The track record of topical vitamins in skin rejuvenation has been mixed at best. Most seem to be ineffective. A few, such as vitamins A and C, do provide some benefits if properly stabilized and applied in sufficient concentrations. It appears that another vitamin, niacinamide, should be added to this select group.
Niacinamide is one of the two principal forms of vitamin B3 (nicotinic acid is the other). Niacinamide serves as a precursor of NADH and NADPH, which are co-enzymes (facilitators of enzymatic reactions) essential for numerous metabolic pathways. In particular, these co-enzymes play a key role in metabolism of glucose, cellular energy production, synthesis of lipids and so forth. The levels of NADH / NADPH decrease with age, and topical niacinamide appears to reverse the decline. Niacinamide also appears to have some antioxidant and anti-inflammatory properties. Furthermore, niacinamide is stable, safe and well tolerated in topical formulations even at relatively high concentrations. All of the above suggests that niacinamide, theoretically, may be useful in skin rejuvenation and some skin conditions. However, if theory always translated into practice, we would already be running our cars on cold fusion rather than gasoline. Fortunately, some research supporting practical uses of topical niacinamide is already available.
In a randomized controlled study, 4% niacinamide gel has been compared to 1% clindamycin gel (a topical antibiotic) in 76 patients with moderate acne. After 8 weeks, 82% of patients treated with niacinamide and 68% of those treated with clindamycin were considered improved. There were no side effects in either group. The researches suggested that anti-inflammatory activity of niacinamide may have contributed to its effect on acne.
The main downside of antibiotics is the emergence of resistant microorganisms. If further research confirms that niacinamide is at least as effective as topical antibiotics, it may become a treatment of choice for many acne sufferers because it does not gives rise to microbial resistance.
Rosacea is a condition associated with excessive skin redness, irritability, sensitivity and inflammation. In one study, niacinamide was shown to improve skin barrier function in rosacea patients, leading to diminished reaction to irritants, such as detergents. In another study, treatment with 1-methylnicotinamide (metabolite of niacinamide with known anti-inflammatory effects) resulted in improvement in 26 out of 34 treated subjects. Further research is clearly indicated.
Unfortunately, the research of the niacinamide's potential for skin rejuvenation is in relatively early stages. However, the few existing studies produced promising results. One study showed niacinamide to increase the skin's production of ceramides (natural emollients and skin protectants), thus improving skin hydration. Another study demonstrated mitigating effects of niacinamide on some of the deleterious effects of UV light.
Of particular interest, is a well designed (double-blind, placebo-controlled, split-face, left-right randomized) 12-week study in 50 women of the effects of 5% topical niacinamide on various signs of skin aging. The researchers reported significant improvement in fine lines/wrinkles, hyperpigmentation spots, texture and red blotchiness. (While well designed, the study was sponsored by Proctor and Gamble, so a potential for bias cannot be ruled out.)
On theoretical grounds, niacinamide has a substantial promise as a versatile skin care and rejuvenation agent. The evidence of practical benefits seems to be accumulating but more research is needed for definitive conclusions. However, considering its well-researched biochemistry, stability and good safety profile, topical niacinamide may be worth a try even before more studies have been completed.
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