Rosacea is not an easy condition to live with. The unpredictable flushing, uncomfortable dryness, and frustrating sensitivity of the skin would make anyone desperate to find a cure.
While there is no treatment that can permanently correct rosacea, there are many chemicals that can help decrease flare-ups. One that is gaining popularity is a cosmeceutical ingredient called niacinamide. With its high safety profile, economic accessibility, and ease of use, it has earned a place in many a rosacea patient’s routine.
What is niacinamide?
Niacinamide, also known as nicotinamide and nicotinic acid amide, is none other than Vitamin B3. Specifically, it is the form of Vitamin B3 that is actively used by the body for various processes--the most basic of which is cellular metabolism. Each and every cell in our body requires NAD(H) and NADP(H) to use and harness energy. In fact, the “n” in the acronym stands for nicotinamide. Without these molecules, cells will not be able to function normally. These also have antioxidative properties that help repair damage to cells.
The entire body benefits from this vitamin, but let’s take a closer look at what it does for the skin. Studies suggest that niacinamide plays an important role in maintaining the skin barrier through upregulating production of ceramides and collagen. Ceramides are lipids that prevent transepidermal water loss, helping keep the skin soft and supple. Meanwhile, collagen is a structural protein that provides for elasticity and tensile strength.
In addition, niacinamide has potent immunomodulatory properties. It inhibits the production of cytokines, the chemical messengers that trigger inflammation. In fact, niacinamide has been used to successfully treat inflammatory dermatoses, including bullous pemphigoid and acne.
How does niacinamide help rosacea patients?
The skin of rosacea patients is much more sensitive than those of people who do not suffer from the condition. Flare-ups are triggered by anything from sunlight to windburn, spicy food to alcohol, cosmetics to strong emotions. The skin reacts disproportionately to the perceived threat, becoming red, blotchy, rough, and swollen. Unfortunately, angry skin is not great at protecting itself from further irritation--and so the cycle continues.
Niacinamide throws a wrench into this process by making the skin more resilient against threats. It does this by improving the structure of the epidermis to prevent moisture loss, improve tensile strength and suppleness. With niacinamide, the cells that much up the layers of the skin have the building blocks to produce NAD(H) and NADP(H), allowing them to do their jobs optimally. It also helps to modulate the overactive immune response associated with rosacea.
Topical use
With niacinamide’s many mechanisms of action for improving skin condition and texture, many products have begun to incorporate this vitamin into their formulas. Serums, moisturizers, foundations, creams--you name it.
However, if it is used as a supportive treatment for rosacea, you should pay attention to the concentration. Using a moisturizer containing 2% niacinamide was shown to decrease blotchiness, flakiness, and bumps in rosacea patients after 4 weeks of use. Other studies that focus on this vitamin’s effect on other skin conditions like acne, wrinkles, and pigmentation use products that have up to 5% niacinamide.
Discuss with your dermatologist what product they would recommend for your condition. Always be sure to spot check before applying on your whole face to see how your skin will react to it. Many rosacea patients love niacinamide and most skin types will tolerate it well, but each body is different. It’s better to err on the side of caution and check first, especially if you have sensitive, rosacea-prone skin.
Oral use
Initial studies on oral niacinamide for rosacea show promise, though it's not a complete fix and there is still much research needed to find out exactly how it works. Likely, its effect may have something to do with the vitamin’s ability to inhibit the chemical triggers for vasodilation, provide energy for cellular repair, and modulate inflammation--this translates to decreased likelihood of flare-ups and improved ability of the skin to regenerate after irritation.
This content is for general information only and is not a substitute for medical advice.
References:
Draelos, Z. D., Ertel, K., & Berge, C. (2005). Niacinamide-containing facial moisturizer improves skin barrier and benefits subjects with rosacea. Cutis, 76(2), 135–141.
Fivenson D. P. (2006). The mechanisms of action of nicotinamide and zinc in inflammatory skin disease. Cutis, 77(1 Suppl), 5–10.
Levin, J., & Momin, S. B. (2010). How much do we really know about our favorite cosmeceutical ingredients?. The Journal of clinical and aesthetic dermatology, 3(2), 22–41.
Matts, Paul & Oblong, John & Bissett, D.L.. (2002). A Review of the range of effects of niacinamide in human skin. Int Fed Soc Cosmet Chem Mag. 5. 285-289.
Niren N. M. (2006). Pharmacologic doses of nicotinamide in the treatment of inflammatory skin conditions: a review. Cutis, 77(1 Suppl), 11–16.
https://dermnetnz.org/topics/nicotinamide
https://dermnetnz.org/topics/rosacea
