Niacinamide: what it does and what it doesn't

Key takeaways

• In a well-known study, 5 percent niacinamide reduced hyperpigmentation and increased skin lightness compared with a plain cream after about four weeks of use.
• It works mainly by blocking the transfer of pigment packets (melanosomes) from pigment cells to skin cells, not by stopping pigment being made.
• A small 2011 randomised trial found 4 percent niacinamide performed comparably to 4 percent hydroquinone for melasma, with less irritation, but evidence overall is limited.
• Low to moderate strengths, around 2 to 5 percent, are enough for most people. Very high strengths irritate some skin without clear extra benefit.
• It is well tolerated, can be used morning or night, and pairs with most other ingredients.

What is niacinamide?

Niacinamide, also called nicotinamide, is a form of vitamin B3. In the body, it helps cells make energy and repair themselves. On the skin, it is a stable, water-soluble ingredient that most people tolerate well, which is why it is in so many serums, moisturisers and sunscreens now.

See, what happens is, because it is gentle, it has been marketed for everything: pores, acne, oil, glow, ageing, dark circles. Some of that has evidence, some is borrowed hope.

What does niacinamide actually do for pigmentation?

This is where the evidence is clearest. Pigment cells in the skin make melanin and package it into tiny sacs called melanosomes, which they hand over to the surrounding skin cells. A study by Hakozaki and colleagues in the British Journal of Dermatology showed that niacinamide inhibited this transfer by 35 to 68 percent in a laboratory model. It did not stop the pigment cells making melanin. It stopped the handover.

In the same paper, people with hyperpigmentation who used a 5 percent niacinamide moisturiser had significantly less hyperpigmentation and lighter-looking skin compared with a plain moisturiser, with changes noticed after about four weeks. A second group using 2 percent niacinamide with sunscreen also improved on facial tanning.

A small double-blind randomised trial published in 2011 found that 4 percent niacinamide gave results comparable to 4 percent hydroquinone for melasma, with less redness and dryness, and that it also helped when combined with peels, lasers and microneedling. That is encouraging, but it is based on limited trials. Normally, I use niacinamide as part of a pigmentation plan, alongside sunscreen and other creams, not as the whole plan.

What about oil, acne and the barrier?

• Oily skin. Many people with oily skin like how a niacinamide serum feels, and some studies suggest it can reduce oiliness. The evidence is smaller than for pigmentation.
• Acne. It has anti-inflammatory effects and is sometimes used alongside acne treatment, especially for people who cannot tolerate stronger options. It is not strong enough for moderate or severe acne on its own.
• Barrier. Niacinamide is described as barrier-supportive, and some research suggests it helps the skin make ceramides, the fats that hold the barrier together. It fits well in routines for dry or sensitive skin.
• Ageing. It may help with tone and texture over time, but the evidence is weaker than for retinoids and sunscreen.

What strength should I use?

Basically, the 10 percent and higher serums sell well because bigger numbers look stronger. In my experience, people with sensitive skin often do better on a moisturiser or sunscreen with a lower strength than on a high-strength serum.

How do I use it?

• Morning or night. It suits both.
• Apply after cleansing, before moisturiser. If it is already in your moisturiser or sunscreen, you may not need a separate serum.
• Pairing. It sits comfortably with sunscreen, retinoids, vitamin C and azelaic acid for most people. If you are sensitive, introduce one product at a time.
• Give it time. Pigment changes take at least four to eight weeks, often longer. Sunscreen every day makes the difference between a result and no result.

What niacinamide does not do

• It does not cure melasma. Melasma needs strict sun protection and often specific prescription creams. See treating melasma safely in Indian skin.
• It does not close pores. Pores cannot be closed. It may help them look less prominent if oil reduces. See open pores.
• It does not replace acne treatment. For active acne that leaves marks, you need proper treatment early.
• It does not change your natural skin colour.
• It does not undo sun damage without sunscreen. That is very important to understand. Pigment keeps coming back if the skin keeps seeing sun.

Can niacinamide irritate the skin?

It is one of the gentler actives, but not everyone tolerates it. Some people get redness, itching or a stinging feeling, especially with high-strength serums or when layering many products. If that happens, drop to a lower strength or use it every other day. If your skin stings with almost everything, the problem may be a damaged barrier, and I would start with the routine in sensitive skin.

How we approach this at Dr Tvacha

I often include niacinamide for patients with uneven tone, dark marks after pimples or oily skin, because it is gentle and easy to keep using. At a Rs 499 skin consultation I find out what is causing the pigmentation or oiliness and build a routine around it, with generic ingredient names. If treatments such as peels or laser therapy would help, they are planned and quoted in writing first. The approach is on the Second Layer Skin Plan page, and how it fits a basic routine is in the only skincare routine most people need.

Written by

Dr Amit KarkhanisAesthetic Physician · MBBS, Dip. Dermatology (UK) · Reg. No. 2001/02/1124

Founder of Dr Tvacha, practising in Thane since 2005. Leads the weight loss and hair programmes.