Tribulus terrestris (puncture vine) is an herb which grows worldwide but particularly heavily on pasture lands and by roadsides in India, which is perhaps the most popular testosterone booster in the world.
It ascended to massive fame in the 1990s and is said to increase strength, mood, focus, muscle-building, and energy. What’s more, Ayurvedic Indian medicine proscribed it for increasing sperm count and the chances of conceiving. Tribulus terrestris is famous for its broad effects on hormones and fertility, but it’s chiefly marketed towards gym rats and the wider bodybuilding community.
Like any testosterone booster, some gym users love tribulus terrestris and proclaim it to be a secret weapon (even though it’s hardly a secret anymore). Others denounce it as being useless, a scam, and having a laughably small effect on muscle mass.
But one effect which has been commonly reported is acne. In fact, acne is perhaps the most common side effect among bodybuilders using it, acne severe enough to make some give up and switch to another famous gym supplement like tongkat ali or deer antler spray.
Is there any truth to these claims? Almost certainly yes, because you only need the most basic grasp of acne science to know that increasing testosterone levels can cause it.
Does tribulus terrestris even increase testosterone?
The two main androgenic hormones in humans, DHT and testosterone, are responsible for muscle building, aggression, and sex drive in both men and women. Tribulus terrestris is touted to increase both of them, but DHT and testosterone also cause acne by stimulating your skin to pump out more oil.
Therefore our first important goal is to establish the precise nature of tribulus terrestris’ hormonal effects. Like the testimonials the scientific research is a vast sea of contradictions and mystery.
Firstly, we have several studies on animals, which started the whole hype. In this study huge increases in testosterone were observed among animals injected with tribulus terrestris. Serum testosterone levels went up by 52% and 25-51% in primates and rats respectively. DHT levels increased by 30-32% in rabbits and 31% in primates.
However, the study was on animals. Also, they used injections of tribulus terrestris directly into the bloodstream, and the huge increases lasted very briefly. The results were repeated on many other animals however, including rabbits and rats.
It’s possible that the bodybuilding community has their facts straight but not proven. Next however we have some positive human studies. This one fed tribulus terrestris to both men and women daily for eight weeks. The active hormonal compound in the tribulus terrestris plant is a steroidal saponin called protodioscin; concentrations of protodioscin are often displayed on the bottle.
Hence the formulation in this study contained 10% protodioscin, to properly measure the effects. Both men and women enjoyed a big increase in luteinising hormone (LH) by the end of the study; LH is one of the main precursors to testosterone.
This study meanwhile, observed no difference in serum testosterone in humans fed tribulus terrestris compared to those fed a placebo. However, free testosterone went up by 32%. Free testosterone is the unbound form in the blood which actually binds to bodily androgen receptors such as those in the skin, and exerts its effects.
Two promising studies then, or unpromising depending on your goals, but two other human studies have revealed no increase. This one examined 21 healthy young men and concluded that tribulus terrestris had zero significant effect on either testosterone or luteinising hormone. In this study scientists tested a placebo against a combination of tribulus terrestris and other herbs (saw palmetto, indole-3-carbinol, chrysin); they detected no change in levels of the “big T”.
Adding to the uncertainty is this 2007 study which found that the broader physical benefits didn’t occur. Rugby players were given a tribulus terrestris supplement or a placebo; both groups gained mass and fat free mass after five weeks of training but there was no difference between the groups.
However, this review of many of tribulus terrestris’ body-enhancing powers noted that the active compound protodioscin increases sex drive by “increasing the conversion of testosterone into the potent dihydrotestosterone”, AKA DHT.
Overall, we have a murky picture. However, the isolated compound protodioscin is a well-established testosterone booster. The tribulus terrestris plant also contains several other steroidal saponins (essentially natural plant steroids) including desgalactotigonin, F-gitonin, desglucolanatigonin, gitonin and tigogenin.
What’s more, many tribulus terrestris products on the market contain almost no protodioscin, the most active hormonal compound. Hence those brands would be useless, and this could explain the mystery of the wildly varying testimonials and results.
In my reckoning, the tribulus terrestris herb is nowhere near proven to increase DHT or testosterone in humans, but there’s a strong chance that well-prepared forms do.
The implications for acne
If that assessment of Tribulus terrestris is correct then the effect on your skin is simple. Tribulus terrestris may have the ability to increase testosterone levels, and testosterone has the ability to increase oily skin and acne.
We’ve discussed the role of DHT and testosterone countless times on this website, since it’s so important, but here’s the gist of it. Testosterone constructs your muscle mass but doesn’t cause acne too badly. DHT is a strong androgen which stimulates oily skin far more powerfully. Higher levels of androgens and an unbalanced ratio towards DHT is a recipe for clogged pores and acne.
This is a common dilemma faced by bodybuilders, by powerlifters and by amateur athletes from all walks of life. How do you enhance performance without getting a faceful of acne? There are many questions on bodybuilding forums relating to this.
Luckily, the nature of testosterone boosters and androgen ratios is not completely equal. As we just covered, DHT is the more potent of the two for stimulating human sebaceous glands to pump out more oil. DHT is heavily involved with cosmetic aspects of androgens such as facial hair growth and acne, but also sex drive. It’s a far more powerful androgen, so to be a healthy man of high vitality you need a good amount of DHT, but you also want a good balance between testosterone and DHT.
If the luteinising hormone theory is correct, then tribulus terrestris will be far safer for acne. Luteinising hormone is the precursor to testosterone formation; higher levels will increase both testosterone and DHT by a similar proportion, since DHT is formed from testosterone.
However, if the review which stated that protodioscin enhances the conversion of testosterone to DHT is accurate, the acne danger increases. This adds yet another layer of uncertainty.
Overall, there’s a strong chance that the hormonal powers of tribulus terrestris will give you acne. It’s happened to many gym users, it could happen to you too.
Tribulus terrestris has benefits for acne as well
But good news – Tribulus terrestris is a complex plant with many other possible effects on acne. It’s been used in Ayurvedic medicine for hundreds of years for killing bacteria, enhancing the immune system, and preventing cancer.
For acne, there’s a flood of new evidence suggesting that this herbal supplement and the compounds within it can lower inflammation. Chronic inflammation is the number one cause of acne; if tribulus terrestris can prevent inflammation then some of the danger of the androgens would be counteracted.
In fact, Ayurvedic medicine classified tribulus terrestris as sheeta, which means cooling. Here are the studies:
STUDY ONE – this 2015 study analysed the anti-inflammatory properties of a specific compound found in tribulus terrestris called N‑trans‑ρ‑caffeoyl tyramine (CT). CT was tested on many pro-inflammatory immune system chemicals, including interleukin-6, COX-2, and TNF-a.
The compound was found to inhibit IL-6 and TNF-a in a dose dependent manner; both of those chemicals are found in higher than average quantities in acne-prone skin. CT also suppressed COX-2, a gene which is the mastermind behind a variety of inflammatory responses.
STUDY TWO – this study examined the anti-inflammatory effect of an extract from the whole tribulus terrestris plant. Like the isolated compound, tribulus terrestris inhibited TNF-a and suppressed the COX-2 gene.
The scientists concluded that tribulus terrestris “inhibits expression of mediators related to inflammation and expression of inflammatory cytokines”, which could benefit “various inflammatory diseases”. Acne vulgaris is exactly that, an inflammatory disease.
STUDY THREE – this study tested both the antimicrobial and anti-inflammatory effects of the whole tribulus terrestris plant. The tribulus terrestris extract was able to calm an inflamed rat paw substantially; the more that was applied the more the inflammation fell (the results were dose-dependent).
There’s plenty of new evidence to say that tribulus terrestris can inhibit a variety of pro-inflammatory chemicals.
Luckily, this occurs when taken in a similar format to the tribulus terrestris you would take when building muscle. The result on your face, excluding the hormonal effects, would be less red, painful and “angry” looking pimples.
Your average gym rat probably has no awareness of this power at all. In fact, anti-inflammatory powers would improve gym performance as well, reducing stiff and aching muscles and joints after a workout.
Then there’s a second power which few know of – increasing antioxidants:
STUDY ONE – this 2011 study fed a group of rats a high dose of oxalates to cause oxidative stress. Oxalates are plant crystals found in vegetables such as kale and spinach, which are safe in moderate amounts but highly inflammatory in higher doses.
One group out of three was fed tribulus terrestris alongside the oxalates for seven weeks. The tribulus terrestris supplement reduced the oxidative stress from excessive oxalates and restored the lost antioxidant enzyme activity. Inflammation fell significantly as well.
STUDY TWO – this study was interesting, as it concluded that some of the fertility benefits form tribulus terrestris supplementation may be down to its antioxidants. The study tested an extract of tribulus terrestris for its antioxidant capacity, and observed a high amount of polyphenols and flavonoids.
This says all you need to know: “the obtained results demonstrated that T. terrestris preparations possess a significant antioxidant activity”. A variety of different tribulus terrestris products were tested, and all demonstrated high antioxidant activity.
STUDY THREE – tribulus terrestris was able to prevent oxidative stress induced apoptosis in this study from 2012. Apoptosis is the process of programmed cell death. Radiation was used to generate reactive oxygen species (free radicals) and tribulus terrestris was able to scavenge them.
The scientists commented that the therapeutic benefits of tribulus terrestris reported in Indian traditional medicine may be down to its antioxidant profile. They concluded that tribulus terrestris could protect cells from “lethal oxidative damage”. Sounds promising.
The tribulus terrestris plant may improve the two worst conditions behind acne – chronic inflammation and oxidative stress.
That would go a long way to combat the danger posed by the testosterone and DHT increase. It definitely wouldn’t eliminate the acne in everyone; some men and women have sebaceous glands which are particularly well stimulated by DHT and testosterone. That’s one of the main genetic aspects of acne.
However, it means that tribulus terrestris is far safer than the statement “increases free testosterone by 32%” suggests.
How to have high testosterone and clear skin
What this also means is that you can enjoy the benefits of the increased testosterone without the downsides. Your muscles can become huge, your energy can go through the roof, and your voice could deepen all without a fresh outbreaks of pimples.
Of course, tribulus terrestris still isn’t proven to work. However, the point is that should you choose it, you won’t be making a decisive choice between muscle and clear skin.
If you came to this article looking for a testosterone booster in general and remain undecided about which one, then there’s a wider strategy for acne, which is that high testosterone and DHT levels are fairly easy to counteract. Basically, they will increase your sebaceous gland output, and you will get oilier skin. However, there are lots of dietary and nutritional tricks for making the oily skin less harmful.
Sebum is most likely to clog skin pores once a compound in it called squalene has been oxidised by free radicals. Oxidised squalene is known as squalene peroxide, and squalene peroxide triggers a further localised increase in sebum and also keratin.
Squalene peroxide can be formed by exposure to many free radicals including from air pollution, chlorine in swimming pools, and parabens. If you add plenty of antioxidants to your diet the extra squalene from testosterone will be protected, and this scenario won’t happen. Vitamin E is particularly important.
If you’re a man, I actually recommend that you don’t focus on reducing testosterone at all, regardless of whether you’re a gym rat or completely lazy. Androgens are too important for health and vitality, whether its muscle growth, mood or sex drive. In this article on DHT and testosterone I covered many strategies to minimise the damage.
However, I only lightly touched upon another great secret. Namely, natural topical treatments which inhibit sebaceous gland activity or androgen receptors.
One of the best topical treatments for oily skin is sea buckthorn oil. The oil of the sea buckthorn berry fruit is extremely high in vitamin A, and when you apply it to your skin, it soaks through to the sebaceous glands and downregulates them.
Have you ever been prescribed topical retinoids? They’re simply a form of synthetic vitamin A, designed to control oily skin. Sea buckthorn oil does the same thing naturally.
What’s more, it contains two compounds called beta-sitosterol and stigmasterol which also control the sebaceous glands. This study found that sea buckthorn oil reduced oily skin by 17% after one week, 18% after two weeks, and 45% after eight weeks.
Green tea, meanwhile, also reduces oily skin but through directly counteracting the androgen receptors of sebaceous glands instead of with vitamin A.
This is down to the antioxidant epigallocatechin gallate (ECGC). ECGC is proven to lower DHT when drunk, and hence is recommended to hair loss patients far and wide, but it’s much smarter to stick it directly on your face.
Are there any studies? Yes, this one found that green tea lowered oily skin by 60% in eight weeks. This study found that green tea lowered acne by 51.3% in eight weeks. Green tea is one of the best natural topical treatments around.
Topical androgen blockers and topical oily skin blockers are one of the best ways to make bodybuilding and any form of sports training harmless for acne.
Regardless of whether you’re taking tribulus terrestris, tongkat ali or just pumping iron to increase testosterone, preventing any increase in acne is a piece of cake.
Topical androgen blockers are great. Stay away from internal androgen blockers like saw palmetto, although if you’re a woman these are great supplements for acne since females are far more likely to have excess DHT.
If you stumbled across this article, excited about taking tribulus terrestris but apprehensive about the side effect of acne, here are your takeaways.
Firstly, tribulus terrestris is not completely proven to increase testosterone and DHT levels, but it might well do. Secondly, if it does then there’s no reason for it to cause acne.
If your gym performance goes through the roof and you pack on so much muscle that you can’t fit through a door frame then acne isn’t inevitable. The tribulus terrestris herb has enough antioxidants and anti-inflammatory properties that the oily skin might be counteracted.
Even if you do get a burst of pimples, there are multiple separate avenues for counteracting the oily skin, including natural topical treatments like sea buckthorn oil.
Overall, tribulus terrestris is a perfectly safe supplement for acne.
Thanks for reading!