Nicotinamide, also called niacinamide, is a form of the water-soluble vitamin B3. Nicotinamide is required in hundreds of enzymatic reactions throughout the body to produce energy called ATP. Nicotinic acid (also called niacin) obtained from food and supplements is converted into nicotinamide in the body. Although niacin and nicotinamide are identical in their role as vitamins, they act on different receptors in the body and produce different effects. Unlike nicotinamide, niacin has the ability to reduce cholesterol, although it is known to cause skin flushing and headache. On the other hand, nicotinamide has been investigated to improve various skin conditions when applied topically to the skin and taken orally as a supplement.
Topical Nicotinamide for the Skin
Nicotinamide (also known as niacinamide) is becoming a popular ingredient in over-the-counter skin care products. Several clinical studies have shown that nicotinamide applied to the skin may improve several inflammatory skin conditions including acne, eczema, and rosacea.
Nicotinamide may improve acne by reducing inflammation and suppressing facial oil (sebum) production. In a study of 50 people with acne, treatment with 2% nicotinamide cream significantly decreased oil production after only 2 weeks. In a separate study using 4% nicotinamide cream, study participants had a significant improvement in pimples and comedones (blackheads and whiteheads) after 8 weeks. Lastly, one study showed that 4% nicotinamide gel was just as effective as antibiotic clindamycin gel in improving moderate acne after 8 weeks.
A 2% nicotinamide gel significantly improved skin hydration in people with eczema after 4 weeks of twice daily use. Researchers think that topical nicotinamide may improve skin barrier function by increasing levels of skin oils such as fatty acids, ceramides, and cholesterol.
Thirty-four people with rosacea who were treated with a 0.25% nicotinamide gel for 4 weeks had 75% improvement in face redness and pustules.
Oral Nicotinamide for the Skin
In addition to topical skin care products containing nicotinamide, the use of oral nicotinamide supplements is also promising to improve skin conditions.
Acne and Rosacea
750 mg of nicotinamide combined with zinc (25 mg), copper (1.5 mg), and folic acid (500 ug) was given to 198 subjects with inflammatory acne and/or rosacea. The investigators used a patient global evaluation where the study participants graded the improvement in their acne or rosacea. 79% of the participants reported significant improvement in skin appearance after 8 weeks of treatment. The investigators also studied how the nicotinamide/zinc combination compared to the use of antibiotics, and they did not see a difference between the nicotinamide/zinc combination tablet and the use of antibiotics. Although this was a relatively small study to make large comparisons, the results are promising enough to warrant more study in how nicotinamide/zinc combination pills may compare to antibiotics.
Dietary Sources of Nicotinamide
Nicotinamide levels in our body are maintained through vitamin B3 in the diet and by eating protein containing the amino acid tryptophan. Tryptophan can be converted to niacin in the liver, but this occurs at a low and inefficient rate. Nicotinamide may not only improve skin appearance, but a deficiency in nicotinamide and vitamin B3 actually leads to a life-threatening condition called pellagra, characterized by dermatitis, diarrhea, dementia, and eventually death in severe cases. However, pellagra is rarely found in developed countries. Vitamin B3 can be obtained efficiently as it exists naturally in a wide range of foods.
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