Written by Ben Carlisle
Last updated on: Sep 18, 2022
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Creatine is a supplement commonly taken by people trying to build muscle and improve their overall athletic performance. Because it is associated with the use of anabolic steroids for body building, it has gotten a bad reputation. There are all sorts of myths about creatine, like that it causes acne breakouts.
There is no medical evidence directly linking any creatine supplement to outbreaks of acne. In fact, creatine has been shown to benefit the skin. Sweating from exercise increases the risk of acne, and an increase in testosterone has also been shown to cause acne.
If you want to start taking a creatine supplement but are scared of how it could affect your skin, you have come to the right place. Here, we explain exactly what creatine is, how it works, and its benefits. We also explain the possible reasons that acne breakouts happen when you are exercising and taking creatine.
Let’s start with the fact that creatine is not a steroid. Creatine monohydrate is a tripeptide molecule made up of 3 amino acids – arginine, glycine, and methionine.
Creatine is actually a molecule that is naturally produced in our kidneys and liver. Almost all the creatine stores in the body are in the muscle cells.
Your body can only naturally produce a certain amount of creatine, so consuming creatine supplements and increasing the body’s creatine stores allows our muscles to perform better.
Because our bodies naturally produce creatine, inside our muscle cells, we have a process called the ATP-creatine phosphate system.
Adenosine triphosphate (ATP) is the molecule our muscles’ use to power our bodies. On a molecular level, ATP is made of adenine (a nitrogenous base), ribose sugar, and 3 phosphate groups.
ATP releases energy by hydrolyzing one of its 3 phosphate groups. When this happens, it becomes adenosine diphosphate (ADP).
ADP is not as useful to our muscles as ATP. It can’t provide us with more energy to fuel our performance. This is where creatine comes in.
Creatine can bond with free phosphate groups to form creatine phosphate. In this form, it can donate its new phosphate group to ADP, turning it back into ATP (the useful stuff!) (1).
Because creatine causes ATP to regenerate in our muscles, the more we have creatine, the better our muscles can perform, and the greater our ability to train at high intensities for longer periods (2).
Many people that take creatine and train intensively report that they struggle with acne breakouts. This led people to assume that creatine supplements must cause acne.
Creatine has been the subject of a lot of research in the field of dermatology. No medical evidence directly links taking creatine supplements with experiencing acne breakouts.
On the contrary, a lot of research shows that creatine has benefits for our skin. Face creams and serums that contain creatine seem to reduce the signs of ageing (3). It tightens the skin, increases its firmness, and visibly reduces wrinkles, sagging and sun damage (4).
If creatine isn’t what is causing the acne, what else could it be?
Taking creatine does not directly cause acne, but the way creatine affects our bodies can influence existing acne problems. There are some things that can cause acne to flare up when taking creatine supplements.
Athletes and fitness enthusiasts that take creatine train harder for longer. They sweat a lot more than one would in a normal 1-hour training session. Research has shown that sweating excessively for prolonged periods can negatively impact our skin and cause acne breakouts (5).
Therefore, it is not the creatine itself that is causing the acne, but what the creatine enables you to do.
Certain types of exercise, like resistance training and hypertrophy, are great for building muscle mass and increasing strength because they increase our body’s testosterone level (6). Having higher levels of testosterone may be great for our physique and performance, but it has also been linked to acne (7).
Having high levels of testosterone (naturally or from taking anabolic steroids) causes the sebaceous glands in our skin to work overtime (8). The excess sebum is what causes pimples and cystic acne because it clogs our hair follicles and sebaceous glands.
Here, it is not the creatine itself that is causing the excess sebum production and subsequent acne. Rather, it is the testosterone boost from the type of training that creatine allows you to do for longer periods that is causing the acne.
Does creatine directly cause an increase in testosterone?
One study found that taking creatine monohydrate for 3 weeks led to an increase in testosterone in rugby players (9). While this suggests that taking creatine causes increased testosterone levels, more research still has to be done to confirm this.
Another study linked creatine supplementation with elevated dihydrotestosterone levels (9). It has been found that dihydrotestosterone plays a role in sebum production, as well as the production of cytokines that cause inflammation in acne (9).
There is, however, not enough evidence to suggest that creatine supplementation causes higher testosterone levels and, therefore, causes acne.
Whether you take creatine supplements or not, the risk of acne is higher if you are very active and sweat regularly. There are several ways to prevent acne breakouts when you are taking creatine supplements and working out intensely. Many of these are just general good hygiene practices.
• Firstly, remove your make-up before exercising. Sweat and make-up are a recipe for a breakout. Don’t touch your face while you are working out.
• Wipe down equipment before you use it, shower as soon as you are done training, and change into a clean, dry set of clothes. The sooner you wash away the sweat, the better. It also helps to wear moisture-wicking workout clothes.
• Have a healthy skincare routine – cleanse your skin twice daily using warm water and a gentle face wash. Avoid picking at pimples or touching your face too much – this will only introduce bacteria that will make acne worse.
• Be mindful of how you shave your beard – go with the grain, not against it.
• Drink lots of water to stay hydrated. But beware of sugary sports drinks! High sugar levels will cause acne.
• Keep your testosterone levels balanced by following a healthy lifestyle – exercise regularly, get at least 7-9 hours of sleep every night, limit your consumption of refined carbs and heavily processed foods, manage your stress levels, and never take anabolic or corticosteroids.
• Do not smoke! Smoking has been shown to increase your risk of acne.
If you still struggle with acne, despite taking these precautions, speak to a dermatologist. There may be other underlying health reasons for your acne.
There is an extensive body of research that shows how beneficial creatine supplementation can be, especially for increasing performance in high-intensity resistance exercises (10).
Creatine supplementation has been shown to boost athletic performance by increasing muscle ATP so that our cells can produce more energy for longer periods. Over 300 studies have shown that creatine supplementation significantly increases peoples’ strength and endurance (11).
Of these studies, 70% reported that athletes taking creatine supplements showed a significant improvement in their exercise performance, anaerobic capacity, endurance, and growth of lean muscle mass (11).
Athletes that supplemented their diets with creatine for a short period demonstrated a 5 to 15% increase in strength and power and 5 to 15% improvement in the performance of repeated sprints (11).
Creatine is proven to be the best dietary supplement for gaining muscle mass. Evidence shows that creatine increases the rate of muscle protein synthesis.
It stimulates the production of actin and myosin – two contractile proteins that create new muscle tissue (12). What this means is that creatine supports the building of lean muscle mass.
Creatine also causes your muscle cells to retain more water, which causes the volume of the cells to increase. Cell hydration and swelling play a key role in muscle growth (13).
Creatine supplementation has been shown to decrease the amount of lactate our bodies produce when we exercise intensively (14). Lactate reacts with hydrogen ions to form lactic acid. The lactic acid in our muscles is what causes them to ache during strength and resistance training. Therefore, creatine can increase athletes’ endurance.
When you don’t take any creatine supplements and just eat a healthy diet with red meat and fish, your muscles’ creatine stores are usually around 60 to 80% full. When you take creatine supplements, you can maximize your muscles’ creatine stores by 10 to 40% (15).
So, how does one start supplementing your diet with creatine?
There are two different methods:
To quickly boost your muscles’ creatine stores, a high dose of creatine (20g) is taken for the first 5 to 7 days. This is called the creatine loading phase. After a week, you take a lower dose (2 to 10g) to maintain your muscles’ creatine stores. This is called the maintenance phase.
The second method is to increase your muscles’ creatine stores more gradually. A low dose (2 to 10g) is taken daily. After around 3 weeks, your muscles’ creatine stores will be maximized (15).
Creatine is generally a flavorless powder. Some people think it tastes a bit salty or sour. The recommended way to take it is to mix the powder with water or juice and drink it as fast as possible.
Divide a large daily dose of 20g into 4 smaller doses of 5g each.
Creatine monohydrate used to be the only type of creatine on the market, but today there is a wide variety of creatine supplements:
• Creatine Magnesium Chelate
• Creatine Pyruvate
• Creatine Citrate
• Creatine Nitrate
• Buffered Creatine (Kre-Alkalyn)
• Creatine Hydrochloride
• Creatine Ethyl Ester
• Liquid Creatine
All these different types of creatine claim to have their own unique advantages, but the main two factors one should focus on are solubility and absorption.
Creatine monohydrate has high absorption because the molecule stays stable throughout the processes of digestion and metabolism (16). The molecules make it all the way from your mouth to your muscles in their useful form.
On the other hand, creatine ethyl ester has a low absorption because the molecules degrade during digestion and metabolism and never make it to your muscles (16).
The vast majority of scientific studies use creatine monohydrate. It is proven to be the most effective form of creatine.
Of all the different sports supplements, creatine is among the most well-researched products. Long term trials have shown no negative effects, even after 4 years of consistent use (17).
Creatine is metabolized in our liver and kidneys. There is no evidence that suggests creatine is harmful to our renal system (17). However, people with pre-existing kidney or liver issues should speak to a medical professional before starting creatine supplementation.
There is a myth that creatine commonly causes cramps and dehydration. There is no medical evidence to suggest this is true. On the contrary, studies have shown that creatine is beneficial for reducing cramping and dehydration during activity in hot conditions (17).
A single study found that creatine may be linked to hair loss. It seems that the supplement causes an increase in the hormone DHT, which contributes to hair loss (17). More evidence is needed to prove this is true, but if you are prone to hair loss and want to be on the safe side, it may be better to avoid taking creatine supplements.
Creatine supplementation comes with many proven benefits backed by extensive research. It is also classed as an extremely safe supplement. No direct medical evidence creatine causes acne. However, it may have indirect causes, such as allowing individuals to carry out a greater volume of testosterone releasing resistance training.