- Vitamin B3
- Nicotinic acid amide
- Nicotinic amide
- Vitamin PP
For Patients & Caregivers
How It Works
In high-risk individuals, nicotinamide supplementation had protective effects against certain types of skin lesions and nonmelanoma skin cancers.
Nicotinamide is a water-soluble form of vitamin B3 or niacin. It is made in the body by eating niacin-rich foods such as fish, poultry, nuts, legumes, eggs, and cereal grains. Nicotinamide supplements are used to treat skin conditions and niacin deficiencies.
Recent studies suggest nicotinamide may protect against some forms of skin lesions in patients with sun-damaged skin. Additional studies are needed to confirm safety and effectiveness across different types of skin cancer and in different people. In addition, the protective effects of nicotinamide against UV exposure does not mean that it protects against sunburn.
To prevent skin cancer
A large study found that taking nicotinamide can reduce the risk of getting certain types of skin cancers. A few small studies suggest it may also reduce the occurrence of rough scaly patches. Additional long-term studies are needed.
To treat acne and other skin conditions
Nicotinamide is used as a medicine for treating skin conditions such as acne and rosacea.
Do Not Take If
- You are taking anticonvulsants such as carbamazepine: Nicotinamide may increase the blood levels and risk of side effects of this drug.
- You have low platelets: A meta-analysis suggests that using nicotinamide may increase the risk for low platelets, so patients should consult with their healthcare provider.
- Although nicotinamide appears to protect against ultraviolet (UV) light exposure, it is not a substitute for sunscreen and does not protect against sunburn.
- Even though niacin can become nicotinamide in the body, their effects and side effects when used as supplements are different and not interchangeable.
For Healthcare Professionals
Nicotinamide, also known as niacinamide, is a water-soluble amide form of niacin or vitamin B3. It is found in foods such as fish, poultry, eggs, and cereal grains. It is also marketed as a dietary supplement, and as a non-flushing form of niacin.
Nicotinamide has established medical uses to treat conditions stemming from niacin deficiency such as pellagra. Oral and topical formulations are used to treat a variety of inflammatory skin conditions including acne vulgaris and rosacea (1) (2).
An animal study suggests nicotinamide supplementation can help prevent glaucoma by preserving mitochondrial function (3). Other preclinical models demonstrate photoimmunoprotective and chemopreventive effects against UV radiation (4). Nicotinamide enhances repair of UV radiation-induced DNA damage in human melanocytes (5) and keratinocytes (6) and similar effects have been demonstrated in human studies (4) (7) (8). Other clinical trials show oral nicotinamide reduces UV-induced (9) and photodynamic therapy (PDT)-induced (10) immunosuppression.
In patients with sun-damaged skin, oral nicotinamide helped prevent the occurrence of nonaggressive skin cancers (11). In a small trial among renal transplant patients however, similar effects were not significant (12). Other studies found a reduction in actinic keratoses, a predictor of melanoma risk (13) (21). Additional studies are warranted (14).
Nicotinamide appears to be largely well tolerated in clinical studies (11) (12) (13). Even though niacin is converted into nicotinamide in the body (1), these two supplements should not be viewed as interchangeable as they have different side effect profiles (11) (15).
Mechanism of Action
Nicotinamide is chemically part of the coenzymes nicotinamide adenine dinucleotide NAD+ and NADH (1), used in oxidation-reduction reactions in the body. Among these activities is the production of adenosine triphosphate (ATP) (11), which fuels cellular metabolic activities.
Photoimmunoprotective effects of oral or topical nicotinamide are linked to its support for DNA repair by preventing post-UV exposure declines in cellular energy or the repletion of energy to irradiated cells (4) (13). Its influence on several pathways contribute to this enhanced repair of UV-induced DNA damage (16). Skin cancer chemoprevention is attributed in part to reductions in inflammatory macrophages (22). In UV-irradiated keratinocytes, nicotinamide reduced expression of IL-6, IL-10, MCP-1 and TNF-alpha mRNA, cytokine mediators whose activity may be involved in inflammation, cellular-tissue injury, cell death, and skin cancer (17). In human melanocytes, nicotinamide increased the global nucleotide excision repair rate and number of irradiated melanocytes undergoing DNA repair (5).
Effects of topical nicotinamide on inflammatory skin conditions are attributed to its sebosuppressive and anti-inflammatory properties (1).
Although niacin and nicotinamide are considered similar in their role as vitamins, their pharmacologic indications, effects, and side effects are different. Niacin has high affinity to a G-protein-coupled receptor HM74A in human cells resulting in the releasing of prostaglandins that cause vasodilation or flushing of the skin. It also lowers cholesterol (11) (18) .
Nicotinamide appears to be largely well tolerated (11) (12) (13). However nausea, vomiting, and other gastrointestinal symptoms, as well as headache, fatigue, dizziness (9) and liver toxicity (19) have been associated with high oral doses.
Increased risk for thrombocytopenia has also been noted in a meta-analysis of RCTs in hemodialysis patients with the use of nicotinamide (23).