Niacinamide

We evaluated 71 human studies on Niacinamide, including 25 randomised controlled trials and 3 meta-analyses or systematic reviews; the controlled studies include 2,588 participants in total. As of 16 October 2026.

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1. What Is Niacinamide? Occurrence, Origin and Forms

Niacinamide is the amide form of vitamin B3 (niacin) and belongs to the water-soluble vitamins. It occurs in animal and plant foods and is also formed in the body from the amino acid tryptophan. It is used as a vitamin supplement and as an ingredient in skin care products.

Niacinamide is found in meat, fish, milk, eggs, legumes and cereals. In skin care it is applied topically to the skin.

For supplements and skin care, niacinamide is produced industrially; in foods it occurs naturally. In human studies, mainly oral forms (tablets, capsules) and topical preparations (cream, gel, serum) are examined.

Forms and Preparations Studied

• Oral form (tablets, capsules, powder)
• Topical preparation (cream, gel, serum, lotion)
• Fortified foods and beverages
• Injection solution
• Combination products with other B vitamins

Not covered on this page:

• Nicotinic acid (niacin) – a different form of vitamin B3 with its own properties
• Nicotinamide riboside and nicotinamide mononucleotide (NMN) – separate substances studied as NAD+ precursors
• NAD+ itself and infusions of it
• Tryptophan – an amino acid from which the body can form niacinamide

2. What Does Niacinamide Do? Results by Area

How to read the table: counted are human studies whose results concern the area. “High” means at least one meta-analysis and two controlled studies showing improvement, or at least three controlled studies of which three quarters show improvement, with at least 300 participants in total. “Moderate” means at least two controlled studies showing improvement, as a majority, or one meta-analysis alongside controlled studies. “Low” means one controlled study showing improvement. Where an area has no controlled study, the strength of evidence is at most “low” (result “reviews only” or “observational data only”). Everything else is “unclear”. A study counts as showing improvement when at least half of its outcomes in this area improved. Reviews of combination products do not count as meta-analyses; results that only describe side effects or shares of users do not count as an effect. The same study is counted only once.

3. What the Studies Show in Detail

Niacinamide and Skin (Acne, Pigmentation, Skin Barrier): Human Studies

In acne, a systematic review, based on a single randomized trial, found lower sebum production with topical nicotinamide 1. For dark discolorations of the armpits, a systematic review counts topical niacinamide among the effective agents 2. A systematic review of natural active substances counts niacinamide, alongside azelaic acid, soy, arbutin, licorice and others, among the agents with a lightening effect in hyperpigmentation 5. In women with aged skin, a niacinamide formulation in a placebo-controlled trial improved stratum corneum moisture, water loss and sebum content; ultrasound alone brought no measurable improvement 13. In mild atopic dermatitis, niacinamide-containing body lotions, partly with cleansing gel, improved SCORAD, itching, quality of life and skin barrier more than in the control group; all received ebastine 8. In discoid lupus erythematosus, the skin lesions in a placebo-controlled trial responded better to 4% nicotinamide than to 2%, with more irritation 15. Against skin redness triggered by retinol, 3% niacinamide did not help in a placebo-controlled patch test 21. In acne, niacinamide as an addition to benzoyl peroxide lowered the non-inflammatory lesions more than benzoyl peroxide alone, but not the inflammatory ones 22. Investigated were predominantly topical preparations such as cream, gel and serum; the evidence is moderate, because the controlled trials are small, short and turned out mixed.

Further studies in this area: 21 22 26 27 28 29 30 31 32 33 34 37 39 40 41 42 43 45 46 47 48 49 50 51 52 53 55 56 57 58 59 60 61

Niacinamide, Kidney and Dialysis: Human Studies

In adults on hemodialysis, orally taken nicotinamide as an addition to phosphate binders lowered the serum phosphate level more than placebo; in the analysis of all randomized participants, the difference was similar but not confirmed 19. This is the only controlled study in this area; it was double-blind, randomized and of crossover design, included 26 evaluable participants and lasted only a short time, so the evidence is weak 19. In an observational study of Chinese adults, the blood level of niacinamide was among several metabolic markers that predicted newly occurring chronic kidney disease; intake was not investigated 24. A review on polycystic kidney disease classifies the benefit of niacinamide, like that of curcumin or vitamin E, as uncertain and advises against such supplements 54. Thus, the efficacy and safety of oral administration in dialysis patients over longer periods remain open.

Niacinamide, Skin Cancer and Precursor Lesions: Human Studies

For skin cancer and its precursors, the evidence is unclear. A randomized controlled trial in 26 patients with actinic keratosis lesions compared a topical niacinamide gel with topical fluorouracil and found fewer treatment complications such as burning, itching and erythema with niacinamide, while fluorouracil was superior in improvement according to photography and dermatoscopy as well as from the patient's perspective 18. Review articles report that non-melanoma skin cancer occurred less frequently with oral nicotinamide 51, describe topical preparations for actinic keratosis 53 and consider vitamin B3 promising for the prevention of non-melanoma skin cancer 57. The studies differ greatly in form, dose, duration and comparator, and the controlled evidence relies on a very small sample.

Niacinamide, Joints and Inflammation: Human Studies

For joints, only one randomized trial is available: in knee osteoarthritis, a hyaluronic acid preparation with niacinamide was compared with another hyaluronic acid preparation; only stiffness improved more 11. A case series with intra-articular hyaluronic acid injections plus niacinamide reported pain reduction, among others in meniscal damage, without a relationship to the radiological or MRI severity 44. Since niacinamide was given in both investigations only as a component of a mixture with hyaluronic acid, no effect can be attributed to niacinamide alone. The overall strength of evidence is unclear: there is no meta-analysis, and the only controlled study is small and limited to one injection form. For oral or topical niacinamide forms for joint complaints, controlled studies in this area are lacking.

Niacinamide and Niacin Deficiency (Pellagra): Human Studies

For pellagra, only one review article is available; it describes the treatment of pellagra with vitamin B3 as an early, historically documented benefit 58. Since the review treats nicotinic acid and nicotinamide together as niacin, the finding cannot be attributed to nicotinamide alone 58. Controlled studies on the treatment of pellagra with niacinamide were not found in this evaluation; the strength of evidence is therefore unclear. It remains open which form, dose and duration are effective for the treatment of pellagra.

Niacinamide, Blood Sugar and Diabetes: Human Studies

For blood sugar and diabetes, no controlled trial on niacinamide is available; the strength of evidence is unclear. An observational study (cross-sectional) in Chinese adults found that diabetics with higher plasma levels of niacin had hyperlipidemia, hypercholesterolemia and hypertriglyceridemia less frequently 25. Blood levels of nicotinamide and nicotinic acid were measured, not an intake; the association also held for nicotinamide alone 25. Since it is a cross-sectional observation, no cause-and-effect relationship can be derived from it. It remains open whether oral or topical niacinamide administration influences blood sugar or diabetic metabolic consequences.

Niacinamide: Further Outcomes in Studies

In this area, mainly observations and individual controlled studies on oral nicotinamide were examined, not on topical application. A randomized controlled trial in adults on hemodialysis found no difference in platelet count with oral administration as an addition to phosphate binders 19. A single-arm study in glaucoma patients reported better vision-related quality of life after oral niacinamide, without a control group 23. Observational studies found no increased risk of serious cardiovascular events with oral nicotinamide 38 and less frequent heart attacks 35. The studies are small, uncontrolled or only observational; the overall strength of evidence is unclear.

4. How Is Niacinamide Dosed? Preparation, Dose and Duration in Studies

The studies predominantly used topical preparations such as cream, gel and serum, as well as oral forms as tablets or capsules and an injection solution into the knee joint. Many topical investigations tested niacinamide as a component of a mixture with other active substances such as salicylic acid, tranexamic acid or hyaluronic acid. The doses and durations of use are shown in the table.

5. Is Niacinamide Safe? Side Effects in Studies

In the studies, niacinamide was predominantly well tolerated, with minor local side effects 15; burning, itching and redness occurred less often than with fluorouracil 18. With oral administration to dialysis patients, there were individual discontinuations due to side effects 19. A review warns against a possible cardiovascular risk from breakdown products at high oral doses 51; large observational studies found no increased risk of serious cardiovascular events 3538. A higher topical concentration was associated with more irritation 15.

6. What Remains Open: Limits of the Evidence

• Many skin studies are small and short, and niacinamide was often tested only as part of a mixture.
• For kidney, joints, blood sugar and pellagra, robust controlled studies are lacking.
• Findings on topical use cannot be transferred to oral forms and vice versa.
• Little is known about the long-term safety of oral administration in dialysis patients.
• Whether niacinamide prevents skin cancer cannot be assessed from the available studies; for the treatment of actinic keratosis there is only one small comparative study.

7. Bottom Line: What Is Established About Niacinamide

Niacinamide is the amide form of vitamin B3 and is used both orally and topically.

On the skin, niacinamide-containing preparations improved the skin barrier in small controlled studies 813, but did not alleviate redness triggered by retinol 21. In other areas, the evidence is weak. In hemodialysis, oral nicotinamide in addition to phosphate binders lowered the serum phosphate level more than placebo; in the analysis of all randomized participants, the difference was not confirmed 19. For joints, blood sugar and precancerous skin lesions, the available studies are insufficient for an assessment 1118; for pellagra, only a review is available 58. Tolerability was predominantly good in the studies, with local irritation as the most common side effect 15.