Niacinamide is a form of vitamin B3 that can treat pellagra, boost skin health, help with diabetes, and more. Topical formulations are used for acne, eczema, psoriasis, and other skin conditions. But how much is too much? Keep reading to learn the benefits, dosage, and potential side effects of niacinamide.
This article will only cover niacinamide.
- Fights skin inflammation, acne, rosacea, and psoriasis
- Reduces dark spots and skin aging
- May prevent skin cancer
- May help with diabetes
- Lowers high phosphate levels
- May improve arthritis
- Mild skin adverse effects (itching)
- Mild oral adverse effects (nausea)
- May lower blood platelets
Niacinamide is a water-soluble vitamin that can be found in animal products (such as meat and poultry) and non-processed cereals; it is also available as a supplement .
Best food sources of niacinamide :
|Food source||Niacinamide content (mg/100 gr)|
|Beans, rice, potatoes||10|
Symptoms of a mild niacin deficiency include :
- Canker sores
Severe niacin deficiency causes pellagra, which manifests with dermatitis, diarrhea, and dementia (known as the “three Ds”) .
Niacinamide (300-500 mg daily) can resolve the symptoms within one week. It’s FDA-approved for the prevention and treatment of pellagra and preferred over nicotinic acid because it doesn’t dilate the blood vessels and cause face flushing [7, 8].
One of the causes of acne is excess sebum production, which makes skin oily. Topical niacinamide lowered skin oil production in 50 Japanese people and decreased skin sebum levels in 50 Caucasian (white) people [9, 10, 11].
On the other hand, some people with acne struggle with dry, damaged skin. Topical niacinamide increases beneficial skin lipids called ceramides. In turn, it strengthens the skin barrier, moisturizes the skin, and reduces water loss [12, 13, 14, 15, 16].
In a clinical study of 28 people with dry skin, niacinamide cream decreased water loss and increased hydration in the outer skin layer (stratum corneum) better than white petrolatum [12, 13, 14, 15, 16].
Oral niacinamide combined with zinc, copper, azelaic acid, pyridoxine, and folic acid reduced acne severity and improved overall skin appearance in a clinical study on 235 people. The same product improved both acne and rosacea in another clinical study on 198 people [21, 22].
A topical gel containing niacinamide reduced skin peeling, redness, lesions, and irritation while increasing hydration and the skin barrier health in clinical studies of over 75 people with rosacea [26, 27].
In 48 patients with facial seborrheic dermatitis, niacinamide 4% cream (once daily for 3 months) reduced the symptoms such as redness and scaling by 75%, compared to a 35% reduction with a placebo cream .
Niacinamide 2% cream (twice daily for 2 months) reduced skin water loss and improved skin hydration in 28 patients with atopic dermatitis .
Two clinical studies support the use of topical niacinamide for skin lightening. In over 160 people with dark patches on the face, it reduced skin pigmentation, inflammation, and premature aging [33, 34].
A serum containing 5% niacinamide and tranexamic acid (a synthetic derivative of the amino acid lysine) improved skin tone evenness and texture in clinical studies with over 97 women with hyperpigmentation (dark skin spots) [35, 36].
Niacinamide stimulates the production of collagen and protective proteins (keratin, filaggrin, and involucrin), which give structure and elasticity to the skin. It may help smooth out wrinkles and prevent premature skin aging from UV rays (photoaging) [42, 43, 44].
In four trials of over 300 women, topical creams with niacinamide and other herbs and vitamins (retinol, resveratrol, safflower, vitamin E, kinetin, and others) reduced the appearance of wrinkles and fine lines and improved skin complexion [50, 51, 52, 53].
Nonmelanoma skin cancer is usually caused by excessive UV radiation, which can damage the DNA in skin cells and reduce their immune function. The most aggressive forms include squamous cell carcinoma and actinic keratoses [54, 55].
In a clinical study of 386 people at a high risk of skin cancer, oral niacinamide reduced the rate of nonmelanoma skin cancer by 23% compared to placebo. More precisely, it lowered the rate of new squamous-cell carcinomas by 30% and actinic keratoses by 13% .
In another clinical study of 74 people with skin cancer, oral niacinamide decreased actinic keratoses compared to placebo .
In human cells and mice, topical and oral niacinamide enhanced DNA repair and prevented UV-triggered immune suppression. It also reduced the growth, spread, and survival of melanoma cancer cells [58, 59, 55, 60, 61, 62, 63, 64, 65].
In clinical studies with more than 450 adults and 60 children with kidney disease, oral niacinamide decreased high blood phosphate and increased the “good” HDL cholesterol without changing calcium levels [67, 68, 69, 70, 71, 72, 73, 66].
In clinical studies with over 343 adults and 300 children with type 1 diabetes, adding niacinamide to insulin therapy maintained normal C-peptide levels. It preserved the function of beta cells and helped delay disease progression [78, 79, 80, 81, 82].
Niacinamide improved C-peptide and blood sugar levels in a small trial of 18 people with type 2 diabetes .
In a clinical study on 72 people with osteoarthritis, niacinamide improved joint movement, lowered inflammation, and decreased the use of anti-inflammatory drugs compared to placebo .
Further research is warranted.
No valid clinical evidence supports the use of niacinamide for any of the conditions in this section. Below is a summary of up-to-date animal studies, cell-based research, or low-quality clinical trials which should spark further investigation. However, you shouldn’t interpret them as supportive of any health benefit.
In rats, niacinamide reduced brain damage and improved recovery after stroke. In mice, it decreased the expression of a gene linked to Alzheimer’s disease (PSER1), while restoring cognition and improving memory [94, 95, 96, 97].
- Skin redness
Oral niacinamide is safe at doses that don’t exceed the safe upper limit. In adults, this limit is 35 mg daily. Most short-term studies used doses above the upper limit and reported no safety issues. Possible mild adverse effects include [70, 66, 102]:
- Watery stools
Very high doses (2 g/kg) in rats caused and may increase the risk of diabetes type 2. High doses also caused liver damage, tumors, and stunted growth in animals .
The below doses may not apply to you personally. If your doctor suggests using niacinamide, work with them to find the optimal dosage according to your health condition and other factors.
- Acne: Nicomide tablets (750 mg of niacinamide, zinc 25 mg, copper 1.5 mg, folic acid 500 mcg) once, twice or 3 times a day. Another option is NicAzel tablets (nicotinamide 600 mg, azelaic acid 5 mg, zinc 10 mg, pyridoxine 5 mg, copper 1.5 mg, and folic acid 500 mcg) up to 4 tablets daily .
- Pellagra: 300-500 mg niacinamide daily .
- Skin cancer prevention: 500 mg niacinamide tablets once or twice daily [57, 56].
- Diabetes: 25-50 mg/kg niacinamide tablets or capsules daily for delaying the progression of type 1 diabetes .
- Reducing high phosphate levels: 500 mg up to 1.75 gr daily niacinamide capsules for 8-24 weeks in people with kidney disease .
- Osteoarthritis: 3 g of niacinamide daily for up to 12 weeks .
Niacinamide (nicotinamide) is a form of vitamin B3 that supports cell repair, immune function, and energy use in the body. Taken orally, it can support skin health, slows the progression of diabetes, and reduce high phosphate levels.
Skin conditions that may benefit from topical niacinamide include acne, eczema, psoriasis, rosacea, and seborrheic dermatitis. Creams and gels with up to 5% of niacinamide can also reduce dark skin spots and the signs of aging.
Unlike regular vitamin B3, niacinamide doesn’t cause flushing. Both oral and topical forms are safe and well-tolerated. Avoid extreme doses of over 2 grams, as they may damage the liver.