There are many skincare ingredients available now with numerous claims of efficacy. There are a few ingredients however that have been studied extensively for many years and have clearly demonstrated their skincare benefits. Niacinamide (also called nicotinamide or NAM), which is the physiologically active form of the essential vitamin niacin or vitamin B3, has been shown to effectively treat various dermatological conditions. This ingredient has been shown to have antioxidant effects, promote epidermal barrier function, decrease redness and blotchiness, minimize fine lines and wrinkles, and more.

Development of Niacinamide as a Supplement

Some of the first research into niacinamide came from studying the effects of its deficiency. Pellagra is a nutritional deficiency of vitamin B3 that results in severe cutaneous lesions. In the early 1900s in the U.S., millions in the South contracted this condition and many died after being ostracized from their communities. Although it is not contagious, it was thought to be at the time. The epidemiologist Joseph Goldberger helped promote the idea that pellagra was due to a nutritional deficiency and not an infection. Over the course of a few decades, his ideas on treating the condition with nutrition became accepted as public policy and pellagra was mostly eliminated. The research into this vitamin B3 deficiency led to the development of niacinamide as a supplement.

Now, niacinamide is often included in skincare formulations for treating a variety of conditions including acne, hyperpigmentation, and aging skin. Sometimes it is combined with retinol, a vitamin A derivative. Retinoic acid is a more powerful ingredient similar to retinol that can be combined with niacinamide by a compounding pharmacy.

Uses for Niacinamide in Skincare Formulations

Acne vulgaris: The main treatments for acne often involve antimicrobials. Acne is often caused partially by the growth of bacteria on the skin. Research has shown that topical niacinamide is as effective as clindamycin in treating acne. Since bacteria can become resistant to antibiotics, niacinamide may be considered an alternative for acne treatment. In one study, 82% of the patients treated with niacinamide and 68% treated with clindamycin were improved after 8 weeks of treatment. Niacinamide has been shown to reduce the amount of sebum in the skin, which is one of the main treatment targets for most acne products.

Aged and photodamaged skin: Niacinamide is a precursor for co-factors NAD(H) and NADP(H) that are important in cellular pathways related to skin physiology. Since NADH and NADP decrease with age, using niacinamide may act to replenish levels. Niacinamide is implicated in the synthesis of intermediates that are essential to the growth of a healthy stratum corneum.

Hyperpigmentation and melasma: Niacinamide has been shown to be comparable to hydroquinone in its effectiveness at treating melasma. In double-blind, placebo controlled trial, excellent improvement was observed with NAM in 44% of patients, compared to 55% with hydroquinone. Niacinamide is a tyrosinase inhibitor (same mode of action as hydroquinone) and prevents transfer of melanosomes to keratinocytes.

Improving epidermal barrier: Topical application of niacinamide may improve stratum corneum barrier function. When niacinamide was applied to the legs for several weeks there was a measurable and significant increase in recovered stratum corneum ceramides and free fatty acid lipid fractions. Other studies have confirmed that niacinamide when applied topically can increase essential lipids that improve barrier function.

Side Effects of Niacinamide

Niacinamide has very low side effect profile, especially compared to other cosmetic skincare ingredients that have similar efficacy. It is generally well tolerated and rarely results in more than minimal irritation. The low incidence of side effects combined with its efficacy make NAM the ideal skin care ingredient.

All retinoic acid formulations made by our compounding pharmacy also include niacinamide 4%. A compounding pharmacy can combine NAM with other effective ingredients. These combinations can not be found in any commercially available product.

Example formulations include:

• Niacinamide 5%, Tranexamic Acid 3%, Kojic Acid 4% Cream (Lightening Cream)
• Niacinamide 4%, Azelaic Acid 5%, Retinoic Acid 0.025% (Acne-Rosacea Cream)
• Retinoic Acid 0.025%, 0.05%, or 0.1%, Niacinamide 4% (Hyperpigmentation, Skin Renewal)

Articles

• Topical nicotinamide compared with clindamycin gel in the treatment of inflammatory acne vulgaris. – International Journal of Dermatology
• Nicotinamide increases biosynthesis of ceramides as well as other stratum corneum lipids to improve the epidermal permeability barrier. – British Journal of Dermatology
• Topical niacinamide reduces yellowing, wrinkling, red blotchiness, and hyperpigmented spots in aging facial skin. – International Journal of Cosmetic Science
• A Double-Blind, Randomized Clinical Trial of Niacinamide 4% versus Hydroquinone 4% in the Treatment of Melasma. – Dermatology Research and Practice
• The effect of 2% niacinamide on facial sebum production. – Journal of Cosmetic and Laser Therapy