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Supplements for Acne

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Supplements are an important part of acne therapy. They can help improve symptoms and prevent new acne breakouts.

Supplements are commonly used in acne treatment either to complement regular acne medications or combined to treat acne on their own.

Generally, the supplements used in acne treatment produce far fewer side effects when compared to other acne remedies. This is because these supplements are naturally occurring compounds needed for normal development in the body.

These supplements improve skin health to treat acne. They can also provide additional effects through their antioxidant, antimicrobial and anti-inflammatory activities.

Some of these supplements are cofactors for enzymes in the body; some are incorporated into proteins, fatty acids, or other structural compounds in the body while others simply prevent deficiencies that can result in acne.

Discussed below are 5 of the most effective supplements used in acne treatment plus one other supplement that may actually trigger acne.

Cod Liver Oil

Cod liver oil is a fish oil obtained from the liver of codfish. It is rich in Omega-3 fatty acids, EPA (Eicosapentaenoic acid) and DHA (Docosahexaenoic acid) as well as in vitamins A and D.

In fact, cod liver oil is used more because of these vitamins than the fatty acids previously mentioned. Today, those who take cod liver oil as a source of Omega-3 fatty acids are advised to reduce other dietary intakes of vitamin A and vitamin D to prevent hypervitaminoses.

Cod liver oil capsules used to be commonly recommended for kids to prevent rickets and correct the signs of vitamin D deficiency.

However, cod liver oil has other therapeutic uses. It is recommended for arthritic patients to help reduce joint stiffness and the pain associated with it. Cod liver oil helps build and repair the bone, nails, teeth, hair, and broken skin. This restorative ability is the main reason this nutritional supplement is used in acne treatment.

Cod liver oil is also beneficial for the heart and it is useful in the treatment of multiple sclerosis.

The supplement is also good for pregnant women since it lowers the risk of Type I Diabetes in children during gestation. It is also recommended for breastfeeding mothers since it can also increase the fatty acid content of breast milk.

However, care should be taken with oral administration of cod liver oil, especially in pregnant women. This is because vitamin A may be linked to birth defects and hypertension during pregnancy. Because vitamin A is a fat-soluble vitamin, it can be accumulated in the body at dangerous levels.

Since cod liver oil is obtained from codfish, there is a risk of exposure to environmental toxins such as mercury.

This risk is lowered when cod liver oil is purified during manufacturing.

How to Use Cod Liver Oil for Acne

When choosing cod liver oil to buy, make sure to pick fermented cod liver oil. Fermented cod liver oil is manufactured without chemical agents.

There are two ways of making cod liver oil.

Fermentation is the first method to be used. To start this process, a wooden barrel is filled with fresh cod livers and seawater and allowed to ferment so that the oil can naturally separate. It is a slow process that can take up to a year before the finished oil is removed.

The modern method is much faster. It involves cooking the tissues of fatty codfish and can also include bleaching, treatment with alkali, winterization, and deodorization.

Since this harsh refinement removes most of the vitamins in the oil, synthetic vitamins are added to the oil after it has been expressed from the fish.

Vitamins are not the only compounds removed from refined cod liver oil. Certain cofactors are also removed and are not replaced in the final product. These cofactors are essential for the absorption and bioavailability of the vitamins and Omega-3 fatty acids found in the oil.

Therefore, fermented cod liver oil provides the full complement of the natural contents of cod liver oil, and these contents are available in easily absorbed forms. This type of cod liver oil provides the most benefits for acne patients.

Furthermore, cod liver oil is best ingested in gel form. To take the equivalent doses in capsule forms would mean ingesting a lot of gelatin capsules.

If you can only get cod liver oil in capsules, make sure to break the capsule and remove the oil before ingesting the supplement. Alternatively, you can bite the capsule, suck out the oil, and spit out the gelatin shells.

Cod liver oil in liquid form needs to be refrigerated. A daily dose of ½ - 1 teaspoon is recommended.

Benefits of Omega-3 Fatty acids

Omega-3 fatty acids are polyunsaturated fatty acids that are commonly found in plant oils (flaxseed oil etc.) and oils obtained from marine life (fish oil, algal oil, squid oil, etc.).

Apart from DHA and EPA, ALA or alpha-Linolenic acid is also an important Omega-3 fatty acid in humans. ALA is a short-chain fatty acid while EPA and DHA are long-chain fatty acids.

In humans, ALA is converted to EPA which is then converted to DHA. While this conversion is only limited in humans, women convert more ALA to EPA and DHA than men.

Still, the amount of EPA and DHA obtained through this conversion is limited, and Omega-3 supplements such as fish oil are advised.

Although Omega-3 fatty acids were recognized to contribute to normal growth as early as in the 30s, their innumerable health benefits only became commonly known in the 90s.

In the 70s, a group of researchers documented the low incidence of cardiovascular diseases among the Inuit living in Greenland despite their high consumption of fatty fish. This cardiovascular protection is now known to be provided by the Omega-3 fatty acids found in those fish.

The cardiovascular benefits of Omega-3 fatty acids are chiefly due to EPA and DHA. ALA has not been shown to provide such benefits.

Omega-3 fatty acids stimulate blood circulation, reduce blood pressure, and prevent blood clots by breaking down fibrin. The breakdown of fibrin can also help acne patients because it can help dissolve scars.

Other medical benefits of Omega-3 fatty acids include their effectiveness in the treatment of rheumatoid arthritis, ADHD, depression, and nerve damage. They are also used for improving appetite and muscle mass in cancer patients, improving immune function, reducing inflammation, and treating skin diseases such as psoriasis and acne.

The Anti-Inflammatory Effect of Omega-3 Fatty Acids

Up until the last few decades, Omega-6 fatty acids were more studied than Omega-3 fatty acids. Therefore, they were the first fatty acids discovered to be converted to compounds known as eicosanoids.

Eicosanoids include leukotrienes, thromboxanes, and prostaglandins. They are components of the immune reaction and are known as inflammatory agents.

Although eicosanoids are short-lived compounds, when the body produces them from Omega-6 fatty acids faster than they are broken down, a cycle of inflammation can result and contribute to acne breakouts.

Therefore, Omega-6 fatty acids can cause inflammation.

Omega-3 fatty acids, on the other hand, are described as anti-inflammatory. However, this is not totally accurate. Omega-3 fatty acids are also converted to eicosanoids but at a much slower rate.

This means that the eicosanoids produced from Omega-3 fatty acids do not stay long enough to cause actual inflammations. Instead, they are broken down faster than they are produced. This produces a net anti-inflammatory effect.

This is one of the reasons why the ratio of Omega-3 fatty acids should exceed Omega-6 fatty acids for fish oils and fatty acid supplements to provide the most therapeutic benefits.

How Fish Oil and Omega 3 Fatty Acids Treat Acne

Diet plays an important role in skin health. While some fats worsen acne, Omega-3 fatty acids actually reduce acne breakouts and severity.

The anti-inflammatory property of Omega-3 fatty acids is the main reason it is useful in acne treatment. By reducing skin inflammation, these fatty acids prevent the formation of acne lesions especially the deep ones such as nodules and cysts which appear in cases of severe acne.

Skin inflammation during acne is a result of bacterial action on the skin. When bacteria such as Propionibacterium acnes and Staphylococcus epidermis colonize the skin, they set off a chain reaction of infections and changes to the pilosebaceous units in the skin.

The immune system responds by sending the eicosanoids to the site of the bacterial attack.

When prostaglandins and leukotrienes reach the area of the skin affected by these bacteria, they can cause the tissues to swell. Leukotrienes also stimulate sebum production from the sebaceous gland.

To combat the actions of eicosanoids such as leukotriene on the sebaceous gland, a drug called zileuton can be taken to prevent increased sebum production. However, the same effect is provided by EPA found in fish oil.

Acne and Omega-3 Fatty Acids: Research Findings

A 2008 study published in Lipids in Health and Disease by M. Rubin et al. showed that acne patients who are given Omega-3 supplements containing 250mg of EPA four times daily for 8 weeks experienced a marked improvement in their inflammatory acne lesions.

However, the benefits of Omega-3 fatty acids were recognized as early as the 60s. In a study published in 1961 by J.M Hitch and B.G Greenburg, all of the signs of acne including papules, pimples, seborrhea, comedones, and cysts were at the lowest in teenagers who ate a lot of fish and seafood.

A 1989 paper published in the International Journal of Dermatology by Schaffer et al. showed that communities whose diets were rich in Omega-3 fatty acids had the lowest rates of acne.

Different studies between 2001 and 2007 established the link between inflammation, acne, and supplementation with Omega-3 fatty acids. A summary of the findings is provided below:

Omega 3 Fatty Acids & Inflammation
  • A subtype of leukotriene called leukotriene B4 or LTB4 was identified as a major cause of inflammatory acne lesions
  • Leukotriene B4 was also discovered to trigger a sharp increase in sebum production
  • Inhibition of leukotriene B4 reduces sebum production and reduces the formation of inflammatory acne lesions by as much as 70%
  • Omega-3 fatty acids can inhibit leukotriene B4. This is one of the mechanisms by which these fatty acids provide their anti-inflammatory effects
  • Fish oil can also provide similar benefits because it contains Omega-3 fatty acids
  • Apart from reducing skin inflammations, Omega-3 fatty acids can also prevent the hyperkeratinization of the sebaceous follicles and, therefore, reduce the breakdown of skin cells as well as the clogging of pores by dead skin cells and sebum

Benefits of Vitamins A

The form of vitamin A which promotes skin health is retinoic acid. Retinoic acid is produced from retinol and it is described as a growth factor especially for epithelial cells.

One of the functions of vitamin A in the body is to maintain skin health. The vitamin does this by turning immature skin cells into mature cells that make up the epidermis. In this way, vitamin A increases skin turnover and encourage new skin to replace damaged skin. This is essential for clearing acne spots and scars.

Also, vitamin A reduces the size of sebaceous glands. By extension, it reduces the production of sebum.

Increased sebum production is one of the three components of acne breakouts. The other two are bacterial colonization of the skin and increased rate of keratinization (production of dead skin cells).

Therefore, vitamin A reduces the amount of sebum available to mix with bacteria and dead skin cells. By extension, this reduces the chance of the pores clogging up with dirt while also making the skin not ideal for bacterial growth.

Vitamin A analogs are commonly used in acne products. These are called retinoids and a good example is Accutane.

However, vitamin A obtained from cod liver oil, which is a natural source, has fewer side effects than synthetic retinoids.

Benefits of Vitamins D

Vitamin D is also called the Sunshine Vitamin because it is synthesized in the skin from cholesterol on exposure to the sun.

Vitamin D is a unique vitamin since it can be produced in sufficient quantity in the body.

Other vitamins are not synthesized in sufficient amounts in humans. Still, vitamin D fulfills the second requirement of vitamins: it is an essential nutrient needed in very small amounts.

Vitamin D is a group of five fat-soluble secosteroids. The two most common forms of vitamin are Ergocalciferol or vitamin D2 or Cholecalciferol or vitamin D3. Both forms of the vitamin can be ingested.

Vitamin D is converted to the prohormone, calcidiol in the liver which is then converted to calcitriol in the kidneys and the macrophage cells of the immune system.

Calcitriol, which is the bioactive form of vitamin D, is then released into the blood.

Calcitriol is a hormone that regulates calcium and phosphate levels in the blood and so promotes bone health. It is also important to the inflammatory process and neuromuscular function.

Besides its production in the skin on exposure to sunlight, vitamin D can also be obtained from food sources.

Dietary sources of vitamin D

Vitamin D2 can be found in alfalfa and mushrooms.

Vitamin D3 can be found in fatty fish such as catfish, salmon, mackerel, tuna, and sardines; eggs, beef liver, and fish liver.

In the US, the recommended daily vitamin D intake is 15 micrograms per day or 600 IU/day. The upper intake limit for adults is however 4,000 IU.

The major symptom of vitamin D deficiency is a disease called rickets. It causes the softening of the bones. A related disease of the bone called osteomalacia is also caused by vitamin D deficiency.

Vitamin D toxicity is also possible. It can be caused by ingesting very high doses (about 50,000 IU) of the vitamin for several months.

Vitamin D toxicity causes hypercalcemia. Therefore, its symptoms are the same as the symptoms of hypercalcemia. These include nausea, vomiting, excessive urination and thirst, weakness, insomnia, and pruritus.  

In the body, the active form of calcitriol binds to carrier proteins which then distribute it to different organs.

When calcitriol is produced by the cells of the immune system, its primary role is to fight off infections. However, calcitriol produced in the kidneys is responsible for regulating calcium and phosphate.

Calcitriol binds to Vitamin D receptors or VDRs. These receptors can be found in major organs including the brain, heart, gonads, prostate, and skin. Therefore, vitamin D can regulate the production of male sex hormones (gonads) and directly produce certain effects on the skin

Vitamin D in Acne Treatment: Does It Work?

Vitamin D is already used for the treatment of other skin diseases like psoriasis. Many acne sufferers who commenced vitamin D supplementation report improvement in their symptoms.

While it may seem that there is little solid scientific evidence to back the efficacy of vitamin D in acne therapy, the truth is that most studies have not directly investigated the link even though there are strong indications that such a link exists.

Vitamin D seems to be a forgotten supplement in acne treatment. This is because one of the best studies on the relationship between the vitamin and acne was done in 1938 and it already established a positive link between the two.

In this study, 5,000 – 40,000 IU per day of vitamin D was given to study participants suffering from severe acne.

This supplementation “cured” 47% of the participants within 3 months while an additional 27% reported improvements in their symptoms.

Since vitamin D is found in animal milk and even added to milk products, some have argued that it might be responsible for the acne breakouts sometimes triggered by milk consumption.

However, scientific evidence has shown that vitamin D has nothing to do with the ability of milk and some dairy products to cause acne. Instead, the increase in the levels of the hormone, insulin-like growth factor-1, is now believed to be responsible for milk-triggered acne.

Vitamin D in Acne Treatment: Why It Works

There are several possible mechanisms by which vitamin D, and especially its analog, vitamin D3, can help prevent and improve acne symptoms. These mechanisms of action are well understood and can easily be the target of vitamin D supplied in supplements.

Anti-comedogenic Effect

A study published in 2006 in Experimental Dermatology by J. Reichrath et al. examined the effect of vitamin D on the cells of the sebaceous glands.

The researchers discovered that vitamin D and its analogs suppress cell proliferation in the sebaceous gland.

This effect is possible because the cells of the sebaceous gland have vitamin D receptors (VDRs). Therefore, when vitamin D binds to these receptors, it can inhibit cell proliferation which can help prevent the enlargement of the gland.

The enlargement of the sebaceous gland is the major change caused by male sex hormones in the development of acne.

When this gland is enlarged, sebum production increases exponentially and excess sebum is pushed to the skin surface where it creates an ideal environment for excessive growth of acne-causing bacteria such as Propionibacterium acnes.

By preventing cell proliferation in the sebaceous gland, vitamin D inhibits the acne-causing effects of androgens such as testosterone.

The ability of vitamin D to suppress the enlargement of the sebaceous gland increases with the dose of the supplement given.

Anti-inflammatory Effect

Vitamin D has varying effects on the immune system some of which counteract each other. The pro-inflammatory and anti-inflammatory effects of vitamin D are examples of this peculiar behavior.

Vitamin D3 regulates the release and action of immune cells related to an inflammatory response.  In some cases, the ability of vitamin D to suppress the inflammatory reaction of the immune system is comparable to the actions of immunosuppressant drugs.

This anti-inflammatory effect is so potent that vitamin D analogs are suggested as candidate drugs for treating surface and systemic inflammatory diseases such as dermatitis and lupus.

Therefore, vitamin D offers potential anti-inflammatory benefits in acne treatment.

However, this effect is dose-dependent and not well-understood.

Given that the vitamin can also be pro-inflammatory, further studies may be needed to increase the anti-inflammatory effect over the pro-inflammatory effect.

Antimicrobial Effect

Different studies have established that vitamin D is a direct regulator of the immune system’s response to attacks from infectious agents including bacteria, viruses, and parasites.

The antimicrobial response triggered by vitamin D is attributed to a class of compounds called cationic antimicrobial peptides or AMPs.

One popular example of AMPs is a group of compounds called cathelicidins.

These antimicrobial peptides are currently the best candidates for antibiotic-resistant bacteria in development. This is because they are fast-acting antibacterial agents and bacteria find it difficult to develop resistance against them.

Since cathelicidins are produced by leukocytes in epithelial cells, vitamin D can stimulate their production in the skin to attack acne-causing bacteria such as P. acnes and Staphylococcus epidermis.

Only some strains of P. acnes cause acne. Others are found on healthy skin and cause no harm.

However, the colonization of the skin by mutated strains of the bacterium causes increased shedding of dead skin cells and inflammatory cycles which lead to acne breakout.

Vitamin D can stimulate the production of cathelicidins which are natural antibiotics capable of kill off P. acnes and prevent the series of events that cause acne.

Antioxidant and Protective Effects

The antioxidant effect of vitamin D includes its ability to protect the skin cells against oxidative stress. To do this, it inhibits the activation of certain protein kinases which are switched on by stress.

This protective effect is the subject of a study in which vitamin D was found effective in protecting epidermal cells from ultraviolet radiation and exposure to chemotherapy. It is believed that the anti-inflammatory effect of this vitamin may also be involved in this protective effect.

Vitamin D is also effective for reducing emotional stress caused by acne breakouts.

Some acne patients suffer from bouts of depression, anxiety, and emotional distress concerning the state of their skin. There is a biochemical basis for such negative psychological states.

In most acne patients who are distressed by their condition, it is found that vitamin D levels are usually low while free radical levels are high. Furthermore, the enzyme, MAO (monoamine oxidase) is also found in low amounts.

Both vitamin D and MAO affect the production and actions of serotonin, a neurotransmitter that contributes to the mood.

Therefore, increased vitamin D supplementation may reduce emotional stress by mopping up harmful free radicals through its antioxidant effect and regulate the production of serotonin.

Fish Oil

Fish oil is obtained from the tissues of fatty or oily fish like cod, salmon, shark, swordfish, mackerel, tuna, halibut, and catfish.

The major constituents of fish oil are Omega-3 fatty acids. These include EPA or Eicosapentaenoic acid and DHA or Docosahexaenoic acid.

These fish do not really synthesize Omega-3 fatty acids but instead obtain them from marine life lower in the food chain. Along with these fatty acids, these fish also accumulate antioxidants like iodine and selenium which find their way into fish oil.

The downside of directly accumulating compounds from their prey is that these fish can also accumulate environmental toxins such as mercury, dioxin, and PCBs.

Almost all of the medical benefits of fish oil are due to the Omega-3 fatty acids. They are currently being investigated or used for the treatment of a wide variety of diseases. Medical conditions for which fish oil show promises range from cardiovascular diseases and cancers to depression and skin diseases.

How to Use Fish Oil For Acne

The actual dose of fish oil to take for your acne will depend on the source of the fish oil you obtained and the severity of your acne.

Since there are no standard doses, it is best to start with a low dose of fish oil. ½ teaspoon per day is a good starting dose. You may increase this to 1 teaspoon if you can tolerate the fish oil well.

It is worth noting that not all fish oils are equal.

Fish oils may contain other substances besides Omega-3 fatty acids. For example, cod liver oil also contains high levels of vitamins A and D. Therefore, it should be carefully used (dietary sources of vitamin A may have to be avoided) to prevent hypervitaminosis A.

Fish oil can also be rubbed on the skin to treat acne. You can take a little with a cotton ball and rub on the area covered by the acne for a minute. Leave it on overnight or at least for 6 hours before washing off.

Fish oil is generally well absorbed through the skin. Since most of the benefits of Omega-3 fatty acids are provided locally in the skin, the topical application of fish oil may provide the same benefits as its oral administration.


Magnesium is an important element in all life forms. It is abundantly found both on land and in water bodies all over the planet. It is rarely found free but bounded to other elements to form stable compounds.

In humans, magnesium is mostly found in the skeleton and within the cells. It is an essential nutrient that is found in all cells. This mineral is essential to biological systems for several reasons.

Sometimes, it serves as a component of major cellular complexes such as ATP (adenosine triphosphate, the chief energy molecule in animals) and chlorophyll (the molecule responsible for photosynthesis in plants).

In humans, magnesium is required for over 300 enzymes to function properly. The recommended daily nutritional requirement of the mineral is 300 – 400 mg.

While acute magnesium deficiency or hypomagnesemia can be caused by the side effects of drugs such as diuretics, chronic hypomagnesemia is caused by inadequate magnesium intake.

Dietary Sources of Magnesium
  • Green vegetables such as spinach because of their chlorophyll content 
  • Nuts 
  • Whole grains 
  • Halibut
  • Milk
  • Oats
  • Peanut butter
  • “Hard” water

Magnesium deficiency is tied to calcium and potassium deficiencies. Symptoms of this deficiency include muscle cramps, weakness, fatigue, dizziness, and hyperexcitability.

In severe cases, magnesium deficiency can also lower the serum concentrations of calcium and potassium while increasing the retention of sodium in the body.

Magnesium deficiency can also reduce appetite as well as the levels of parathyroid hormones, and also cause neurological damage. It will also cause arrhythmia and worsen insulin resistance.

Magnesium and Acne

Magnesium deficiency is not directly linked to acne development. However, because of the importance of the mineral to even the most basic biochemical reactions in the body, it is possible that magnesium supplementation can improve acne symptoms.

Magnesium is believed to be especially useful for skin health given that it is involved in many cellular processes especially the expression of DNA and RNA and also the production of proteins such as collagen.

By the same mechanisms, magnesium can help relieve stress. Stress is one of the factors identified to cause and contribute to acne breakouts.

Magnesium can also restore hormonal balance by regulating the very biochemical processes by which they are synthesized.

Hormonal imbalance as a cause of acne relates to the increased production of male sex hormones or androgens, especially during the teenage years. Androgens especially testosterone and its metabolites such as DHT or dihydrotestosterone are produced by the body to promote the developmental changes experienced during puberty.

However, male sex hormones do change the nature of the sebaceous follicles by increasing the production of sebum. This is why the skin is usually oily during the years of puberty.

With increased sebum production, the skin becomes conducive to bacterial colonization. Acne-causing bacteria include Propionibacterium acnes and Staphylococcus epidermis. These bacteria cause inflammatory lesions (papules, pimples, and nodules) seen in acne patients.

The increased sebum production also causes the clogging of the pores by a plug made of dead skin cells, bacteria, and sebum. This leads to seborrhea and the formation of comedones such as whiteheads and blackheads.

With the wide variety of roles played by magnesium in the body, it is possible that the mineral can stop the development or progression of acne by arresting most of the causative factors.

Magnesium and Acne Inflammation

It has been proven that magnesium has a direct result on skin inflammation. A study published in the American Journal of Clinical Nutrition in 2007 investigated the effectiveness of magnesium in reducing both systemic and epithelial inflammation. The study involved over 600 women.

The results of the study showed that magnesium supplementation was able to reduce the plasma concentrations of C-reactive protein and E-selectin.

Both C-reactive protein and E-selectin are involved in inflammatory processes in the body. While high levels of C-reactive protein causes inflammation inside the body, E-selectin causes inflammation in the endothelial layer of the skin.

E-selectin is also called endothelial-leukocyte adhesion molecule I. It is activated by cytokines and binds to leukocytes. This molecule is produced only in endothelial cells.

E-selectin attracts leukocytes to the site of injury and contributes to local inflammation. Therefore, when androgens and acne-causing bacteria change the nature of the skin, E-selectin is produced by the endothelial cells in response to the injury. By doing this, they contribute to the formation of inflammatory acne lesions.

Magnesium helps reduce the local inflammation caused by E-selectin and prevents the formation of acne lesions.

Taking Magnesium for Acne

Many magnesium salts can be taken as magnesium supplements. Common magnesium salts include chloride, citrate, carbonate, bicarbonate, sulfate, and the oxide of the mineral.

Other magnesium salts are complex molecules formed with amino acids. These include aspartate, glycinate, orotate, taurate, lysinate and ketogluconate complexes.

Usually, the bioavailability of magnesium salts varies between 30% and 40%. Of the simple salts, the citrate is the least expensive and it also has a high bioavailability too. However, some people prefer complex chelates salts made with amino acids.

These salts come in different oral forms including capsule, tablet, and powder forms. The effervescent powder form is believed to provide the most bioavailability but individual results may vary.

To improve the absorption of magnesium, vitamin C and calcium supplements are sometimes recommended alongside.

The use of magnesium supplements in acne treatment should be restricted. This is because no strong links are demonstrating the effectiveness of magnesium in acne treatment. Some acne patients do report experiencing positive results though.

Care should also be taken with magnesium supplementation because while dietary sources of magnesium cannot lead to hypermagnesemia, magnesium supplements can cause this especially in people with kidney impairment.

However, in healthy people, excess magnesium is quickly excreted in the urine.

The most common side effect of magnesium supplements is diarrhea. This is because the mineral has a laxative effect. This laxative effect is greatest with magnesium sulfate since the sulfate part of the molecule also produces the same effect.

Magnesium will turn the stomach environment alkaline. Therefore, it should be taken on an empty stomach and preferably at bedtime so that it does not neutralize the stomach enzymes and the acidic environment needed for digestion.


Selenium is a rare but essential mineral. In humans, selenium is required in small amounts; therefore, it is a trace micronutrient.

The most important biochemical function of selenium is serving as a cofactor for antioxidant enzymes. Therefore, it contributes to the antioxidant properties of such enzymes and can help in the neutralization of harmful free radicals especially the reactive oxygen species produced from peroxides.

Selenium also plays a regulatory role in the production and use of thyroid hormones in the body. It serves as a cofactor for enzymes that activate and deactivate thyroid hormones and their metabolites.

For example, selenium is useful in the treatment of some thyroid diseases such as Hashimotos’ disease. It is effective because it reduces the production of antibodies signaling the autoimmune attack of the thyroid gland.

Selenium is mostly found in some plants grown in soils rich in the nutrient. It can be accumulated in toxic amounts in these plants. This is a common defense mechanism in forage plants that protects them against extensive consumption from animals.

Some plants do use the selenium that they take up from the soil. Locoweed is a good example of a plant that needs selenium for growth. In fact, the growth of locoweed in an area is a good indication that the soil there contains selenium.

Other plants that need high amounts of selenium to grow are prince’s plume, false goldenweed, and woody asters.

Dietary Sources of Selenium
  • Nuts. Brazil nut has the highest concentration of selenium.
  • Eggs
  • Meat
  • Crimini mushrooms
  • Cereals
  • Tuna
  • Halibut 
  • Lobster
  • Crab
  • Kidney 
  • Mustard seeds.

Selenium is best ingested in very small amounts. When it is taken in amounts higher than 400 micrograms per day, signs of selenosis or selenium toxicity will present.

Symptoms of selenosis include stomach upset, garlic mouth odor, fatigue, irritability, nerve damage, hair loss, and nail loss.

Selenium deficiency is rarely seen but when it occurs it is often caused by vitamin E deficiency or iodine deficiency.

Generally, selenium is rarely used in medical treatment alone. It is often combined with vitamin E (to improve its antioxidant effects) or iodine (to treat thyroid diseases).

Early investigative studies have already linked selenium supplementation with improvement in cancer therapy, HIV/AIDS, tuberculosis, and diabetes.

Selenium and Acne

The chief benefit of selenium in acne treatment is its antioxidant effect.

However, selenium can also improve acne symptoms through its anti-inflammatory activities and its contribution to a healthy immune system.

Selenium can also improve the elasticity of the skin, and in this way reduce acne scars.

Selenium produces two kinds of antioxidant effects. First, it serves as a cofactor for certain enzymes that protect the body from harmful free radicals. Secondly, it improves the antioxidant effect of vitamin E which is a natural antioxidant itself.

Selenium is recommended to be used along with vitamin E (and vitamin A) to get the most of the antioxidants’ benefits.

Antioxidants help mop up reactive free radicals which can cause damage to the skin.

Since the skin serves as the main protective barrier for the body, environmental toxins and byproducts of biochemical reactions accumulate on it. These toxins can change the nature of the skin if they are not immediately and completely neutralized.

When toxins accumulate on the skin, they create an ideal environment for bacterial growth as well as increase sebum production by interfering with the sebaceous follicles.

When bacteria such as Propionibacterium acnes and Staphylococcus epidermis invade the skin, they cause a cycle of inflammation and clog pores. These actions quickly lead to the formation of acne lesions.

Selenium may also help prevent the development of inflammatory acne lesions such as nodules, papules, and pimples through its anti-inflammatory activities. However, this effect has only been found useful in the treatment of systemic inflammatory diseases such as lupus, gingivitis, and rheumatoid arthritis.

Selenium and Vitamin E in Acne Treatment

The efficacy of combined selenium and vitamin E treatment in acne patients was the focus of a study published in 1984 by G. Michaelsson et al.

In that study, 29 acne patients were given 400 micrograms of selenium and 20 IU of vitamin E every day for 6 – 12 weeks.

The result of the study showed improvements in acne symptoms in all the study participants. Those in the small control group, who were not given this combination of selenium and vitamin E, experienced more acne breakouts.

The most dramatic improvements were seen in test individuals who had the lowest levels of the enzyme, glutathione peroxidase.

The Antioxidant Effects of Selenium

There are two enzymes responsible for the antioxidant effects of selenium. These are glutathione peroxidase and thioredoxin reductase. Selenium serves as a component and cofactor for these enzymes.

Glutathione peroxidase is the name of some similar enzymes that protect the body from oxidative damage from hydrogen peroxide and lipid hydroperoxides.

There are 5 bioactive glutathione peroxidases in humans. Four of them are enzymes containing selenium while the fifth one is a selenoprotein. Therefore, their antioxidant activities depend on the availability of selenium for binding.

Glutathione peroxidase reduces hydrogen peroxide to water and lipid hydroperoxides to the corresponding alcohols.

Since these peroxides can be found on the skin, they can create an enabling environment for acne breakouts. This makes selenium essential in preventing acne breakout from such sources.

Thioredoxin reductase is related to glutathione peroxidase. It acts similarly too but its specific benefits in acne treatment are not well studied.

Taking Selenium for Acne

The recommended dose for selenium in acne treatment is 200 micrograms per day. This daily dose can be increased up to 400 micrograms but not above that.

Selenium supplementation is most beneficial to acne patients with low levels of glutathione peroxidase. Daily doses between 200 – 400 micrograms can help such patients quickly restore glutathione peroxidase to normal levels.

To improve the antioxidant effect of selenium and get the best from it, vitamins E and A should also be used alongside.

It is important to note that selenium is only a supplement in acne treatment. Therefore, it should not substitute for acne remedies that directly treat the root causes of skin disease.

The best way to take selenium for acne is to find an acne product that includes this essential micronutrient. One such acne product is Actimine which also contains other acne remedies.

In such formulations, selenium can contribute more to the anti-acne benefits of other remedies and vice versa. This synergistic effect means that products like Actimime can resolve acne faster and prevent new acne breakouts.

Selenium Sulfide

Selenium sulfide is a topical preparation that can be used to treat acne. It has a strong antifungal property and is usually used to treat dandruff.

However, selenium sulfide also has an antibacterial effect and is also recommended in acne treatment.

This topical selenium preparation has very little similarities to oral selenium formulations. The antibacterial effect of the topical preparation is mostly due to the sulfur component of the drug.

Selenium sulfide is a cheap alternative to benzoyl peroxide and salicylic acid. It is also an exfoliating agent, and by peeling the oily layer off the skin, it helps unclog the pores.

Selenium sulfide is commonly sold as a lotion. To use it, simply wash the area affected by the acne with the lotion. The lotion should not stay longer than 20 seconds on the skin before it is rinsed off.

Besides the sulfur-like odor of selenium sulfide which can be off-putting, it can cause dry, peeling skin, itching, irritation, redness, and allergic reactions.


Zinc is a valuable trace mineral that is essential for our bodies to function properly. Zinc is found in a lot of foods naturally, like meat, fish, nuts, and grains, but poor soil quality and food processing removes zinc from foods that we eat, making zinc deficiencies common. Zinc and acne go hand in hand as low zinc levels are commonly reported in individuals with acne.

A person with acne typically either has a harder time absorbing zinc or simply isn’t getting enough in their diet. Increasing zinc levels has been shown to discourage the production of P. acnes bacteria on the skin, often linked to a hormonal imbalance. High levels of estrogen (in women and girls) and high levels of dihydrotestosterone (in men and boys) are linked with a higher likelihood of acne breakouts. Zinc helps regulate these hormones in the body and protects against the development of acne by killing bacteria on the skin.

Zinc is often used in topical acne treatments, but research also suggests that zinc is beneficial for acne when taken in supplement form, too. Taking zinc supplements ensures you are getting enough of this vital mineral that is essential for the body to work properly, and as a side benefit, zinc supplements have been shown to help reduce acne in individuals with low zinc levels. 

Zinc and Acne

Zinc is effective in the treatment of acne for several reasons. However, the two most important benefits of zinc to acne patients are its antimicrobial properties and its ability to reduce the production of dihydrotestosterone.

A study published in the International Journal of Dermatology in 1982 established that zinc levels in acne patients were lower than in the general population.

In fact, the lower the amount of serum zinc, the more severe the acne in the study participants. Also, women generally have lower zinc levels than men.

These findings are not surprising considering that zinc deficiency causes several skin conditions. These include stretch marks, varicose veins, boils, vitiligo, psoriasis, eczema, and acne.

Teenage girls and women are most affected by this direct link between zinc levels and acne. This is because zinc and its balance with other minerals, such as copper, are lost during menstruation.

The Role of Zinc in Humans

Zinc is an essential but trace elements in all life forms. It is the second most important mineral in humans after iron and it is the only mineral found in all classes of enzymes.

A typical human normally holds 2 – 4 g of zinc in the body. This is mostly found in the prostate gland (in men), parts of the eyes, brains, bones, muscles, kidneys, and liver. Zinc is also found bound to many proteins and it is transported and used bound in such forms.

Zinc transport in the body is mostly managed by proteins, albumin, and transferrin.

Transferrin also binds to and transports iron and copper. This means that zinc competes with these minerals. Therefore, it can affect their absorption and vice versa.

Zinc also competes with copper in the intestine. The absorption of both minerals is managed by a compound called metallothionein which is found in intestinal cells. Metallothionein can affect the absorption of zinc by 15 – 40%.

The recommended dietary intake of zinc is 8 mg/day for women and 11 mg/day for men.

What Zinc Does

The biological roles of zinc are extensively studied. The mineral is needed for gene expression, signal transduction, and the proper functioning of RNA and DNA.

It is also involved in neurotransmitter activity in the brain and can regulate excitability as well as promote adaptability of the synapses and so improve learning.

Zinc ions have antimicrobial properties even at low concentrations. They are sometimes included in topical antimicrobial preparations as zinc pyrithione which is an anti-dandruff preparation or taken orally to kill harmful microorganisms in the gastrointestinal tract.


Sources of Zinc
Excellent animal sources of zinc are red meats, liver, oyster, and lobsters. 

Plants obtain their zinc from the soil, and the best zinc sources are wheat germ and bran, whole grain, nuts, beans, seeds, almonds, and blackcurrant.

Zinc can also be obtained from fortified cereals and dietary supplements.


Zinc Supplements and Zinc Deficiency

Different salts of zinc are used in supplements. Studies have shown that zinc glycinate and zinc picolinate are better absorbed than zinc oxide, zinc carbonate, zinc citrate, and zinc gluconate.

Zinc deficiency can be caused by low dietary intake of the mineral and also by medical conditions such as malabsorption of zinc, renal and liver diseases, diabetes, sickle cell anemia, and cancers.

Since zinc is an extensively distributed mineral in the body that is involved in many essential reactions, symptoms of zinc deficiency are diverse. Some of these symptoms are delayed growth and sexual maturation, impotence, diarrhea, hair loss, cognitive problems, immune system impairment, abnormal carbohydrate metabolism, and skin lesions such as acne.

While vegetarians can get their daily zinc requirements from nuts, seeds, beans, and fortified cereals, some plant food sources also contain phytate which chelates zinc and reduces its absorption.

Therefore, zinc supplements are still recommended for vegetarians to prevent zinc deficiency and acne.

It is estimated that globally, almost 2 billion people have a zinc deficiency. This is mostly caused by low levels of zinc intake and diets rich in plants grown in zinc-deficient soils. Zinc supplements are useful for increasing zinc levels in people who are deficient in the mineral.

Zinc Toxicity

While zinc deficiency is dangerous, zinc toxicity is just as harmful. Free zinc ions are toxic to plants even in small amounts. Free zinc ions will dissolve in stomach acid to form zinc chloride which is a corrosive compound.

Furthermore, excess zinc affects the absorption of iron and copper. Therefore, it can induce deficiencies of these minerals. This is the main reason why zinc supplements are supplied in combination with other minerals.

The FDA specifically bans zinc-based intranasal preparations following reports that zinc damages the nerve receptors in the nose.

Zinc and Acne

Zinc is effective in the treatment of acne for many reasons. However, the two most important benefits of zinc to acne patients are its antimicrobial properties and its ability to reduce the production of dihydrotestosterone.

A study published in the International Journal of Dermatology in 1982 established that zinc levels in acne patients were lower than in the general population.

In fact, the lower the amount of serum zinc, the more severe the acne in the study participants. Also, women generally have lower zinc levels than men.

These findings are not surprising considering that zinc deficiency causes several skin conditions. These include stretch marks, varicose veins, boils, vitiligo, psoriasis, eczema, and acne.

Teenage girls and women are most affected by this direct link between zinc levels and acne. 

Zinc and The Hormonal Cause of Acne

Because zinc is involved in the metabolism of different hormones including testosterone, low levels of zinc create the condition needed for increased conversion of testosterone to dihydrotestosterone or DHT.

DHT is one of the androgens that contribute to the hormonal cause of acne.

The first acne breakouts usually occur during the teenage years when there is an increased production of male sex hormones in the body. The male sex hormones that promote acne breakout are testosterone and its metabolites such as DHT.

DHT causes the enlargement of the sebaceous gland which increases the production of sebum. It also promotes hyperkeratinization which leads to an increased formation of dead skin cells.

WHITEHEADSThese two actions contribute to the colonization of the skin by acne-causing bacteria such as Propionibacterium acnes.

The net effects of DHT and P. acnes include the clogging of the skin pores (which leads to the appearance of whiteheads and blackheads) and an abnormal cycle of inflammation (which leads to the appearance of papules, pimples, nodules, and cysts).

Therefore, zinc can help reduce acne breakout by reducing the amount of DHT produced. This effectively stops the root cause of acne breakouts.

Other Benefits of Zinc in Acne Treatment

Furthermore, zinc is an effective antimicrobial agent. In a study published in Clinical Pharmacology & Therapeutics in 1992, zinc ions were found to be potent antimicrobial agents even in low concentrations.

Therefore, it is possible that topical zinc preparations can effectively kill off the population of acne-causing bacteria such as P. acnes on the skin.

Yet another positive effect zinc has on acne is its anti-inflammatory effects. In a study published in Acta Dermato-Venereologica by French researchers, low doses of zinc gluconate (the zinc salt contained in the anti-acne formulation, Actimine) were given to study participants suffering from inflammatory acne.

Even at 200 mg/day of zinc gluconate (30 mg/day of elemental zinc), the symptoms of acne inflammation such as pimples, nodules, and cysts were much improved compared to the placebo group.

The anti-inflammatory effect of zinc is attributed to its actions on granulocytes which are immune cells involved in inflammation. Zinc is absorbed by and secreted from all granulocytes. 

Zinc is required for the absorption of vitamins A and E. These are essential vitamins in acne treatment. They help reduce sebum production and the breakdown of keratin while also providing an antioxidant cover that protects the skin.

Zinc also can reduce keratinocyte activation. Basically, these are cells that produce keratin, which is a protein the binds skin cells together. When you have elevated levels of keratin, this blocks pores on the skin. Zinc can reduce keratin and make pores remain open longer.


Signs You Might Need a Zinc Supplement

Even if you have acne, you might not need a zinc supplement. However, there are clear signs that a zinc supplement might be necessary. If you have several of the following signs, you might benefit from the use of a zinc supplement. If you notice these symptoms, ask your doctor for a blood test to check zinc levels. You don’t want to start taking massive amounts of zinc without confirmation from your doctor, because it is possible to overdose on zinc, which can lead to complications including stomach cramps and worse symptoms. But the following symptoms can be a sign of zinc deficiency:

Signs of a Zinc Deficiency

Impaired sense of smell and taste: IF you can’t taste or smell food properly, you could be low in zinc. One of the first symptoms of a zinc deficiency is a reduced sense of taste and smell.


Hair loss: Lack of zinc can trigger hair fall and make you lose hair rapidly. Hair loss can be triggered by other causes, but combined with other symptoms, zinc deficiency could be the cause.


Slow wound healing: If your wounds take forever to heal, a zinc deficiency could be to blame.


A diet high in grains: Although grains do contain zinc, processed grains also contain phytic acid, which can make it harder for the body to absorb nutrients. Eating a lot of processed grains could mean that you are eating too much phytic acid, which could be interfering with how much zinc your body can actually use. 

Choosing A Zinc Supplement In Acne Treatment

Zinc supplements should be combined with other anti-acne supplements in acne treatment. Zinc can help improve the effectiveness of other supplements such as vitamins A, B, and E.

biotinWhile topical zinc preparations can provide immediate antibacterial effects on the skin, zinc is recommended to be taken orally for acne treatment. This is because most of its positive effects are provided internally.

To correct hormonal imbalances, reduce inflammation, boost immunity, increase the absorption of vitamin A and produce its antioxidant effects, zinc must be orally ingested.

There are many zinc supplements to choose from. However, the form of zinc found to be effective in acne treatment in most studies is zinc gluconate.

Actimine, an effective anti-acne supplement contains this form of zinc and in a concentration (10 mg/capsule or 30 mg/day) that provides the most therapeutic benefits without causing zinc toxicity.

Types of Zinc

There is no single form of zinc. In fact, there are several types of zinc available, but some are harder for the body to use than others. Research suggests that zinc picolinate and zinc methionine are easier for the body to absorb than other kinds of zinc. Look for supplements that contain these forms of zinc. If neither of these is available, look for zinc gluconate.

If that is not available either, zinc citrate and zinc sulfate can be taken, but they are the least beneficial forms for the body. Avoid supplements that don’t list the type of zinc inside the supplements, as these are likely to be of lower quality than zinc supplements that list the type of zinc.

Types of Zinc Supplements

  • Zinc oxide: Commonly used in low-budget supplements. It is difficult for the body to use.
  • Zinc gluconate: Harder for the body to use, but not impossible. Several studies support the use of zinc gluconate for skin health.
  • Zinc sulfate: Studies on zinc sulfate suggest that this version of zinc has positive effects on the skin and overall health.
  • Zinc glycinate: This form of zinc is credited to be 16 perfect more effective and usable by the body than zinc sulfate.
  • Zinc citrate: Well absorbed, but not as effective as some other forms of zinc.
  • Zinc orotate: Reports suggest that zinc orotate is one of the most effective forms of zinc.
  • Zinc l-methionine: Another form of zinc that is usable by the body and shown to improve the appearance of skin.
  • Zinc picolinate: Studies suggest that zinc picolinate is one of the best forms of zinc available and is significantly better than most other forms of zinc.  

What About Topical Zinc?

Zinc can be taken internally for a host of benefits, but topical zinc creams are also available. However, studies on topical zinc don’t show much promise for its effectiveness in reducing acne bacteria. In one study, topical zinc was no better for skin than a placebo cream.

Studies evaluating zinc creams on acne don’t give much reason to celebrate. While some show positive results, the evidence overall is not promising. The only study where zinc sulfate cream was compared to placebo cream showed no difference in results.


According to the USDA recommended daily intake guidelines, an adult male should take no more than 11 milligrams and an adult female should take no more than 8 milligrams of bound zinc per day. However, there is another form of zinc supplement available, called elemental zinc.

In some studies, elemental zinc is more effective than bound zinc, and safer to take at higher levels. The recommended daily intake of elemental zinc is no more than 50 milligrams per day. Higher doses of bound and elemental zinc can cause irritating side effects, most commonly, and upset stomach and cramps.

A few studies have examined higher doses of bound zinc for acne. In these studies, study participants consumed between 40 and 300 milligrams of elemental zinc. This is not recommended unless you are under the direct supervision of a health professional. It can be dangerous to take too much zinc, particularly as it can interfere with copper absorption, which is dangerous for health. If you take zinc supplements, you must also take copper supplements to balance the minerals in the body and prevent overdosing and side effects.

How to Use Zinc for Acne

Many acne supplements contain a blend of zinc and other skin-healing vitamins, including copper, vitamin A, vitamin E, and vitamin C. These vitamins and minerals work together to boost skin health and clear the skin from the inside out. Vitamin A and E have long been used to improve skin health and fight acne, and vitamin C helps regenerate the skin and boost collagen production, fighting the signs of aging.

Some research suggests that mixing zinc with other supplements is more beneficial than taking stand-alone supplements. You can also try mixing topical acne treatments along with zinc and other vitamin supplements for maximum acne-fighting properties.

Take your zinc supplements in the morning along with any other medications and supplements you take in a day. Don’t consume zinc supplements without food, or you might have stomach cramps or irritation. Add your zinc supplements to a meal for maximum benefit and the least amount of side effects. 

A Word of Caution

The upper tolerable intake limit of zinc is 40 mg/day.

Zinc supplements should not be taken along with tetracycline antibiotics (including minocycline and doxycycline) or quinolone antibiotics such as ciprofloxacin. This is because the drug-drug interactions will affect the absorption of zinc and antibiotics.

Where zinc supplements are recommended along with antibiotics for acne treatment, the zinc supplements should be taken 6 hours before or 2 hours after the antibiotics. 

You Can Use Zinc for Acne

Zinc is a promising remedy for acne. Many individuals with acne also have low zinc levels, and research has shown that adding zinc supplements and topical zinc treatments (combined with other skin-boosting supplements) can improve the appearance of skin by discouraging the spread of acne bacteria, reducing inflammation, and keeping the pores open and clean. Some studies have shown that taking zinc supplements alone can have as much as a 50 percent improvement in the number of acne breakouts within just a few weeks.

If you have always struggled with acne and have breakouts even as an adult, adding more zinc to your diet just might be the extra advantage that your body needs to keep your skin clear and healthy. Combined with effective topical care and a healthy diet, your acne could start to fade in just a few weeks. 


Creatine is a protein-like compound found mostly in the cells of the skeletal muscles. It increases energy production in cells by increasing the production of adenosine triphosphate or ATP which is the chief energy molecule in the body.

The most accurate description of creatine is that it is a nitrogenous organic acid. It is produced from 3 amino acids (glycine, L-methionine, and L-lysine) in the liver and kidneys.

Creatine is interconverted to creatinine (a compound whose serum levels are used to access renal function and for diagnostic purposes) in the body.

Creatine can also be obtained from meat. Therefore, vegetarians need to take creatine supplements to get appreciable amounts of creatine.

This energy supplement also improves cognition and memory. In a study involving vegetarians, creatine supplements were found to provide these benefits by increasing the body’s store of the compound. However, since vegetarians usually have lower levels of creatine, it is still unknown whether creatine supplements can also improve cognitive performance and memory functions in non-vegetarians.

Creatine supplements are commonly ingested by athletes especially bodybuilders and wrestlers who want to quickly build up their muscle mass. Different studies have identified several mechanisms by which creatine contributes to muscle development.

The most common conclusions are that creatine

  • increases water retention in muscle cells
  • stimulates the activity of satellite cells which causes muscle hypertrophy
  • repairs damaged muscle fibers by contributing to their growth

Creatine is extensively used in sports. It can provide the burst of energy needed to improve power and performance, especially for anaerobic high-intensity exercises.  The effect of creatine is lesser and short-lived for aerobic exercises.

Even though creatine is an energy compound, its use is not discouraged in athletics and the compound is not included in any list of banned substances provided by anti-doping agencies.

Creatine Supplements

The most popular creatine supplements are creatine monohydrate and creatine ethyl ester.

These are supplied as caplets, capsules or powders to be reconstituted as a drink. The anabolic effects of creatine are enhanced when taken along with high glycemic carbohydrates.

Of the two creatine supplements, creatine monohydrate has a better therapeutic profile. Contrary to popular belief, the ethyl ester salt of creatine is easily affected by stomach acid. In this supplement, the creatine is unstable in an acidic environment.

A new creatine supplement, creatine hydrochloride, has an even better therapeutic profile than creatine monohydrate. Creatine hydrochloride is 59 times more soluble than the monohydrate. Therefore, it is more extensively absorbed and given in lower doses.

Creatine is extensively absorbed and highly bioavailable when supplied by these supplements. However, it is also quickly used up by the body. Therefore, constant supplementation with 2 -5 g is required to maintain a high level of creatine in the body.

Short-term creatine supplementation is generally considered safe. Even long-term use of 3 g per day of creatine is also regarded as safe.

The use of creatine is not recommended for those with impaired liver and kidney functions, asthmatics, pregnant, and breastfeeding women. However, there is no convincing scientific proof that creatine causes liver or kidney damage.

Other side effects that are reported but not proven include dehydration, muscle cramp, electrolyte imbalances, and reduced blood volume.

Does Creatine Cause Acne?

Although most creatine users and manufacturers argue that creatine does not cause acne, there is now overwhelming evidence that it most likely does. At best, creatine worsens acne.

Creatine supporters are eager to conclude when acne breaks out during creatine supplementation, it is usually the high glycemic diet taken alongside and/or the dehydration following strenuous exercise that should be blamed.

The rationalization is that sugar and dehydration cause hormonal imbalance and thus acne.

However, when the results of different studies examining the effects of creatine on the endocrine system are critically analyzed, it becomes clear that creatine can directly cause or at least contribute to acne development.

The Endocrine Effects of Creatine

Besides the anabolic effects that creatine produces in the body, it also affects the endocrine system.

Different studies have shown that creatine supplementation increases the levels of testosterone, dihydrotestosterone (DHT), and insulin-like growth factor I (IGF-I).

In a 2006 study published in the International Journal of Sport Nutrition and Exercise Metabolism, 39 college football players were given either creatine or placebo over a period of 10 weeks while partaking in resistance training. The results showed that resting testosterone levels were increased by an average of 22%.

A 2008 study published in the same journal examined the levels of insulin growth factor-1 (IGF-1) in young adults following creatinine supplementation and regular resistance exercise during an 8-week period.

The study result showed that regardless of diet, the IGF-1 levels in the study participants increased by 24%.

A 2009 study published in the Clinical Journal of Sports Medicine examined hormonal production in 20 male South African rugby players after 3 weeks of supplementation with creatine monohydrate. A 6-week washout period was allowed following this double-blind, placebo-controlled, crossover study.

The result of the study showed that the conversion of testosterone to DHT was increased during the period of the supplementation.

DHT levels were increased by 56% during the first week of loading up on creatine and maintained at 40% above normal levels during the 2-week period when maintenance dose was taken.

What the Results Mean

The studies summarized above establish that creatine increases the levels of the very hormones that have been shown to cause acne. Testosterone, DHT, and IGF-1 are all directly linked to acne.

Male sex hormones such as testosterone are produced in increasing amounts during puberty and they are the chief cause of acne in teenagers.

Testosterone is not the only androgen that is known to cause acne: DHT produces an even greater effect.

Androgens cause the enlargement of the sebaceous glands which leads to increased production of sebum. With excess sebum reaching the skin, an ideal environment for bacterial colonization is created. Therefore, acne-causing bacteria such as Propionibacterium acnes thrive on the skin.

Furthermore, increased sebum production means that there will be increased clogging of the skin pores by a mixture of dead skin cells, bacteria, and sebum.

This causes the formation of acne lesions and a cycle of inflammation that produces all the symptoms of acne such as seborrhea, comedones, papules, pimples, nodules, cysts, and acne scars.

Besides the androgens, the other hormone implicated in acne development is insulin-like growth factor 1.


Since creatine directly increases the levels of these hormones, it can clearly cause and/or worsen acne.

It may well be that low doses of creatine can be well tolerated in some individuals.

Also, the role of creatine in acne development might be cumulative and, therefore, short-term use of the supplement may not cause acne in some people. However, there have been reports of acne breakouts even with low doses and a few days after the start of creatine supplementation.

Clearly, more studies are needed to conclusively explore the likelihood of creatine causing acne but the results from available studies all point to the fact that creatine supplementation creates the very hormonal imbalance that triggers acne.

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