Creatine and Hair Loss: The DHT Question, Finally Answered

The claim that creatine causes hair loss originates from a single 2009 study of 20 rugby players that recorded a rise in dihydrotestosterone (DHT) but never measured hair. No trial has reproduced that DHT result in the years since, and the only study to assess hair follicles directly — a 2025 randomised controlled trial — found no difference between creatine and placebo. On current evidence, creatine monohydrate at standard doses is not shown to cause hair loss.

Creatine monohydrate is among the most studied supplements in sports nutrition, with a long-established safety record at recommended doses (Kreider et al., 2017, Journal of the International Society of Sports Nutrition). Yet one concern resurfaces more than almost any other: that taking creatine accelerates male-pattern baldness. The mechanism people describe sounds plausible, which is part of why the worry persists.

This article sets out the evidence in chronological order — what the 2009 study did and did not measure, what every subsequent attempt to reproduce it found, and what the first trial to look at hair follicles directly reported in 2025. The aim is not reassurance for its own sake, but an accurate reading of the published record.

The proposed mechanism: how DHT relates to hair loss

The biological premise behind the concern is real and well established. Dihydrotestosterone is a potent androgen produced from testosterone by the enzyme 5-alpha-reductase. In people genetically predisposed to androgenetic alopecia (male- or female-pattern hair loss), DHT binds to androgen receptors in susceptible scalp follicles and triggers follicular miniaturisation — the follicle progressively shrinks, producing thinner, shorter hairs until it stops producing terminal hair altogether (Kreider & Stout, 2021, Nutrients).

That part is not in dispute. The DHT–hair-loss link is the basis of approved treatments such as finasteride, a 5-alpha-reductase inhibitor that lowers scalp DHT.

The disputed link is the step before it: whether creatine supplementation meaningfully raises DHT in the first place, and whether any such change is large enough to affect hair. The entire scare depends on that single connecting claim — and that claim rests on one study.

The 2009 origin: what the van der Merwe study did and did not show

The source of the entire concern is a single randomised controlled trial published in 2009 in the Clinical Journal of Sport Medicine (van der Merwe, Brooks & Myburgh, 2009). College-aged male rugby players supplemented with creatine monohydrate through a one-week loading phase followed by a two-week maintenance phase. After the loading week, the creatine group showed a 56% increase in DHT; after three weeks, DHT remained about 40% above baseline, and the ratio of DHT to testosterone also rose.

Those percentages are what circulate online. The detail that rarely travels with them is what the absolute values were, and what the study did not do.

The single most important point about the 2009 study is the one most often omitted: it did not measure hair loss at all. It measured a hormone. The leap from "DHT rose by a percentage, while staying inside the normal range" to "creatine causes baldness" was an inference layered on top of the data, not a finding within it (Antonio et al., 2021, Nutrients).

What happened next: more than fifteen years of failure to replicate

A single positive result is a hypothesis, not a conclusion. The relevant question for the years since 2009 is whether the DHT finding held up when other researchers looked for it. It did not.

To date, the 2009 trial remains the only study to report an increase in DHT with creatine supplementation. A 2021 review examined the broader hormonal literature and identified twelve further studies measuring creatine's effect on testosterone; ten reported no effect, and the two that did were very short (six and seven days) and concerned testosterone rather than DHT (Antonio et al., 2021, Nutrients). Five of those studies specifically measured free testosterone — the fraction available for conversion to DHT — and found no significant increase. No subsequent study reproduced the DHT result itself.

1. 2009

   van der Merwe et al. report a DHT rise in 20 male rugby players over 3 weeks. Hair not measured.

   The claim
2. 2009–2021

   Twelve further trials measure creatine and testosterone/free testosterone; ten show no effect, none reproduce the DHT rise.

   Evidence against
3. 2017

   ISSN Position Stand concludes creatine is safe at recommended doses with no evidence of the alleged adverse effects.

   Evidence against
4. 2021

   Antonio et al. review concludes the hair-loss claim rests on one unreplicated study and remains unsupported.

   Evidence against
5. 2025

   First randomised controlled trial to measure hair follicles directly finds no difference between creatine and placebo.

   Evidence against

Sources listed in full in the references and citations throughout this article.

The position of the International Society of Sports Nutrition reflects this pattern. Its 2017 Position Stand reviewed the safety literature on creatine monohydrate and concluded there is no compelling scientific evidence that short- or long-term use at recommended doses produces the adverse effects commonly attributed to it. Hair loss is not listed among substantiated effects (Kreider et al., 2017). A subsequent comprehensive review reached the same conclusion across populations (Kreider & Stout, 2021, Nutrients).

2025: the first trial to measure hair directly

For all the years of argument, one gap remained in the literature. Every study to that point had measured hormones and inferred a hair outcome; none had measured the hair itself. That gap closed in 2025.

A 12-week randomised, double-blind, placebo-controlled trial published in the Journal of the International Society of Sports Nutrition set out specifically to test the claim (Quesnele et al., 2025, JISSN). Thirty-eight healthy young men were randomised to 5 g per day of creatine monohydrate or an identical-tasting maltodextrin placebo, alongside a minimum of three resistance-training sessions per week. The study measured testosterone, free testosterone, and DHT — and, for the first time, hair follicle health directly, using Trichogram testing and the FotoFinder imaging system, with assessments conducted by board-certified dermatologists.

The authors found no significant difference between the creatine and placebo groups for testosterone, free testosterone, DHT, or the DHT-to-testosterone ratio — and no significant difference in hair follicle parameters. Their stated conclusion was that the study provided strong evidence against the claim that creatine contributes to hair loss (Quesnele et al., 2025).

This is what changed the question from "plausible but unmeasured" to "measured, with a negative result." The mechanism people feared was tested at the level it had never been tested before, and it was not observed.

Reading the evidence honestly: limitations and what is not claimed

A rigorous reading acknowledges what the evidence does and does not establish. The 2025 trial studied healthy young men over 12 weeks; it did not specifically enrol men with active androgenetic alopecia or genetic predisposition, and its sample, while adequate for its primary outcomes, was modest (n = 38). Longer-term and higher-risk populations have not been studied with direct hair measurement (Quesnele et al., 2025).

What can be stated accurately is this: across more than fifteen years, the DHT finding behind the concern has never been reproduced; the broader hormonal literature shows no consistent androgen increase; and the one trial that measured hair directly found no effect (Antonio et al., 2021, Nutrients; Quesnele et al., 2025). The balance of published evidence does not support the claim that creatine monohydrate at standard doses causes or accelerates hair loss.

It is also worth separating two questions that are often merged. Hair loss has many established causes — genetics, age, thyroid disorders, iron deficiency, certain medications, and stress among them. A person who begins creatine and notices shedding may be experiencing one of those causes coincidentally. Anyone concerned about hair loss should seek assessment from a doctor or dermatologist to identify the actual cause, rather than attributing it to a supplement the evidence does not implicate.

How this fits the wider creatine safety picture

The hair-loss question is one item in a small set of recurring safety concerns about creatine, most of which follow the same pattern: a plausible-sounding mechanism, thin or absent supporting evidence, and a large body of reassuring data. The same applies to the long-standing claims around kidney function and water retention, which are addressed across this safety series. For the full catalogue of which concerns hold up and which do not, the overview of what is real and what is myth about creatine gummy side effects sets out the evidence for each.

Because much of the hair-loss worry sits with men — and specifically with men who are also weighing creatine's effects on testosterone — it intersects with the broader question of the testosterone-adjacent story for men over 40, where the same hormonal data is examined from a performance and longevity angle. The closely related kidney question, often raised in the same breath, is covered in detail in the review of creatine and kidney health across 30 years of evidence.

One practical point applies regardless of the hair question: the safety evidence concerns creatine monohydrate that actually contains what its label claims. Independent testing in 2025 found that a substantial share of creatine gummies on the market contained far less creatine than stated, which is its own quality issue — covered in the guide to whether creatine gummies are legit and how to verify yours.

FAQs