Ashwagandha (Withania somnifera) is a highly valued adaptogenic herb used for centuries in Ayurvedic medicine. It is primarily recognized for its ability to help the body manage and adapt to physical and psychological stress. The plant’s roots are typically processed into extracts or powders and marketed as a supplement to support overall well-being, manage fatigue, and promote balance. Despite its widespread use and many reported benefits, a growing number of consumers are asking whether this popular herb could be responsible for acne breakouts. This concern warrants a closer look at the herb’s biological actions and its potential influence on skin health.
Examining the Reported Connection to Breakouts
The question of whether ashwagandha causes acne does not have a simple yes or no answer because robust clinical trials directly linking the supplement to acne development are currently lacking. Most of the evidence suggesting a connection comes from anecdotal reports from a subset of users. These individuals often report a flare-up or increase in inflammatory lesions shortly after beginning supplementation.
In some instances, a temporary increase in breakouts might be mistaken for a sustained adverse reaction. This brief phase, sometimes referred to as a “purge,” is a rare phenomenon reported with certain supplements as the body adjusts to new internal chemistry. However, if breakouts are persistent, severe, or concentrated in areas typical of hormonal acne, the supplement may be incompatible with that individual’s physiology. Ashwagandha also contains anti-inflammatory properties that may help reduce acne in users whose skin issues are primarily stress-related.
Ashwagandha is not a universal acne trigger, but it does appear to affect a small, sensitive population. The majority of users do not experience adverse skin reactions. For those who do, the reaction is not due to a direct toxic effect, but rather a consequence of the herb’s influence on the body’s endocrine system.
The Hormonal Mechanism
Ashwagandha’s primary mechanism of action is its modulatory effect on the Hypothalamic-Pituitary-Adrenal (HPA) axis, which is the body’s central stress response system. By influencing this axis, the herb reduces the circulating levels of the stress hormone cortisol. Studies have shown that in chronically stressed adults, Ashwagandha supplementation can lower morning cortisol levels by nearly 28% compared to a placebo.
While lowering cortisol is generally beneficial for reducing stress-related inflammation, this modulation can inadvertently shift the balance of other hormones. Cortisol and sex hormones, like androgens, share common biochemical pathways and precursors in the adrenal glands. Altering the function of the HPA axis can have downstream effects on other parts of the endocrine system.
The specific concern for acne relates to the androgenic hormones, such as testosterone and dehydroepiandrosterone sulfate (DHEA-S). Clinical data, particularly in men, indicates that ashwagandha supplementation can lead to an increase in both DHEA-S and testosterone levels, with reported increases averaging around 15% and 18%, respectively. Even a slight increase in free androgens can stimulate the sebaceous glands in the skin.
This stimulation leads to an overproduction of sebum, the oily substance that lubricates the skin. Excess sebum mixes with dead skin cells, clogs pores, and creates the ideal environment for Cutibacterium acnes bacteria to thrive, resulting in inflammatory lesions. Individuals who are already genetically predisposed to hormonal acne—often characterized by breakouts along the jawline, chin, and back—are the most likely to experience this side effect.
Practical Steps for Users
If new breakouts occur after beginning ashwagandha, the first step is to carefully monitor the timing and location of the lesions. A practical strategy is to begin with a low dosage, a process known as titration, which allows the body to gradually adjust to the herb’s effects. If a higher dose is being taken, reducing it may be enough to mitigate the hormonal shift causing the skin reaction.
Some users find that cycling the supplement helps prevent the body from becoming overly accustomed to its effects. This typically involves taking the supplement for a period, such as two or three months, and then taking a break for a month before resuming. Users should prioritize high-quality, standardized extracts that have been third-party tested. Poor quality products may contain unknown fillers or contaminants that could contribute to adverse reactions.
Discontinue use if the acne persists or worsens significantly. Should skin issues continue after stopping the supplement, or if the breakouts are severe, consulting a dermatologist or a physician is advisable. This allows for a professional evaluation to determine the root cause of the acne and to discuss whether the supplement is incompatible with the user’s hormonal profile.