Is ingesting creatine (a dietary supplement) as a supplement associated with itchy skin?

Creatine Supplementation and Itchy Skin

Creatine supplementation is not associated with itchy skin as a recognized adverse effect based on current high-quality evidence. 1

Evidence from Guidelines

The most authoritative guideline on creatine supplementation, the 2021 UEFA Expert Group Statement published in the British Journal of Sports Medicine, explicitly lists the concerns associated with creatine use and does not include itchy skin or any dermatologic reactions. 1 The only documented concern is potential body mass increase of 1-2 kg after loading, with "no negative health effects following appropriate protocols." 1

Notably, when the same guideline discusses β-alanine (another performance supplement), it specifically warns about "possible skin rashes and/or transient paraesthesia (skin tingling)," demonstrating that the authors were attentive to dermatologic side effects when present. 1 The absence of any mention of skin-related issues with creatine is therefore meaningful.

Contrast with Other Supplements

To put this in context, the guidelines clearly differentiate supplements by their dermatologic profiles:

• β-alanine: Explicitly causes skin rashes and tingling 1
• Creatine: No dermatologic adverse effects mentioned 1

This distinction is important because it shows the guideline authors systematically evaluated and reported skin-related side effects when they existed.

Research Evidence on Safety

Multiple comprehensive research reviews spanning decades confirm creatine's safety profile without mentioning pruritus or skin reactions:

• A 2021 systematic review addressing common misconceptions about creatine safety found it "relatively well tolerated" at recommended doses (3-5 g/day), with no mention of dermatologic effects 2
• The International Society of Sports Nutrition's 2017 position stand, reviewing studies of supplementation up to 30 g/day for 5 years, found creatine "safe and well-tolerated" without reporting skin-related adverse effects 3
• A 2000 review specifically examining adverse effects noted only "gastrointestinal disturbances and muscle cramps" as occasional anecdotal reports, with no mention of skin reactions 4

Most Common Actual Side Effects

The documented adverse effects of creatine are limited to:

• Transient water retention during early supplementation (most common) 5, 4
• Body mass increase of 1-2 kg after loading 1
• Gastrointestinal disturbances (occasional, anecdotal) 4
• Rare cases of liver/renal complications only when combined with other supplements or taken at higher than recommended doses for prolonged periods 5

Clinical Implications

If a patient reports itchy skin while taking creatine:

• Consider alternative causes of pruritus, as this is not a recognized creatine side effect 1, 2, 3
• Evaluate for drug-induced pruritus from other medications the patient may be taking 1
• Assess for other dietary supplements being used concurrently, as contamination or adulterants in supplements can cause various reactions 1
• Rule out unrelated dermatologic conditions that may have coincidentally developed 1

Important Caveat

While creatine itself does not cause itchy skin, contaminated or adulterated supplements theoretically could cause reactions. 1 Third-party testing programs (such as Informed Sport or Kölner Liste) can help ensure product quality. 1