Does creatine (creatine monohydrate) supplementation cause hair loss?

Does Creatine Monohydrate Cause Hair Loss?

No, creatine monohydrate supplementation does not cause hair loss. The most recent and highest-quality evidence directly examining this question—a 12-week randomized controlled trial—found no effect of creatine supplementation on hair follicle health, hair density, or androgen levels that would promote hair loss 1.

Direct Evidence on Hair Loss

The 2025 randomized controlled trial specifically designed to answer this question provides the strongest evidence available 1:

• 45 resistance-trained males (ages 18-40) were randomized to either creatine monohydrate (5 g/day) or placebo for 12 weeks 1
• Hair follicle health was directly measured using the Trichogram test and FotoFinder system, assessing hair density, follicular unit count, and cumulative hair thickness 1
• No significant differences were found between creatine and placebo groups for any hair-related outcomes 1
• DHT levels and DHT-to-testosterone ratios showed no significant changes with creatine supplementation 1
• This was the first study to directly assess hair follicle health following creatine supplementation, providing strong evidence against claims that creatine contributes to hair loss 1

Hormonal Considerations

The concern about creatine and hair loss stems from a single 2009 study suggesting increased DHT levels, but this has not been replicated 1:

• The 2025 RCT found no changes in DHT levels or DHT-to-testosterone ratio with creatine supplementation 1
• While total testosterone increased and free testosterone decreased over the 12-week period, these changes were independent of supplementation and occurred in both creatine and placebo groups 1

Safety Profile in General

Multiple systematic reviews confirm creatine's safety profile 2, 3:

• Over 500 peer-reviewed publications have examined creatine supplementation, with consistent evidence of safety at recommended dosages (3-5 g/day or 0.1 g/kg body weight/day) 2
• A systematic review of females taking creatine found no serious adverse outcomes and no significant differences in total adverse events compared to placebo 3
• Long-term studies (up to 5 years) have shown no adverse effects on organ function when monitoring liver and kidney parameters 4

Guideline Perspective on Creatine Use

Sports medicine guidelines recognize creatine as an effective ergogenic aid with minimal concerns 5:

• Improves high-intensity repeated sprint performance and enhances training capacity 5
• Potential for 1-2 kg body mass increase after loading, but no negative health effects following appropriate protocols 5
• The main documented concern is the potential for body mass increase, not hair loss 5

Clinical Bottom Line

Creatine monohydrate does not cause hair loss. The concern is based on outdated speculation rather than evidence. The most recent direct investigation of this question—using objective hair follicle measurements—definitively shows no effect on hair health 1. Clinicians can confidently reassure patients that creatine supplementation at recommended doses (3-5 g/day) does not increase risk of hair loss 1, 2.

The only documented adverse effects with creatine are occasional gastrointestinal disturbances and the expected increase in body mass from increased muscle creatine stores 5, 2. Hair loss is not among the evidence-based concerns with this supplement 1, 2.