The role of nicotinamide in acne treatment

Abstract

Safe and effective treatment options for acne vulgaris are needed to address side effects and increasing rates of antibiotic resistance from current treatments. Nicotinamide is a vitamin with potent anti-inflammatory properties that could offer a potential treatment option. We aim to summarize the relevant literature on the role of nicotinamide in acne vulgaris and discuss the next steps necessary to move this approach into clinical practice. We searched PubMed for clinical studies using nicotinamide for treatment of acne vulgaris. We summarized the 10 studies that met our search criteria. Six of eight studies using topical nicotinamide led to a significant reduction in acne compared with the patient's baseline or performed similarly to another standard-of-care acne treatment. Both studies using an oral supplement containing nicotinamide resulted in a significant reduction in acne compared with baseline. No major adverse side effects were noted. Our review suggests that topical and oral nicotinamide has an unclear effect on acne vulgaris due to the limited nature of the available literature. Additional studies are needed comparing nicotinamide to other first-line acne treatments and evaluating the efficacy and side effect profile of nicotinamide over an extended period of time.

An integrated RNA‐Seq and network study reveals the effect of nicotinamide on adrenal androgen synthesis

“…The androgenic character makes human adrenal NCI‐H295R cells a good model to study androgen biosynthesis as they produce more androgen in a starvation state . NAM plays roles in the treatment of acne vulgaris and the development of diabetes but its effects on androgen production is unknown . Using this ideal cell model, we found that NAM not only inhibits cell viability but also reduces testosterone production in starved NCI‐H295R cells at high doses.…”

“…12 NAM plays roles in the treatment of acne vulgaris and the development of diabetes but its effects on androgen production is unknown. 5,13,14 Using this ideal cell model, we found that NAM not only inhibits cell viability but also reduces testosterone production in starved NCI-H295R cells at high doses. The reduced cell viability might affect the total testosterone production, although the androgen synthetic ability of adrenal cells was also reduced.…”

“…It is used to treat a variety of skin conditions in addition to acne vulgaris including melasma and atopic dermatitis . NAM is used in various forms such as gel, emulsion and oral tablets (e.g., oral Nicomide, oral NicAzel) . The treatment dosage for an adult varies from 20 mg/d to 3.5 g/d (0.2–350 mmol/L), depending on the severity of the condition being treated.…”

“…4 NAM is used in various forms such as gel, emulsion and oral tablets (e.g., oral Nicomide, oral NicAzel). 5 The treatment dosage for an adult varies from 20 mg/d to 3.5 g/d (0.2-350 mmol/L), 3 depending on the severity of the condition being treated. Although current studies suggest that topical or oral use of NAM has a low incidence of side effects and a wide therapeutic index, there are no studies on the effect of oral NAM on acne vulgaris as a single-agent and these variable pharmacological doses require more research.…”

Topical niacinamide does not stimulate hair growth based on the existing body of evidence

“…The authors were specific to call out that Nam is not considered to be a hair growth promoter. Although the authors reported data that 0.1% Nam treatment had a statistically significant increase in hair thickness and density when compared to baseline, it is difficult to conclude that 0.1% Nam actually had a relevant effect on hair biology properties for the following reasons: (1) the lack of a placebo control renders the conclusions non-relevant that Nam can stimulate hair growth because it is well known that a placebo treatment can have a directionally positive effect on hair growth [3]; (2) 0.1% Nam is an order of magnitude lower in concentration than what is typically tested in dermatology-related studies [4,5]. Minoxidil, one of the only two FDA-approved hair growth molecules, needs to be applied at 2-5% to attain efficacy.…”