Creatine and Hair Loss: What the One Rugby Study Found, and What Came After

Who This Is For#

This guide is for you if:

• You take creatine, or are thinking about it, and have read that it causes hair loss
• You started creatine and noticed more shedding or a thinner hairline
• You have pattern hair loss in your family and want to know whether creatine raises your risk
• You want to know exactly what the 2009 rugby study did and did not measure
• You want to know what has been tested since, and where the evidence runs out

This guide is NOT for you if:

• Your hair loss is in distinct round patches with smooth skin between them; start with Alopecia Areata and see a dermatologist
• You want the biology of DHT itself rather than the creatine question; DHT and Hair Loss covers it
• You are asking about exercise and hair loss more broadly; see Exercise and Hair Loss
• You are looking for supplements that might help hair grow; see Best Hair Growth Supplements

Where the Claim Came From: The 2009 Rugby Study#

What van der Merwe and Colleagues Measured#

The entire "creatine causes hair loss" idea rests on a single paper, published in the Clinical Journal of Sport Medicine in 2009 [1]. It was a "Double-blind placebo-controlled crossover study with a 6-week washout period" in "College-aged rugby players (n = 20)" [1]. The protocol was a standard loading-then-maintenance schedule: "Subjects loaded with creatine (25 g/day creatine with 25 g/day glucose) or placebo (50 g/day glucose) for 7 days followed by 14 days of maintenance (5 g/day creatine with 25 g/day glucose or 30 g/day glucose placebo)" [1]. The aim was hormonal: to see whether the ratio of DHT to testosterone would change [1]. It did:

• "After 7 days of creatine loading, or a further 14 days of creatine maintenance dose, serum T levels did not change" [1].
• "However, levels of DHT increased by 56% after 7 days of creatine loading and remained 40% above baseline after 14 days maintenance (P < 0.001)" [1].
• "The ratio of DHT:T also increased by 36% after 7 days creatine supplementation and remained elevated by 22% after the maintenance dose (P < 0.01)" [1].

The authors' conclusion was cautious: "Creatine supplementation may, in part, act through an increased rate of conversion of T to DHT. Further investigation is warranted" [1].

What It Did Not Measure#

Hair. The study measured resting serum androgens and nothing else relevant to the scalp: no hair count, no scalp photograph, no dermatological assessment. Every statement of the form "the rugby study found creatine causes hair loss" is a step the study never took. It found a rise in a hormone known to drive pattern loss in susceptible people, over 3 weeks, in 20 young athletes [1].

Where the evidence is thin. No source behind this guide replicates the 2009 protocol with the same DHT measurement. It stands alone as a 20-person crossover [1].

What Came After: The 2025 Randomized Trial#

The First Trial to Look at Hair#

In 2025 a trial titled, plainly, "Does creatine cause hair loss? A 12-week randomized controlled trial" appeared in the Journal of the International Society of Sports Nutrition [2]. Its authors framed the gap the same way: "Currently, there is no direct evidence examining the relationship between creatine supplementation and hair follicle health" [2].

The design: "Forty-five resistance-trained males (ages 18-40 years) were recruited and randomly assigned to either a creatine monohydrate (5 g/day) or placebo (5 g maltodextrin/day) group" [2]. Hormones were drawn "at baseline and after 12 weeks to measure total testosterone, free testosterone, and DHT," and this time hair was measured: "Hair follicle health was assessed using the Trichogram test and the FotoFinder system (hair density, follicular unit count, and cumulative hair thickness)" [2].

The results: "Thirty-eight participants completed the study, with no significant differences in baseline characteristics between groups. There were no group-by-time interactions observed for any hormones or hair-related outcomes (p > 0.05)" [2]. On the specific question: "There were no significant differences in DHT levels, DHT-to-testosterone ratio, or hair growth parameters between the creatine and placebo groups" [2]. The authors call this "strong evidence against the claim that creatine contributes to hair loss" [2].

How Much Weight It Can Carry#

This is the best evidence on the question, and it points one way. It is also one trial, with limits:

• Size. 45 men randomized, 38 finished [2]: still a small trial.
• Population. Resistance-trained men aged 18-40 [2], not selected for existing pattern loss or family history, so a null result does not fully answer the question for a man whose follicles are already miniaturizing. Both trials enrolled men only [1][2].
• Dose and duration. 5 g/day for 12 weeks [2]; the retrieved abstract describes no loading phase. The 2009 DHT rise was largest during 25 g/day loading and had already fallen from 56% to 40% by the end of maintenance [1]. Whether a loading week behaves differently is untested with a hair endpoint, and 12 weeks is short against a condition that unfolds over years.
• Disclosed conflicts. The ISSN's CEO is a co-author of the trial [2] and sits on supplement-company advisory boards, and the ISSN itself "receives grants on occasion from companies that manufacture, sell, and market dietary supplements" [5]. That is not a flaw in the randomization or the outcome measures; it is a reason to want independent replication.
• Topical lotions are a different question. A 2021 randomized trial of "a hair lotion containing creatine, acetyl tetrapeptide-2 and B vitamins" in women with acute telogen effluvium [9] is a different exposure, condition and population; it says nothing about oral creatine and pattern loss.

Where the evidence is thin. No search behind this guide found a second randomized trial measuring hair after oral creatine, or any systematic review or meta-analysis pooling creatine-and-DHT or creatine-and-hair trials.

What the Sports-Nutrition Bodies Say#

The ISSN Position#

The International Society of Sports Nutrition's 2017 position stand on creatine concludes that "short and long-term supplementation (up to 30 g/day for 5 years) is safe and well-tolerated in healthy individuals and in a number of patient populations ranging from infants to the elderly" [3]. As retrieved for this guide, that document does not address hair, so it should not be read as an ISSN ruling on the hair question [3].

The ISSN took the hair question up directly in a 2021 paper, "Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show?" [4]. Among the questions it set out to answer is "4. Does creatine cause hair loss / baldness?" [4]. The same paper notes that creatine "is relatively well tolerated, especially at recommended dosages (i.e. 3-5 g/day or 0.1 g/kg of body mass/day)" [4]. The abstract retrieved for this guide does not contain the paper's specific answer on hair, so this guide does not put one in its mouth. What can be said is that the sports-nutrition establishment treats "creatine causes baldness" as a named misconception it chose to address formally [4], and that the 2025 trial from the same journal is the direct test that followed [2].

Why a DHT Rise Would Only Matter in Sensitive Follicles#

The Mechanism Is Conditional#

Suppose creatine did raise your DHT the way it did in the rugby players. Whether that would cost you hair depends on something the supplement cannot change: whether your follicles respond to DHT by shrinking.

Androgenetic alopecia (AGA) is defined by that sensitivity. The Italian AGA guideline, adapted from the European Dermatology Forum/EADV guidelines, states that "AGA is caused by a progressive reduction in the diameter, length and pigmentation of the hair, resulting from the effects of the testosterone metabolite dihydrotestosterone (DHT) on androgen-sensitive hair follicles" [6]. An independent review puts it in terms of inheritance: AGA "is a hereditary condition characterized by hair follicles that are sensitive to androgens" [7].

Two things follow. First, DHT alone does not bald anyone; the deciding variable is follicle-level and inherited, which is why the condition is common and patterned rather than universal: it affects "up to 80% of men and 50% of women in the course of their life" [6] and takes the crown-and-temple shape mapped by the Norwood scale. Second, if you have no androgenetic susceptibility, a temporary rise in serum DHT would not explain hair loss, because the miniaturization that defines pattern loss happens only in follicles that are androgen-sensitive [6][7]. If you do, a sustained rise is at least biologically plausible as an accelerant, because the follicles that miniaturize are the ones responding to exactly this hormone [6][7].

What the Finasteride Label Tells Us About Scale#

Finasteride, a prescription drug for AGA, works by lowering DHT [8]. The Propecia label states that "Finasteride produces a rapid reduction in serum DHT concentration, reaching 65% suppression within 24 hours of oral dosing with a 1-mg tablet" [8]. A treatment that cuts serum DHT by 65% treats pattern loss [8]; the rugby study reported a rise of 56% during loading, in the other direction [1]. But the comparison has a hole in it: the rugby study's DHT rise was never followed to the scalp [1], and the one trial that did follow creatine to the scalp found no significant difference in DHT between creatine and placebo to begin with [2]. The Complete Guide to Finasteride covers the drug; it is a prescription decision for a clinician, and this guide is not advising anyone to start or stop it.

If You Take Creatine and Are Losing Hair#

Sort the Pattern Before Blaming the Powder#

The study that started the worry never looked at hair [1]. The one study that has looked at hair found no significant difference in hair or DHT versus placebo over 12 weeks at 5 g/day [2]. There is no direct evidence that creatine causes hair loss, and one trial's worth of evidence that it does not. That does not make your hair loss imaginary. It means creatine is an unlikely cause on current evidence, and the common causes of hair loss deserve to be ruled out first.

1. Identify the pattern. Pattern loss recedes at the temples and thins at the crown while the sides and back stay dense; a diffuse shed thins everywhere and fills the drain. How to Tell If You're Going Bald and Diffuse Thinning vs Pattern Baldness walk through the differences; the Receding or Maturing Hairline tool gives a structured self-check.

2. Check the timeline. People often start creatine when they start lifting seriously or cutting calories hard. A diffuse shed that follows a period of hard calorie restriction is the pattern of telogen effluvium rather than an androgen effect; see Telogen Effluvium and Best Diet for Hair Growth.

3. Ask about family. If pattern loss runs in your family and your hairline is changing, that is AGA on its own schedule. See Androgenetic Alopecia and When to Start Hair Loss Treatment.

4. Measure, then talk to a clinician if it matters. Take the same photograph in the same light, monthly, before changing anything; Tracking Hair Loss Progress shows how. If AGA runs in your family and you want to keep taking creatine, that is a reasonable conversation for a dermatologist, who can examine the scalp under magnification, order blood tests if a diffuse shed needs a cause, and discuss treatments with trial evidence behind them (Hair Loss Medications Compared). Do not start or stop any prescription medicine on the strength of a supplement question.

5. Know the red flags. Sudden loss in round patches, scalp pain, burning, redness or scale, shiny skin where follicle openings have disappeared, or hair loss with fatigue, weight change or other new symptoms are not creatine questions. They go to a dermatologist promptly; see When to See a Dermatologist and Scarring Alopecia.

What this guide cannot tell you. Whether a man with active, fast-progressing AGA who loads creatine at 25 g/day changes his rate of loss. Nobody has measured it. The risk is unproven and the reassurance is one trial deep.

Frequently Asked Questions#

Related Resources#

• DHT and Hair Loss: Complete Explanation
• Androgenetic Alopecia: Complete Guide
• Exercise and Hair Loss: What Research Actually Shows
• Best Hair Growth Supplements: What the Evidence Actually Shows
• How to Tell If You're Going Bald
• Telogen Effluvium: Causes and Recovery Timeline
• Tracking Hair Loss Progress: Photo Guide
• When to See a Dermatologist for Hair Loss