A pre-workout with a dozen ingredients is not the monohydrate protocol in the 685-trial pool.
Whey and high-glycemic eating have their own acne literature. Those papers are not creatine papers, and this page does not borrow their results. If a breakout started the week a multi-ingredient tub showed up, the first useful step is to notice what else changed, then talk with a clinician if it persists. Stopping creatine for two weeks is a personal experiment, not a finding you can generalize from one bathroom mirror.
The women's strength record, which is the reason most readers picked up the tub, is on creatine benefits for women. The early scale change that often arrives with it is on will creatine make me gain weight.
Who should not use this page as clearance
Teens are outside the adult rankings on this site. Pregnancy and breastfeeding are not covered by these trials. If you are prescribed isotretinoin, follow the monitoring your prescriber set. A creatine-kinase blood test on that drug is about muscle enzyme leak, not about whether a scoop causes comedones. Polycystic ovary syndrome has its own androgen story. Nothing on this page is a treatment claim, and nothing here shows that creatine monohydrate worsens PCOS acne, because that trial is not in the file.
Painful nodules, scarring, or a breakout that arrives with other new symptoms belong with a clinician. A supplement page cannot see your skin.
What we still do not know
Absence of an acne-lesion trial is not proof that no one breaks out. Rare reactions are hard to see even in a large side-effect inventory, and the skin row is a reported category, not a photographed face. Women are underrepresented in the older performance trials. The rugby DHT result has not been run again as a skin study in women at 3 to 5 grams. Until someone counts lesions in a randomized creatine trial, the accurate sentence stays narrow: the studies we have did not measure acne, and the skin reports in the 685-trial inventory were about as common as placebo.
Common questions
Does creatine cause acne?
No randomized trial counted acne lesions on creatine monohydrate. Kreider 2025 recorded a skin side-effect category in 0.15% of studies in both arms, and in 1.65% of placebo participants versus 1.76% of creatine participants. That isn't a pimple score.
Did the DHT study show creatine causes acne?
No. It didn't look at skin. van der Merwe 2009 measured testosterone and DHT in 20 college-aged male rugby players on a loading dose. Hair and acne weren't outcomes.
Why did I break out when I started creatine?
The trials don't answer one person's week. New training, a calorie surplus, dairy protein, and multi-ingredient pre-workouts often start in the same month. A breakout that stays is a clinician's question.
Are creatine kinase papers about the supplement?
No. Those papers measure an enzyme in the blood, often in people taking isotretinoin. They aren't trials of creatine monohydrate powder.
Sources
- Kreider RB, et al. 2025. Safety of creatine supplementation. J Int Soc Sports Nutr. Used for the skin category: 1/652 placebo studies and 1/685 creatine studies (0.15%, p = 0.972); participants 222/13,452 (1.65%) versus 226/12,839 (1.76%), p = 0.983. Acne is not named in the full text.
- van der Merwe J, Brooks NE, Myburgh KH. 2009. Clin J Sport Med. Used for n = 20 college-aged male rugby players, the 7-day load and 14-day maintenance, unchanged testosterone, the DHT and DHT:T changes, and the absence of an acne or hair outcome.
- Rondanelli M, et al. 2021. Berberine phospholipid in women with PCOS. Nutrients. Listed only to show a PubMed acne-and-supplementation hit that is not a creatine trial.
- DeKlotz CMC, et al. 2017. Dietary supplements, isotretinoin, and liver toxicity. Pediatrics. Listed only to show the other supplementation-and-acne hit is not a creatine-powder trial.
Editorial note: This page is informational and does not provide personalized medical advice. Study findings describe groups, not guarantees for individuals. If you have a medical condition, take prescription medication, are pregnant, or have symptoms that concern you, discuss supplement use with a qualified clinician.