Ashwagandha, or Withania somnifera, is a popular adaptogenic herb used to help the body manage stress and boost energy. As this supplement gains wider use, many people wonder about potential side effects, especially concerning skin health. Whether Ashwagandha can cause acne has a complex answer that depends heavily on individual hormonal makeup and the quality of the product consumed.
The Direct Answer Ashwagandha and Acne Incidence
Clinical evidence does not currently list Ashwagandha as a common direct cause of acne. The herb is not flagged as an acne-genic substance in the way some synthetic drugs or high-dose supplements are. In fact, some research suggests that the anti-inflammatory and antioxidant properties of Ashwagandha may be beneficial for managing acne, though more studies are needed.
The direct reports of acne are mostly anecdotal, often shared by individuals who noticed breakouts shortly after beginning the supplement. While these personal accounts are valid, the overall incidence rate in controlled clinical trials is low, and the herb has been generally well-tolerated in short-term studies.
How Ashwagandha Interacts with Hormones and Skin Health
Ashwagandha’s influence on the skin is indirect, primarily through its effects on the body’s endocrine system. The herb works by modulating the Hypothalamic-Pituitary-Adrenal (HPA) axis, which is responsible for the stress response. Its main action is to reduce levels of the stress hormone cortisol, with some studies reporting reductions in chronically stressed adults.
While lowering high cortisol is generally beneficial and can reduce stress-related inflammation that triggers breakouts, this hormonal modulation can have secondary effects. The body uses the same precursor molecules, like cholesterol, to produce both cortisol and certain sex hormones. By shifting the hormonal balance in the HPA axis, Ashwagandha can sometimes lead to an increase in androgen hormones.
Clinical trials have shown that Ashwagandha supplementation can elevate levels of testosterone and its precursor, DHEA (dehydroepiandrosterone), particularly in men. Higher levels of these androgens are directly linked to acne formation because they stimulate the sebaceous glands to produce excess sebum, or oil. This increase in oil production, combined with dead skin cells, clogs pores and creates an environment for Cutibacterium acnes bacteria to thrive, resulting in breakouts. Individuals sensitive to hormonal fluctuations, such as those with Polycystic Ovary Syndrome (PCOS) or pre-existing hormonal acne, may be more susceptible to this androgen-related response.
Quality Control and Non-Herbal Triggers
A non-hormonal factor in unexpected skin reactions is the quality of the Ashwagandha supplement itself. Unlike pharmaceutical drugs, herbal supplements are not regulated by the U.S. Food and Drug Administration (FDA) with the same strict standards, allowing for wide variability in product quality. A low-quality product might contain undisclosed ingredients or fillers that are the actual source of the skin irritation.
Contamination is a concern, as some supplements have been found to contain heavy metals, such as lead or arsenic, which can cause systemic inflammation and skin issues. To avoid this, choose supplements verified by a third-party organization, such as the United States Pharmacopeia (USP) or NSF International. Some supplements use common fillers or binders, like milk derivatives, that can trigger allergic reactions or sensitivities, manifesting as skin rashes or acne-like symptoms. Reviewing the full ingredient list for common allergens is an actionable step to rule out a non-herbal cause for the breakout.