Niacinamide is a form of vitamin B3 that can treat pellagra, boost skin health, smooth out wrinkles, and prevent skin cancer. But how much is it too much? Keep reading to find out how to safely use this vitamin.

What is Niacinamide?

A Variation of Vitamin B3

Vitamin B3, also known as niacin, consists of two forms: niacinamide (or nicotinamide) and nicotinic acid. Although both molecules compose vitamin B3, they affect your body in different ways [1].

This article will only cover niacinamide.

How It Works

Niacinamide is needed to make NAD+/NADH and NADP+/NADPH, which slow aging and support cell repair, immune function, and energy use in the body [2, 3].

Food Sources

Niacinamide is a water-soluble vitamin that can be found in animal products (such as meat and poultry) and raw cereals (not processed), but it is also available as a supplement [4].

Main food sources of niacinamide [4]:

Food sourceNiacinamide content (mg/100 gr)
Brewer’s yeast120
Red meat100
Peanuts100
Chicken70
Fish50
Coffee50
Barley20
Wheat15
Beans, rice, potatoes10
Fruits4-8
Vegetables2-4

Your body can also make niacinamide from the essential amino acid tryptophan, but it takes 60 mg of tryptophan to produce only 1 mg of niacinamide [1].

Relevance for Health

A vitamin B3 deficiency can lead to pellagra, which can cause 4 “Ds”: diarrhea, dermatitis, dementia, and death. Niacinamide is the preferred option for treating pellagra as it does not cause skin flushing, a common adverse effect of niacin [5, 6].

Niacinamide can also boost skin health and reduce skin inflammation. It helps with acne and rosacea, prevents skin aging, and protects from skin cancer and UV damage [7, 2, 8].

The benefits of niacinamide are not limited to the skin. This vitamin also lowers high phosphate levels and delays the progression of type 1 diabetes. Lastly, it may help relieve anxiety and improve joint health in people with arthritis [9, 10, 11, 12, 13].

Snapshot

Here is an overview of the health benefits and risks of niacinamide [7, 14, 8, 9, 10, 11, 13]

PROs

  • Fights skin inflammation, acne, rosacea, and psoriasis
  • Reduces dark spots (skin hyperpigmentation)
  • Delays skin aging
  • May prevent skin cancer
  • May prevent the worsening of diabetes
  • Lowers high phosphate levels
  • May protect the brain
  • May improve arthritis

CONs

  • Mild skin adverse effects (itching)
  • Mild oral adverse effects (nausea)
  • May lower platelets

Niacinamide Benefits

1) Fights Skin Inflammation & Acne

Niacinamide helps with a range of skin conditions. Based on cellular studies, it might soothe irritated and inflamed skin by lowering inflammatory compounds (including NF-kB, IL-1, IL-6, TNF-a, and IL-12) [6, 15].

Additionally, niacinamide can block the growth of fungi (Candida albicans, Trichophyton rubrum, and Trichophyton mentagrophytes) causing skin yeast infections [16].

Acne

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 people [17, 18, 19].

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 [20, 21, 22, 23, 24].

In a clinical study on 28 people with dry skin, niacinamide cream decreased water loss and increased hydration in the outer skin layer (stratum corneum) better than white petrolatum [20, 21, 22, 23, 24].

In other clinical studies with over 210 people with mild or moderate acne, niacinamide gel improved acne and decreased acne lesions as effectively as the antibiotic clindamycin [25, 26, 27, 7].

Oral niacinamide combined with zinc, copper, azelaic acid, pyridoxine, and folic acid also 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 [28, 29].

However, in clinical trials conducted on a total of 185 people with acne, adding niacinamide to clindamycin had no effect or was only slightly better than clindamycin alone [30, 31, 32].

Topical niacinamide improves acne by moisturizing the skin and reducing excess sebum. However, it is less effective in combination with the antibiotic clindamycin.

Rosacea

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 [33, 34].

Psoriasis

Topical niacinamide together with a synthetic form of vitamin D (calcipotriol) improved psoriasis in 50% of the cases in a clinical study on 66 people, compared to a 19% response with placebo [35].

2) Improves Dark Skin Patches

Melanocytes, cells that produce the skin pigment melanin, work in the deep layers of the skin. They store melanin in so-called melanosomes to transfer it to the outer skin cells (keratinocytes), which gives skin its color. Melanin build-up in the skin causes dark spots or patches (hyperpigmentation) [36].

In cell studies, niacinamide blocked the transfer of melanosomes to the outer skin layer, which may explain its skin-lightening effect [36, 37, 38, 39, 40].

Two clinical studies support the use of niacinamide for skin lightening. In over 160 people with dark patches on the face, topical niacinamide reduced skin pigmentation, inflammation, and premature aging [41, 40].

In two other studies, researchers tested niacinamide in combination with other skin-lightening substances. It’s hard to tease apart its contribution.

In the first study, 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 [42, 43].

In the second study, topical niacinamide with vitamin C and ultrasound radiation decreased skin coloring after 4 weeks in 60 people with hyperpigmentation [44].

All in all, topical niacinamide improves the appearance of dark skin patches – both alone and in combination with other nutraceuticals like vitamin C.

3) Delays Skin Aging

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) [45, 46, 47].

Plus, it may delay skin aging by restoring DNA damage and lowering oxidative stress [48, 49].

In clinical studies with over 130 women, topical niacinamide decreased wrinkles and fine lines, skin redness, and yellowing (sallowness) while improving skin elasticity [50, 51, 52].

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. This combination also improved skin clarity, evenness, radiance, and smoothness [53, 54, 55, 56].

Topical niacinamide helps reduce wrinkles and fine lines, giving skin a more youthful look.

4) May Prevent Skin Cancer

Nonmelanoma skin cancer is caused by 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 [57, 58].

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 after 12 months. It also decreased the rate of new squamous-cell carcinomas by 30% and actinic keratoses by 13% compared to placebo [59, 60].

In another clinical study of 74 people with skin cancer, oral niacinamide decreased actinic keratoses compared to placebo [61].

In both 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 [62, 63, 58, 64, 65, 66, 67, 68, 69].

Oral niacinamide may help prevent skin damage and cancer caused by excessive UV exposure.

5) Reduces High Phosphate Levels

In rats, niacinamide reduced the activity of a transporter that carries sodium and phosphorus from the gut into the bloodstream, thus lowering phosphorus blood levels [70, 71].

This is particularly helpful for people with chronic kidney disease, whose phosphate levels are very high [72].

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 [73, 74, 75, 76, 77, 78, 79, 72].

Oral niacinamide is beneficial for people with kidney disease since it lowers blood phosphate levels.

6) May Prevent Diabetes Progression

In people with type 1 diabetes, insulin-producing beta cells in the pancreas get destroyed. Low insulin, high blood sugar, and low C-peptide often point to type 1 diabetes [80, 81].

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 [82, 13, 83, 84, 85].

In rats, niacinamide prevented diabetes by reducing beta-cell destruction, lowering oxidative stress, improving immune function, and maintaining normal insulin and glucose levels [86, 87, 88].

However, oral niacinamide failed to prevent diabetes in clinical studies of over 600 people at a high risk of type 1 diabetes [89, 90].

Lastly, niacinamide also improved C-peptide and blood sugar levels in another small study of 18 people with type 2 diabetes [91].

Oral niacinamide likely helps delay the progression of type 1 diabetes, but it can’t prevent it.

7) May Protect the Brain

Niacinamide may lower oxidative stress in the brain and reverse damage to blood vessels and nerve cells [92, 93, 94].

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 [95, 96, 97, 98].

In a clinical study on 30 people with schizophrenia, vitamin B3 (niacin and niacinamide) successfully treated 80% of the patients after one year, compared to only 33% in the placebo group [99, 100].

Oral niacinamide also reduced anxiety in 3 people [101].

Oral niacinamide may protect the brain from Alzheimer’s and improve mood disorders, but the evidence is limited.

8) May Help with Osteoarthritis

Niacinamide blocks the inflammatory compound IL-1, which contributes to osteoarthritis [102, 103].

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 [11].

9) May Improve Cancer Survival

In clinical studies with 446 people with cancer of the larynx and 333 people with bladder cancer, radiotherapy combined with niacinamide and carbogen improved survival rates and decreased cancer recurrence [104, 105, 106].

Since carbogen itself makes tumors more sensitive to radiotherapy, it’s unclear if niacinamide contributed to the effect [107].

Niacinamide Side Effects & Safety

Topical

Topical niacinamide is considered to be safe and non-toxic up to a concentration of 4-5% [108, 53, 50].

Common, mild side effects include [41, 53]:

  • Skin redness
  • Itching
  • Dryness
  • Flaking

Oral

Oral niacinamide is safe at doses up to 1.75 g daily. Mild adverse effects include [76, 72]:

  • Nausea
  • Cramps
  • Diarrhea
  • Vomiting
  • Watery stools

Oral niacinamide can also cause a low platelet count (thrombocytopenia), which can lead to excessive bleeding and prevent wounds from healing properly [77, 79].

Toxicity

Doses higher than 3 g/day should be avoided, as niacinamide can be toxic to the liver [109, 110].

Very high doses (2 g/kg) in rats caused insulin resistance and may increase the risk of diabetes type 2. High doses also caused liver damage, tumors, and stunted growth in animals [111, 109].

Niacinamide Supplements & Creams

Dosage & How to Use

Topical Use

A topical gel or cream containing 4% or 5% niacinamide applied on the skin twice a day for up to 8 weeks reduces acne, hyperpigmentation, and skin aging [26, 25, 41].

Oral Use

  • 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 [7].
  • Pellagra: 300-500 mg niacinamide daily [112].
  • Skin cancer prevention: 500 mg niacinamide tablets once or twice daily [61, 59].
  • Diabetes: 25-50 mg/kg niacinamide tablets or capsules daily for delaying the progression of type 1 diabetes [13].
  • Reducing high phosphate levels: 500 mg up to 1.75 gr daily niacinamide capsules for 8-24 weeks in people with kidney disease [79].
  • Osteoarthritis: 3 g of niacinamide daily for up to 12 weeks [11].

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Takeaway

Niacinamide is a form of vitamin B3 that supports cell repair, immune function, and energy use in the body.

Taken orally, it supports skin health, slows the progression of diabetes, and may have benefits for mental health. Unlike regular vitamin B3, niacinamide doesn’t cause flushing. Avoid high doses, as they may damage the liver.

The most popular and well-researched use of niacin is for skin health. Niacinamide is formulated into serums, creams, and gels that improve acne, skin inflammation, dark spots, and wrinkles. If you want to give your skin a more healthy and youthful look, go for high-quality products that contain up to 5% niacinamide.

About the Author

Anastasia Naoum, MS (health informatics)

MS (Health Informatics)

Anastasia holds an MSc in Health Informatics from the Sheffield University, an MSc in Health Economics from the Erasmus University of Rotterdam and a BSc in Economics from the University of Macedonia.

Anastasia grew up in a medical environment, as both her parents are doctors and developed from a young age a passion for medicine and health. She has worked in several institutions and associations which promoted healthy living and sustainable healthcare systems. Currently, she is leading a green life, sailing with her boyfriend across Europe, living in their sailboat with the help of solar and wind power, minimizing CO2 production.

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