Creatine and Hair Loss: What the 2009 Rugby Study Actually Said

Every gym has that guy who dropped creatine because 'it causes hair loss.' The claim comes from one small study of twenty college rugby players — that measured serum DHT, not hair. Here's the honest breakdown.

Ask ten guys at your gym why they don't take creatine and at least three will say "it causes hair loss." Ask them where they read that and they'll shrug. This is one of the most durable exercise-supplement myths of the last fifteen years — and it comes from a single small study of college rugby players in South Africa. Here's what it actually said, and why the internet's takeaway went badly wrong.

The one study everyone is citing without knowing it

The origin of the creatine-hair-loss claim is a 2009 paper by Van der Merwe, Brooks, and Myburgh, published in the Clinical Journal of Sport Medicine. The study enrolled 20 college-age male rugby players from a South African university. Participants were randomized to either creatine monohydrate (7 days loading at 25 g/day, then 14 days maintenance at 5 g/day) or placebo, in a double-blind crossover design.

The primary outcome was serum DHT (dihydrotestosterone). The researchers found:

After the 7-day loading phase, serum DHT rose approximately 56% above baseline. After the 14-day maintenance phase, DHT remained roughly 40% above baseline. Total testosterone did not significantly change. The testosterone-to-DHT ratio decreased, suggesting more testosterone was being converted to DHT.

What the study did not measure

This is the part every internet post skips. The study measured serum DHT levels. It did not measure:

• Hair loss.
• Hair thickness.
• Scalp DHT (which is what actually matters for androgenic alopecia).
• Any hair-related outcome whatsoever.

The chain of logic in the internet-summary version of the study is: creatine raises serum DHT → serum DHT causes hair loss → therefore creatine causes hair loss. Each link in that chain is either weak or wrong.

Link 1 — creatine raises serum DHT

The 2009 study showed this in 20 young athletes on aggressive loading protocols. Attempts to replicate the finding have been sparse and inconsistent. A 2021 review by Antonio et al. characterized the DHT-creatine literature as "insufficient to draw firm conclusions" — one small study, no strong replication, no dose-response data.

Link 2 — serum DHT drives hair loss

Serum DHT and scalp DHT are related but not identical. Androgenic alopecia is driven by local DHT concentration at genetically susceptible follicles. Men with elevated serum DHT don't necessarily have more scalp DHT, and men on 5-alpha-reductase inhibitors show marked scalp DHT reduction with less dramatic serum DHT reduction. Extrapolating from serum DHT changes to hair follicle-level effect requires assumptions the data doesn't support.

Link 3 — small serum DHT increases produce visible hair loss

Even accepting that creatine modestly raises serum DHT in some men, the clinical question is whether this magnitude of change accelerates androgenic alopecia in a genetically susceptible scalp. There is no direct evidence that it does. No trial has measured hair density or hair loss progression in creatine users versus non-users.

What would actually change the picture

The claim "creatine accelerates hair loss in susceptible men" would be scientifically credible if we had:

1. Multiple replications of the 2009 serum DHT finding across different populations and dosing protocols.
2. At least one trial measuring hair density outcomes in creatine users vs matched controls over 12+ months.
3. Dose-response data showing higher creatine intake correlates with faster hair loss.

None of this exists as of 2026. What we have is one small serum-marker study extrapolated into a population-level clinical claim, propagated for fifteen years by well-meaning internet forums.

Practical decision framework

If you have no personal or family history of pattern loss

The evidence base does not support avoiding creatine for hair-loss concerns. Use it if you want the well-established performance and cognitive benefits.

If you have early pattern loss or strong family history

The evidence still doesn't support avoiding creatine, but the risk-benefit calculation is more personal. If you're already on finasteride or dutasteride, the drug's DHT suppression likely swamps any modest supplement effect. If you're not on medical therapy and are actively losing hair, the case for creatine is weaker only because you should probably be on medical therapy anyway — the creatine question is secondary to the finasteride question.

If you're planning a hair transplant in the next 6–12 months

Most Colombian surgeons will tell you honestly that creatine is not on the list of things they'd ask you to stop pre-op. They will strongly recommend you be on finasteride or dutasteride, and they will ask you to stop blood thinners, high-dose fish oil, and alcohol in the days before surgery. Creatine is not in that category.

The one legitimate reason to be cautious

Creatine can cause water retention and mild acne in some users, mostly during loading. If you notice increased sebum production or scalp oiliness after starting creatine, it's reasonable to reduce dose or discontinue — not because of DHT, but because a chronically oily scalp can amplify seborrheic dermatitis, which itself worsens androgenic hair loss. That's a downstream nuisance, not the direct hair-loss mechanism the internet claims.