Every few years, a new “it” ingredient starts making the skin-care rounds—even if it’s not new at all. This time it’s niacinamide, a form of vitamin B3 that’s been a fixture in commercial cosmetic formulations and dermatologists’ offices for decades. Recently, though, it’s been popping up in all types of products as a recognizable and desirable skin-care ingredient.
But if you’re not quite sure what niacinamide is or what it’s doing in your moisturizer, you’re not alone. Here’s what you should know before adding it to your skin-care routine.
What exactly is niacinamide?
Niacinamide, which is also called nicotinamide, is one of two major forms of vitamin B3 (niacin) found in supplements (the other is nicotinic acid). It’s often touted to help manage acne, rosacea, pigmentation issues, and wrinkles. But is there any science behind those claims?
Scientists theorize that niacin (and therefore niacinamide/nicotinamide) may be effective because it’s a precursor to two super-important biochemical cofactors: nicotinamide adenine dinucleotide (NAD+/NADH) and nicotinamide adenine dinucleotide phosphate (NADP+). Both of these molecules are central to the chemical reactions that your cells—including skin cells—need to repair damage, propagate, and function normally. Many of these essential reactions can’t occur at all without NAD+, which your cells can’t make without niacinamide.
“By giving your body the precursor, the thought is that it allows your body to make more NAD+,” John G. Zampella, M.D., assistant professor in the Ronald O. Perelman department of dermatology at NYU Langone Health, tells SELF. This fuels your cells to proliferate and also allows your body to absorb and neutralize more free radicals.
Essentially, free radicals are molecules that have either lost or gained an extra electron, which makes them unstable and highly reactive. In high enough doses, they can damage healthy cells. But NAD+—courtesy of niacin (and niacinamide)—contributes an extra electron to those unpaired free radicals so they can chill out and stop wreaking havoc all over the place.
Interestingly, the same process—helping your body create more NAD+ and, therefore, repair damage—is thought to be the root of both topical and oral benefits derived from niacinamide on the skin. (Reminder: Niacinamide is just another form of niacin.) There’s also evidence that topical niacinamide can increase the production of ceramides (lipids that help maintain the skin’s protective barrier), which may contribute to its topical effects on wrinkles, fine lines, and the skin’s moisture barrier. All of this is probably why you’re seeing niacinamide listed in a bunch of skin-care products.
However, there aren’t a ton of high-quality studies looking at topical niacinamide for many cosmetic uses.
What can niacinamide actually do for you?
If niacinamide is involved in most important cell functions, then there’s nothing it can’t cure, right? Well, no—if every cellular process in our bodies could be perfected with vitamin supplements, we wouldn’t need antibiotics or radiation therapy. That said, oral and topical niacinamide may have some actual benefits for skin health:
Skin cancer prevention:
Ask a dermatologist what niacinamide does best, and the very first thing they’ll say is probably “skin cancer prevention.” In a 2015 study in the New England Journal of Medicine, researchers gave 386 patients 500mg of oral niacinamide or a placebo twice daily for 12 whole months. All the participants had at least two non-melanoma skin cancers within the previous five years and, therefore, were at a high risk for developing another skin cancer. Results showed that during the study year there were 23 percent fewer new cases of skin cancer in the group that received niacinamide (336 cancers) compared to those who got the placebo (463 cancers).
Both Dr. Zampella and Laura Ferris, M.D., Ph.D., associate professor in the department of dermatology at the University of Pittsburgh, told SELF they frequently suggest oral niacinamide to their patients with a high risk for non-melanoma skin cancers, and cited this study as the reason why.
This doesn’t mean that two niacinamide capsules a day (which is what participants took in the study) will stave off skin cancer forever. The study focused on people who had experienced skin cancer before—not the general public. And it doesn’t tell us anything about using niacinamide to help prevent melanoma skin cancers (and the research we do have suggests it’s not super helpful for those). But if you’ve had multiple non-melanoma skin cancers in your life, it could be worth asking your dermatologist about oral niacinamide.
So, there is some evidence that oral niacinamide can be helpful for skin health in this specific situation. But is topical niacinamide helpful too?
Acne, rosacea, and other inflammatory skin conditions:
Niacinamide’s anti-inflammatory properties make it an attractive treatment for skin conditions marked by inflammation, like acne. In fact, in two double-blind studies—one published in 2013 and the other published in 1995, both in the International Journal of Dermatology—a topical preparation of 4 percent niacinamide treated moderate acne just as well as 1 percent clindamycin (a topical antibiotic commonly prescribed to acne patients) when applied twice daily for eight weeks.
Other research suggests that a 2 percent topical niacinamide may also inhibit the production of oil, which could be beneficial to people dealing with acne. Plus, both dermatologists we talked to say that niacinamide is relatively nonirritating compared to other acne treatments, making it an especially attractive option for people with dry or sensitive skin.
In addition to topical preparations, oral niacinamide supplements have been shown to reduce inflammation associated with mild to moderate rosacea and acne, particularly when oral antibiotics aren’t an option. But according to both Dr. Zampella and Dr. Ferris, the key words here are “mild to moderate.” They advise that severe cases usually call for stronger medications like retinoids or systemic steroids in the case of acne, not vitamins.
There is also limited evidence that topical niacinamide can help repair the function of the stratum corneum, the protective outer layer of skin, which may add to its anti-inflammatory effects.
Pigmentation issues, fine lines, and wrinkles:
There are very few clinical studies on the effects of niacinamide on fine lines and wrinkles, so the evidence we have is somewhat sparse. But there are a few studies. For instance, in one study published in 2004 in the International Journal of Cosmetic Science, researchers had 50 women (all white and between the ages of 40 and 60) apply a moisturizer containing 5 percent niacinamide to one half of their face and a placebo moisturizer to the other half for 12 weeks. Their results showed that the halves of their faces receiving niacinamide had significant improvements in hyperpigmentation spots, fine lines, and wrinkles compared to the control side.
Another split-face study, this one published in 2011 in Dermatology Research and Practice, found that a topical 4 percent niacinamide treatment was less effective than 4 percent hydroquinone (usually considered the gold standard) for treating melasma over eight weeks in 27 participants. Specifically, 44 percent of patients saw good-to-excellent improvement with niacinamide and 55 percent saw the same with hydroquinone. So, the niacinamide wasn’t totally ineffective—and it came with fewer side effects (present in 18 percent of participants) than the hydroquinone (present in 29 percent).
However, niacinamide is more frequently studied in combination with other topical medications—not on its own, which makes it difficult to know how effective it would be by itself. Based on the available evidence, well-studied options like prescription retinoids (and sunscreen!) or other antioxidants, like vitamin C, will probably do more for you than niacinamide if hyperpigmentation, fine lines, or wrinkles are your primary concerns. But if your skin is too sensitive to handle those other options, or you’re just looking for a gentler treatment for whatever reason, niacinamide might be a helpful alternative.
Here’s how to get started with niacinamide.
Adding topical niacinamide to your skin-care routine is simple and low risk: Buy a product that contains it, and apply as directed. Some people experience some mild irritation, which will likely go away with repeated use. (If it doesn’t, or you have any questions about what kind of side effects you’re experiencing, definitely check in with your derm to make sure you don’t end up with something more serious.)
Most major studies used topical preparations containing 2 percent to 10 percent niacinamide, so look for a product in that range if you can. Those who are looking for a moisturizer with niacinamide may want to check out CeraVe PM Face Moisturizer ($16, Ulta), and Dr. Zampella also recommends the Ordinary Niacinamide 10% + Zinc 1% serum ($6, Ulta).
There isn’t a prescription version of topical niacinamide, but your dermatologist may be able to add it to topical prescriptions in a process called “compounding”. According to Dr. Ferris, if you go through a pharmacy that specializes in compounded medications, it could be cheaper than a generic. The actual cost depends on your insurance and the compounding pharmacies in your area, so be sure to ask your dermatologist for more information.
Keep in mind that while niacinamide is unlikely to hurt you, it’s not a miracle drug—if you’re thinking niacinamide is the solution to all your problems, you may be sorely disappointed. “Not everything that’s red on your face is going to be acne or rosacea,” Dr. Ferris reminds us, “so make sure you have the right diagnosis before trying to come up with a treatment plan.” A dermatologist can help you decide if niacinamide is worth trying or if there’s another option that may be better for you and your skin.
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