How to Use Niacinamide to Treat Acne
You’ve probably heard about niacinamide online or on the social feeds of your favorite skinfluencers. It’s trending, as the kids say. And if you’re not already using a product with niacinamide, you might want to change that. The wonder ingredient is popping up more and more in skincare formulas and getting a lot of love for all it can do for your complexion, especially when it comes to acne. Is it right for you? Julie Harper, M.D., past president of the American Acne and Rosacea Society and an Acne Store advisory board member offers this primer to help you sort things out.
What is niacinamide?
Niacinamide, a.k.a. nicotinamide, might sound like a fancy lab-made ingredient, but it’s actually just a form of vitamin B3 that’s gotten a reputation as a pimple whisperer. “When it comes to acne ingredients, salicylic acid is probably the most common, but, boy, niacinamide is knocking at its door,” says Harper
Doctors love it because there’s a lot of data behind its effectiveness. “If you look at the medical literature, you’ll see some pretty good studies with niacinamide, both in treating acne and rosacea,” says Harper. In fact, a 2017 research review found that in six of eight studies looking at niacinamide used topically, the ingredient “led to a significant reduction in acne compared with the patient’s baseline or performed similarly to another standard-of-care acne treatment,” Harper explains. 
Why does niacinamide help with acne?
Niacinamide works in a few different ways to help support an overall acne treatment regimen. First, says Harper, “It’s anti-inflammatory, and I think that's probably what it does best. Research also suggests it has antimicrobial properties  and there’s also evidence to suggest niacinamide helps keep the skin barrier intact.  That’s key, says Harper, because the barrier essentially acts as “the skin’s own early immune system, protecting us from foreign invaders. It's just super important that the barrier be in good shape so it can fend off acne.”
How to incorporate niacinamide into your acne routine
You want to put this wonder ingredient all over the face preventatively rather than here and there as a spot treatment. That’s true of all acne fighting ingredients, but Harper says it’s especially important with niacinamide because, “it's not directly cleaning out the pore the way a salicylic acid or retinol product is.” Instead, it’s targeting inflammation, one of the very first things that happens in the chain that causes acne. “Treating the whole affected area is important because we don't know where next month's acne is going to pop up,” she adds.
“When it comes to acne ingredients, salicylic acid is probably the most common, but, boy, niacinamide is knocking at its door.”
Who should add niacinamide to their routine?
Everyone can, says Harper. “I can't think of a reason not to use it. No matter what topical products you're on, it's not going to cause peeling—there are no negatives.”
In fact, it could potentially help soothe cranky skin with its anti-inflammatory effects and barrier-boosting powers, which makes it a natural buddy ingredient for potentially harsher topicals like retinol. “You could expect the niacinamide to help with the burden of the potential irritation and dryness that you see with retinoids,” she says.
And there’s no wrong way to incorporate it. “That's one of the lovely things about niacinamide. You can use it in the morning, you can use it at night, you can use it twice a day, and you can use it in combination with your other products without irritation,” says Harper. As for the formula to choose: “I’d probably just pick one that you like the texture of and dive in.”
Julie Harper, M.D.
Dr. Julie Harper is a member of the Acne Store Board of Dermatologists and the owner of The Dermatology and Skin Care Center of Birmingham in Birmingham AL. She also served on the faculty at the University of Alabama- Birmingham as an Assistant Professor of Dermatology and was promoted to Associate Professor during her time there. She is a founding director of the American Acne and Rosacea Society and is the society’s immediate past president. She has served on the American Academy of Dermatology’s task force assigned to develop guidelines for the management of acne, which were published in 2016. Dr. Harper is also a former president of the Alabama Dermatologic Society. She has written and spoken on the subjects of acne and rosacea extensively.
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