Niacinamide for Acne: Benefits, How to Use It, Side Effects and More

• Niacinamide is an essential nutrient that is a form of vitamin B3
• It can effectively treat both inflammatory and noninflammatory acne
• Niacinamide can also reduce the appearance of hyperpigmentation that accompanies acne scars
• This compound can be used either as a topical application or taken orally as a supplement

What Is Niacinamide?

Niacinamide, also known as nicotinamide, is a form of vitamin B3 that is naturally found in foods such as meat, milk, eggs and green vegetables. It can also be found as an oral supplement to prevent a vitamin deficiency, treat certain health conditions or deliver several skin-enhancing benefits. Niacinamide for acne has also been shown to achieve results due to several key qualities.

What Types of Acne Can Niacinamide Treat?

Acne develops when pores become blocked with sebum (oil), debris and dead skin cells which is referred to as comedonal or noninflammatory acne. This is characterized by the formation of whiteheads, blackheads and pimples.  

With the proliferation of Cutibacterium acnes (formerly Propionibacterium acnes), trapped within pores, acne worsens, becomes inflamed and degrades to painful lesions called papules and pustules.

Niacinamide has been shown to effectively treat mild-to-moderate noninflammatory and inflammatory acne as well as hormonal acne due to its exfoliating and antibacterial properties. 

It also offers other benefits for acne-prone skin. 

It’s difficult to identify exactly how niacinamide works against acne as there are few scientific studies on this topic. In addition, niacinamide is typically used alongside other treatments, which can make it difficult to firmly establish its value as an individual acne treatment.

Niacinamide for acne scars

Niacinamide can play a strong role in tamping down the inflammation that accompanies acne and by doing so, it acts as a preventative to postinflammatory hyperpigmentation (PIH) – the scar formation and pigmented dark spots left behind once an acne lesion heals. It can also fade existing pigmented areas of skin.

While niacinamide is not an established treatment for acne scarring, especially severe scarring, it has been shown to diminish their appearance by fading dark spots, and by boosting collagen production to plump and strengthen skin. 

Unlike some other compounds, niacinamide does not inhibit the production of melanin but instead inhibits the transfer of melanized melanosomes to surrounding keratinocytes. This results in pigmented spots slowly fading as new, fresh cells take their place.

In one small study of patients, researchers found niacinamide significantly decreased hyperpigmentation and increased skin lightness after 1 month of a topical application.

Niacinamide Benefits for Acne

Niacinamide has several beneficial qualities that make it a valuable addition to any acne-fighting skin care routine; studies show that it can produce a significant reduction in acne, although these effects are not well understood. Additional studies are needed as the mechanism of action is not yet known. 

Reduces bacteria

While niacinamide has not been proven to kill C. acnes bacteria, it can reduce the level of bacteria by protecting the skin barrier and inhibiting the proliferation of this bacteria. This contributes to less inflammation and reduces the incidence of breakouts.

Reduces sebum

The accumulation of sebum is seen as a major instigator of both comedonal and inflammatory acne. Niacinamide can both prevent and treat acne by regulating sebum production and reducing the risk of pores becoming blocked with oil, debris and bacteria.

Niacinamide has been proven to reduce oil production and enable skin to be moisturized at a balanced level. One study showed that niacinamide significantly lowered sebum levels after 2 and 4 weeks of topical application.

Soothes inflammation

Niacinamide has potent anti-inflammatory properties, which can reduce the redness and swelling that presents with acne. This anti-inflammatory activity also serves to decrease severity and lesion count of acne which in turn reduces the likelihood of PIH and pigmented spots from developing.    

Strengthens skin barrier

The skin barrier plays an essential role in providing protection from environmental hazards such as viruses, bacteria and fungi, as well as protecting from moisture loss. If this barrier is weakened or damaged, irritation and inflammation can occur.

Acne is linked to a skin barrier dysfunction; however this barrier can be restored with the topical application of niacinamide. It can stimulate ceramide synthesis to boost the level of ceramides within the skin, normalize moisture levels and strengthen the skin barrier.

It has also been proven to have an antioxidant effect and help repair damaged DNA.

These benefits are especially important for skin conditions such as acne as they can counteract the irritation and dryness that typically result from topical acne treatments.

Other skin care benefits

Niacinamide is a powerhouse when it comes to anti-aging and skin health. Some benefits include:

• Evens skin tone by targeting redness, sallowness and blotchiness
• Improves elasticity
• Protects against sun damage
• Reduces enlarged pores
• Smooths rough skin
• Softens the appearance of fine lines and wrinkles

How to Use Niacinamide for Acne

Niacinamide can be applied topically or taken orally, however there is a lack of large scale studies to establish safety and dosing for supplementation.

With this in mind, it is advised to consult with your care provider to determine what is best for you. This is especially important if you are taking other oral treatments for acne to avoid any adverse reactions. 

Topical application of a moisturizing serum or cream containing niacinamide has been established to be effective and safe for skin. You can easily incorporate either one into your current skin care routine. The general rule is to layer your products from thinnest to thickest: cleanser, toner, serum then moisturizer. 

This treatment can be applied every day but monitor for irritation if you have sensitive skin, and apply every other day if you experience any irritation.

Niacinamide combinations

For greater acne control, you can safely combine niacinamide with other agents. Use them separately to avoid irritation or potentially deleting the effects of an accompanying topical medication; for example, you can apply niacinamide during your morning routine and topical retinoids or benzoyl peroxide at night. 

The following compounds have been established as effective in treating acne:

• Benzoyl peroxide is first-line therapy for acne as it can kill acne-causing bacteria and clear blocked pores   
• Retinol exfoliates pores of debris, dead skin cells and oils; it can penetrate deep within the top layers of skin to boost collagen production and reduce the appearance of scars 
• Salicylic acid is a chemical exfoliant that can also deeply penetrate to clear pores; it is most effective against noninflammatory acne 
• Vitamin C is a powerful antioxidant that has been demonstrated to improve acne by reducing inflammation and hyperpigmentation, and improving the look of scars
• Zinc has proven anti-inflammatory and antibacterial effects to reduce acne breakouts  

Expected Results

There is a dearth of studies on niacinamide. Some studies conclude that this compound is effective when used alone; however most studies involve comparisons of combined treatments. 

What has been established is that this compound is effective in treating mild-to-moderate acne as a sole treatment but optional results can be achieved when paired with other acne-fighting agents. 

In one scientific literature review searching for results of niacinamide as an acne treatment, researchers found that all eight studies using nicotinamide as an oral or topical treatment significantly reduced acne compared to baseline.

How long does it take to work? 

As with any acne medication, it takes consistency and several weeks to see results. You may start to notice a difference in 2 weeks but it can take up to 12 weeks to see the full effects; every person responds differently and severity as well as other treatments need to be factored in.

Side Effects of Using Niacinamide on the Skin

Topical niacinamide is typically well tolerated for all skin types, especially dry skin as it helps retain moisture. That being said, associated side effects include mild itching, burning and redness.

When used as directed, supplemental niacinamide has not been shown to cause any side effects; however these supplements are not recommended for people with diabetes, or who have gallbladder disease.

Alternatives

If you can’t or don’t want to use niacinamide to treat your acne, you can simply choose to use any of the established agents as listed under niacinamide combinations.  

Takeaway

Niacinamide is an essential nutrient found in certain foods and is available as a topical or oral treatment for mild-to-moderate inflammatory and noninflammatory acne.

This compound treats acne by clearing pores of debris, reducing and controlling the level of bacteria that is present on skin, balancing sebum production and targeting inflammation. 

These actions work to reduce redness and irritation, control and reduce acne breakouts and lower the risk of scarring and hyperpigmentation.

Niacinamide also aids acne-prone skin by boosting collagen production and maintaining the integrity of the skin barrier.  

You can opt for oral supplementation or a topical application used alone or with other skin care products or acne topical treatments. Before doing so, see your care provider to determine if there are any contraindications.