Niacinamide: The All Star Acne Ingredient

Niacinamide: The All Star Acne Ingredient

Niacinamide: A Versatile Ingredient for Acne and Beyond

Niacinamide is a form of vitamin B3 and is considered a star in the skincare world. It is a true "multi-tasker,” as it tackles various skin concerns such as acne, compromised skin barrier, and hyperpigmentation.

Studies support Niacinamide’s role in promoting skin health. Here's a breakdown highlighting its role based on research:

  • Combating Acne:
    • Sebum Regulation: Studies show Niacinamide helps control sebum (oil) production, a key factor in acne development. [1] By regulating sebum, it can potentially reduce the occurrence of clogged pores and subsequent breakouts.
    • Anti-Inflammatory Properties: Research suggests Niacinamide possesses anti-inflammatory properties, potentially aiding in reducing the redness and inflammation associated with acne. [2]
  • Promoting Overall Skin Health:
    • Skin Barrier Function: Studies indicate Niacinamide strengthens the skin barrier, the outermost layer protecting against environmental aggressors and promoting healthy skin hydration. [3] This can improve overall skin texture and resilience.
    • Antioxidant Effects: Some research suggests Niacinamide might hold antioxidant properties, potentially helping combat free radical damage and contributing to a more youthful appearance. [4]
  • Improving Hyperpigmentation:
    • Niacinamide inhibits Tyrosinase, the most important enzyme in pigment formation and may inhibit melanin transfer, making it useful in treatment of acne marks (post-inflammatory hyperpigmentation) and melasma.

How Niacinamide Works and Its Impact on the Skin

What does Niacinamide do to the Skin?

1. Combating Acne:
  • Sebum Regulation: Research shows Niacinamide helps control sebum (oil) production, a major contributor to acne development. By regulating sebum, it can potentially reduce the occurrence of clogged pores and subsequent breakouts. [5,6]
    • Studies:
      • A clinical trial demonstrated that topical Niacinamide effectively reduced sebum production in patients with acne vulgaris. [5]
      • Another study highlighted the sebum-suppressive effects of Niacinamide in a separate group of acne patients. [6]
    • Possible Mechanisms:
      • Inhibiting Sebocyte Activity: Niacinamide might influence sebocytes, the skin cells responsible for sebum production. Studies suggest it can decrease sebum secretion by inhibiting their activity [5].
      • Improving Skin Barrier Function: A healthy skin barrier plays a role in regulating sebum levels. Niacinamide's well-established benefit of strengthening the skin barrier may indirectly contribute to sebum regulation [5].
      • Fatty Acid Metabolism: Some research suggests Niacinamide might influence the way sebum is synthesized by affecting fatty acid metabolism within sebocytes [5].
  • Anti-inflammatory Properties: Niacinamide possesses anti-inflammatory properties, potentially aiding in reducing the redness and inflammation associated with acne.
    • Studies:
      • A study compared a 5% topical niacinamide gel to a 2% Clindamycin solution (antibiotic) for acne vulgaris. The study found that Niacinamide significantly improved acne and achieved similar results to Clindamycin, with the benefit of causing less dryness and irritation [5].
      • A review of studies analyzed eight studies using topical Niacinamide for acne treatment. Six of the eight studies demonstrated significant acne reduction compared to baseline or showed similar effectiveness to standard acne treatments [6]. Reduced inflammation likely contributes to this improvement.
    • Possible Mechanisms
      • Downregulating Pro-inflammatory Mediators: Niacinamide may influence the production of certain molecules involved in the inflammatory cascade. Some studies suggest it can decrease the activity of enzymes like cyclooxygenase-2 (COX-2) and 5-lipoxygenase (5-LOX), which are involved in the production of inflammatory mediators like prostaglandins and leukotrienes [7, 8]. By downregulating these enzymes, Niacinamide could potentially dampen the inflammatory response.

      • Modulating Nuclear Factor Kappa B (NF-κB) Pathway: NF-κB is a key signaling pathway involved in many inflammatory processes. Some studies suggest Niacinamide might suppress the activation of NF-κB, thereby hindering the expression of pro-inflammatory genes [9].

      • Other effects
        • Less redness and swelling associated with acne.
        • A calmer, more soothed skin environment.
        • Niacinamide’s inflammatory effect independently reduces the risk of post-inflammatory hyperpigmentation (PIH) and post-inflammatory erythema (dark spots).

2. Promoting Skin Health

  • Strengthens Skin Barrier: Studies indicate that Niacinamide strengthens the skin barrier, the outermost layer protecting against environmental aggressors and promoting healthy skin hydration. [10] This can improve overall skin texture and resilience.
    • Possible Mechanisms
      • Increased Ceramide Production: Ceramides are crucial lipid molecules that form the backbone of the skin barrier. Studies like one by Elias et al. (2001) demonstrate that Niacinamide can stimulate the synthesis of ceramides in the skin, leading to a stronger and more resilient barrier [11].
      • Enhancing Keratinocyte Differentiation Markers: Keratinocyte differentiation is a multi-step process where immature cells mature into specialized cells that form the outermost layer of the skin (stratum corneum). Some studies suggest Niacinamide might increase the expression of specific proteins (differentiation markers) involved in this process [12, 13]. This could lead to the formation of a more mature and robust stratum corneum, which is the key component of the skin barrier.
      • Promoting Filaggrin Production: Filaggrin is a crucial protein involved in building a strong and healthy skin barrier. Studies suggest Niacinamide might promote the production of filaggrin by keratinocytes [14]. Filaggrin helps form the "bricks and mortar" structure of the skin barrier, further strengthening its defense against external stressors.

3. Promoting Uniform Skin Tone

  • Reduces Hyperpigmentation: Some research suggests Niacinamide may help fade dark spots and hyperpigmentation by inhibiting the transfer of melanin to the skin's surface.
    • Possible Mechanism
      • Inhibition of melanin production: Tyrosinase is crucial in melanin production and there could be indirect mechanisms by which Niacinamide influences its activity. Niacinamide might interfere with signaling pathways that stimulate tyrosinase activity [13]. Niacinamide's anti-inflammatory properties could create a less stimulating environment for melanocytes, potentially leading to lower tyrosinase activity [12].
      • Inhibition of melanin transfer: Melanin transfer from melanocytes to keratinocytes involves complex interactions between these cells. Niacinamide might disrupt these interactions, hindering the melanin transfer process [15] by influencing specific molecules or receptors on the cell surfaces. The cytoskeleton is a network of fibers within cells that plays a role in various cellular processes, including melanin transfer. Niacinamide might influence the organization of the cytoskeleton in keratinocytes, potentially affecting their ability to receive melanosomes [16], the cellular packets of melanin.
  • Reduces Red Acne Marks: Niacinamide's ability to improve post-inflammatory erythema (PIE), the redness that lingers after acne inflammation subsides, is attributed to 1) its ability to dampen inflammation, which is a major contributor to PIE and 2) its ability to constrict blood vessels and potentially reducing redness [17] of PIE lesions.

Here is a Table Summarizing Niacinamide Benefits:





Sebum Regulation

Excess Sebum Production

Reduces sebum production enzymes


Fewer clogged pores, reduced breakouts


Skin Inflammation


Downregulates inflammatory pathways

Calmer skin, reduced acne severity

Skin Barrier Strengthening

Compromised Skin Barrier

Increases ceramide synthesis


Stronger, more resilient barrier, improved moisture retention

Potential Hyperpigmentation Reduction Uneven Skin Tone Inhibits melanin transfer, reduces tyrosinase activity More even skin tone, potentially brighter complexion
Potential Reduction in red ace marks Uneven Skin Tone


Anti-inflammatory activity, constriction of superficial blood vessels

More even skin tone, less red acne marks


Other Skin Benefits of Niacinamide

Niacinamide’s Anti-Aging Property

Besides its potential to improve acne, Niacinamide may also provide anti-aging effects due to its potential to reduce fine lines and wrinkles. Possible mechanisms include:

  • Stimulating Collagen Production: Studies suggest it may increase collagen synthesis, a protein that provides structural support to the skin. [18] This can help maintain skin elasticity and potentially reduce the appearance of fine lines.
  • Antioxidant Properties: Free radicals contribute to skin aging by damaging cells. Niacinamide's antioxidant properties may help reduce free radical damage, potentially slowing down visible signs of aging.
  • Improving Skin Barrier Function: As mentioned earlier, a strong barrier helps retain moisture, leading to a plumper, more youthful appearance. [19]

Niacinamide’s Skin Protective Qualities

Our skin is constantly exposed to various stressors, including:

  • Ultraviolet (UV) radiation: A major contributor to premature aging, wrinkles, and hyperpigmentation.
  • Pollution: Airborne pollutants can damage skin cells and contribute to inflammation.
  • Free radicals: Unstable molecules generated by UV radiation and other environmental factors that can damage skin cells and accelerate the aging process.

Here is a closer look at Niacinamide's cytoprotective potential:

  • Indirect antioxidant activity: While research on niacinamide's direct antioxidant properties is ongoing, some studies suggest it may:
    • Enhance the skin's natural antioxidant defenses: Niacinamide may increase the production of glutathione, an antioxidant within skin cells. [20]
    • Reduce the production of free radicals: By inhibiting certain enzymes involved in free radical formation, niacinamide may help minimize their damaging effects. [4]
  • DNA Protection: Studies suggest niacinamide may offer some protective effects against UV-induced DNA damage in skin cells. [21]

Because of these, Niacinamide can be considered cytoprotective to some extent. It can help reduce markers of cell damage and may help create a more favorable environment for cell survival.

Niacinamide for Sensitive Skin

Niacinamide's soothing properties make it a valuable addition to skincare routines, particularly for those with sensitive and reactive skin conditions due to its anti-inflammatory and skin barrier repairing properties.

Benefits for Sensitive Skin:

  • Reduced Redness and Inflammation: By addressing the underlying inflammatory processes, Niacinamide can effectively calm irritated skin and minimize redness associated with conditions like rosacea and eczema.
  • Improved Tolerance: A stronger skin barrier, makes the skin less susceptible to irritation from active ingredients or environmental factors.
  • Overall Soothing Effect: Niacinamide's combined anti-inflammatory and barrier-strengthening properties contribute to a calmer, more comfortable, and predictable skin.

Why is Niacinamide Ideal for Sensitive Skin:

  • Gentle: Unlike some acne-fighting ingredients that can be harsh, Niacinamide is generally well-tolerated by most skin types, including sensitive skin. Several factors contribute to Niacinamide's generally good tolerability on the skin.
    • Chemical Structure: Niacinamide is a water-soluble vitamin B3 derivative with a relatively simple structure (Nicotinamide). This simple structure makes it less irritating to the skin compared to some other skincare ingredients. This simplicity also makes it less likely to be recognized by the skin immune system as a foreign invader.
    • pH: Niacinamide products are typically formulated at a slightly acidic pH (around 5.5-6.5), which is close to the natural pH of healthy skin.
    • Molecular Size: Niacinamide has a relatively small molecular size. This allows it to penetrate the outer layer of the skin (stratum corneum), but it's unlikely to penetrate deeply enough to reach the deeper layers where immune cells are more concentrated. This limited penetration can minimize its interaction with the immune system and reduce the risk of an allergic reaction
    • Low Allergenic Potential: Niacinamide is generally considered to have a low sensitization risk. The body is immunologically familiar to this naturally occurring nutrient making it less likely to elicit a strong immune response.
  • Soothing Properties: Some studies suggest Niacinamide may have mild soothing properties that could further enhance tolerability [3].
  • Multifaceted Approach: Note that sensitive skin does not tolerate over layering of active ingredients. Due to its ability to address many skin concerns, Niacinamide can offer a mild but effective approach for those with sensitive skin having multiple skin concerns.

In essence, Niacinamide's ability to soothe inflammation and strengthen the skin barrier makes it a valuable ingredient for managing sensitive skin conditions, including acne. Its gentle nature and multifaceted approach contribute to a calmer, more comfortable complexion.

Addressing Concerns: Niacinamide Side Effects

 Mild and Infrequent Side Effects:

  • Irritation: While uncommon, some individuals might experience mild irritation, especially when using high concentrations (above 10%) or introducing it for the first time. [22] This can manifest as redness, stinging, or burning.
  • Dryness: In rare cases, Niacinamide might cause temporary dryness, particularly for those with already dry skin. [23]

Factors Contributing to Side Effects:

  • Concentration: Higher concentrations are more likely to cause irritation, especially for sensitive skin.
  • Individual Sensitivity: Some people may be more susceptible to experiencing side effects than others.
  • Combination with other Ingredients: Using Niacinamide alongside certain harsh ingredients like potent acid exfoliants or high-percentage retinoids might increase the risk of irritation.

Niacinamide Allergy: Niacinamide is generally considered a well-tolerated skincare ingredient with a low incidence of allergy. However, allergies can occur in any individual, so it's important to be aware of the potential.

Low Allergic Potential:

  • Studies suggest Niacinamide has a low sensitization risk due to factors like its simple chemical structure and limited penetration into skin layers [24, 25].

Signs of a Niacinamide Allergy:

  • If you experience any of the following after using a product containing Niacinamide, discontinue use and consult a dermatologist: redness, rashes, itching, burning, hives, and swelling.

Can allergy to Nicotinamide, oral Vit B3, B12, and other B vitamins lead to allergic reaction to topical Niacinamide?

There are not extensive studies specifically investigating this link.

Factors Suggesting Low Likelihood:

  • Route of Exposure: Allergies typically arise from exposure to an allergen. Oral B vitamins like Niacin enter the bloodstream, whereas topical Niacinamide has limited penetration and may not reach deeper immune-rich skin layers [24].
  • Chemical Differences: Niacinamide is a derivative of vitamin B3 (niacin) with a slightly altered chemical structure. This variation could affect how the immune system recognizes the molecule, making cross reaction unlikely.

Rarity of Side Effects:

  • Studies suggest that Niacinamide-induced side effects are relatively uncommon, with a low incidence rate. [22, 23]

Tips for Minimizing Niacinamide Adverse Reactions:

Gradual Introduction:

  • Start Low: Begin with a low concentration of Niacinamide (ideally 2-5%). Higher concentrations (above 5%) are more likely to cause irritation, especially for sensitive skin.
  • Patch Testing: Before applying to your entire face, patch test an ample amount of your Niacinamide skincare on a small, non-sensitive area like the inner upper arm. Apply a small amount and monitor for 24-48 hours. Discontinue use if you experience any redness, stinging, or burning.
  • Introduce Gradually: Once you've patch tested with no issues, gradually incorporate Niacinamide into your routine. Start by using it thrice a week and increase frequency every 2 weeks or as tolerated.

Addressing Potential Dryness:

  • Moisturize: Niacinamide can cause temporary dryness, especially for those with already dry skin. Combat this by using a gentle, light weight, skin barrier repair moisturizer after applying niacinamide. Look for ingredients like hyaluronic acid which provides hydration and ceramides, fatty acids, and cholesterol which help repair the skin barrier. We suggest the Mission: Skin HydroLock Lite Moisturizer.

Combining with Other Ingredients:

  • Be mindful of strong ingredients: Avoid using Niacinamide alongside harsh exfoliants (e.g., AHAs like Glycoloc acid and Lactic acid) or high-percentage retinoids in the same routine. These combinations can further irritate the skin.
  • Introduce new products slowly: If incorporating other new skincare products, introduce them one at a time to isolate any potential reactions.

Addressing Existing Skin Conditions:

  • Consult a Dermatologist: If you have flare of pre-existing skin condition like seborrheic dermatitis, rosacea, or eczema, consult a dermatologist before using Niacinamide. They can advise on the suitability of incorporating it into your routine and recommend the appropriate concentration.

Patch Testing and Niacinamide: Minimizing Risk of Reactions

Patch testing is crucial before incorporating any new skincare product, including Niacinamide, especially for those with sensitive skin. Here is a breakdown of its importance and the best method:

Importance of Patch Testing:

  • Identifying Potential Irritants: Patch testing allows your skin to show any adverse reactions to a product in a controlled setting.
  • Minimizing Risk: By testing a small amount on a non-sensitive area, you can avoid applying the product to your entire face that can potentially lead to a widespread irritation.
  • Personalized Approach: Everyone's skin reacts differently, and patch testing helps you understand how your individual skin tolerates a new product.

Best Method for Patch Testing Niacinamide:

  1. Cleanse: Wash a small area of your inner arm with a gentle cleanser and pat it dry.
  2. Apply Product: Apply a small amount of the Niacinamide product directly to the chosen area.
  3. Leave Uncovered: Allow the product to air dry completely. Do not apply any bandage or occlusive dressing.
  4. Monitor for 24 to 48 Hours: Observe the area closely for any signs of reaction, such as redness, itching, burning, or stinging.
  5. Positive vs. Negative Result: If you experience no reaction within 24 to 48 hours, it is generally considered safe to proceed with using the product on your face. Discontinue use if you experience any adverse reactions.

Additional Tips:

  • Repeat Patch Test: If unsure about a mild reaction, consider re-patch testing the product on a different day to confirm. You can continue the process up to 2 weeks.
  • Consult a Dermatologist: If you have any concerns or pre-existing skin conditions, consult a dermatologist before using Niacinamide and for guidance on patch testing.

Remember: Patch testing is a valuable tool for ensuring safe introduction of new skincare products. By following these guidelines and consulting a dermatologist if needed, you can minimize the risk of adverse reactions to Niacinamide and enjoy its potential benefits.


    Incorporating Niacinamide into Your Skincare Routine

    Here is a table summarizing the our recommendations when starting Niacinamide:


    Ideal Niacinamide Concentration



    Sensitive Skin


    Combining with other Actives

    Start with 2%, introduce other actives gradually with time separation

    Experienced Users (with no prior irritation)

    May consider higher concentrations (up to 10%) but with caution


    If unsure, always start with a water-based Niacinamide serum. These are usually well tolerated and non-comedogenic. We suggest a gel based Niacinamide serum such as the Etherius Niacinacor Serum.

    Remember the following when using Niacinamide with other skincare products:

    • Separate Application: Avoid applying other actives directly with Niacinamide. Apply them in your routine with some time separation.
    • Here's a possible routine example:
      • Morning: Apply your cleanser, followed by a Niacinamide serum, moisturizer, and sunscreen.
      • Night: Apply your cleanser, followed by retinol and moisturizer.

    Common Skincare Ingredients that can be Combined with Niacinamide:

    • Niacinamide and Hyaluronic acid: Compatible, can even offer additional hydration benefits when used together. We suggest the Etherius Hyalurane Hyaluronic Acid Serum.
    • Niacinamide and Vitamin C: Generally well-tolerated when used at different times in the routine (e.g., Vit C in the morning, Niacinamide at night). We suggest the Etherius Ascor Vitamin C Serum.
    • Niacinamide and Salicylic acid: Use with caution. Consider applying them on separate days. Or wait 30 minutes in between application if used in the same routine. We suggest the Mission: Skin Acnoregulin Spray or the AcnoKlair AcnoTone Solution.
    • Niacinamide and Retinol: Use with caution, especially for beginners. Consider applying them on separate nights. Or wait 15 to 30 minutes in between application if used in the same routine. We suggest the Mission: Skin Retinol 1% Defender Cream.

    Note that Niacinamide helps repair the skin barrier and this usually allows a robust foundation of robust skin barrier cells that are able to support combination therapy.

    Active Monitoring During Combination Therapy:

    • Pay close attention to your skin's condition after introducing Niacinamide and other active ingredient combination.
    • Look for any signs of irritation that might develop, including: redness, rashes, stinging, burning, dryness, and itchiness.
    • Monitor your skin closely for at least the first two weeks. New products can sometimes take time to show potential reactions, even beyond the initial two weeks, be mindful of any new developments in your skin's condition.

    Adjusting Usage:

    • If you experience any persistent or severe irritation, discontinue use immediately and consult a dermatologist.
    • If you experience mild irritation, you may reduce the frequency of application until your skin adjusts.
    • Once your skin tolerates the initial concentration, gradually increase the frequency of application back to your desired routine.

    Our Skincare Solutions

    Know more about the star ingredient that is taking the skincare world by storm. Deep dive into the science behind Niacinamide and discover how the Etherius Niacinacor Niacinamide Serum can augment your current skincare routine.

    Get ahead in the anti-acne race with Niacimide and know exactly how to use it to your advantage with the guidance of Dr. Mike and the DMD Team!

    Start your journey to a clearer and healthier skin and book a quick email consultation now!



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