Article

An Investigation of Efficacy of Topical Niacinamide for the Treatment of Mild and Moderate Acne Vulgaris

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Abstract

Objective: Niacinamide is a newly-approved anti-acne drug with a potent anti-inflammatory ef-fect. In this study, safety and efficacy of topical 4% niacinamide gel in mild and moderate acne vulgaris was investigated. Methods: Forty-one patients aged 18-25 (mean: 21.6±2.52) with mild and moderate acne vulgaris seen in dermatology outpatient clinic were enrolled in the study. All patients were treated with nia-cinamide 4% topical gel (Vivatinell Acnecinamide Gel) for eight weeks. Results: 38 patients among 41 were able to complete the treatment. Decrease in the number of pustules comedones and papules were statistically significant at the end of the treatment com-pared to onset of treatment (p<0.05). Few side effects such as pruritus (n=1) and mild burning (n=3) were observed in very small percentage of patients. Conclusions: Findings of this study indicate that 4% niacinamide containing gel is effective and safe in alleviating symptoms of mild to moderate acne, with earlier improvement in pustules.

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... The positive control group was included to support validation of the clinical study and to provide a reference point for estimates of effect size. The regimen in this group consisted of a cosmetic moisturizing cream with niacinamide, which has been reported as efficacious in subjects with blemish-prone skin [14,16] and a cosmetic cleanser containing 2% salicylic acid for exfoliation. At 1 h, 3 h and 1 week, a significant difference in change from baseline in corneometer values was observed for the comparison between the positive control group and the control group, in favour of the positive control group. ...
... Similarly, significant reductions in the blemish count at Week 4 and Week 8 were seen within the positive control group but there were no significant differences between this group and the control group. Previous studies have demonstrated a significant reduction in total blemish count (comedones, papules and pustules) at 8 and 12 weeks with twice-daily use of Acnecinamideâ Gel Cream [14,16], but these studies did not include a control arm. In the present study, blemish appearance was evaluated as being similar for the positive control group and the control group; this finding may benefit from further investigation. ...
Article
Objective: A randomised study was designed to evaluate the potential cosmetic benefit of a biomimetic, niacinamide-containing moisturising cream in oily, blemish-prone skin. Methods: Healthy adult women with oily, blemish-prone skin were randomised to one of three treatment groups: test, control, or positive control. In the test group, subjects used the test product (containing 4% niacinamide), plus the standard cleanser (Simple® Kind to Skin Moisturizing Facial Wash). In the control group, subjects received no moisturiser but used the standard cleanser. In the positive control group, subjects used Vivatinell Acnecinamide® Gel Cream (containing 4% niacinamide) as a moisturiser and Neutrogena Visibly Clear® Spot Clearing Facial Wash (containing 2% salicylic acid) as a cleanser. The positive control regimen was included to provide a comparison for estimates of effect size. The primary objective was to evaluate skin moisturisation as a change from baseline in corneometer values at 8 hours for the test regimen versus the control regimen. Analysis of covariance was applied for the primary efficacy analysis. Results: A total of 132 subjects were randomised with 44 included in each treatment group. A significant difference was observed in the primary endpoint for the test regimen compared with the control regimen (least squares mean difference [95% CI]: 3.12 [0.68, 5.56], p=0.0128). A trend was observed in favour of the positive control regimen compared with the control regimen. Secondary measurements of moisturisation supported the primary efficacy outcome. Assessment of blemishes showed a significant difference between the test regimen versus the control regimen for change from baseline in mean total blemish count at Week 8 (least squares mean difference [95% CI]: -1.80 [-3.41, -0.19], p=0.0290). No statistical comparisons between the positive control group and the test group were performed. Conclusion: This study provides proof-of-concept evidence that a novel lamellar lipid moisturiser containing niacinamide, in combination with a standard cleanser, can help moisturise the skin and provide an overall improvement in the complexion appearance of people with blemish-prone skin. Study registration: NCT03093181.
... The volunteers applied the functional cosmetics including niacinamide and G. glabra root extract. Niacinamide has a strong anti-inflammatory effect for acne which is a [17,18]. Among the symptoms, damaged stratum corneum barrier function caused by UV light exposure increased vascularity related to vasoactive amine and inflammation by melasma -all of which are involved with redness [17][18][19]. ...
... Niacinamide has a strong anti-inflammatory effect for acne which is a [17,18]. Among the symptoms, damaged stratum corneum barrier function caused by UV light exposure increased vascularity related to vasoactive amine and inflammation by melasma -all of which are involved with redness [17][18][19]. It also decreases redness by altering of vascular characteristics in melasma [5] or by improving of stratum corneum barrier function and hydration in rosacea [2,5,19]. ...
Article
Melasma has several well-recognized etiologic factors, but most researches focus on melanogenesis. The purpose of this study is to show improvement of melasma by reducing vascularity distinguished from melanogenesis. We examined 20 Korean women with both melasma and solar lentigo that were visually assessed by a dermatologist. The volunteers applied functional cosmetics for 8 weeks. We analyzed the results obtained using the chromameter, evaluating the skin color of three areas (melasma lesions, solar lentigo lesions, and non-lesional skin) on the face of volunteer. There was a statistically significant improvement in the brightness and redness of melasma lesions compared to those of non-lesional skin after 8 weeks. Also, we observed that the improvements in the brightness of melasma lesions and solar lentigo lesions were similar. However, the redness of melasma lesions improved more than that of solar lentigo lesions with statistical significance after 8 weeks. In this study, we have shown that brightness and redness in melasma lesions can be improved by functional cosmetics. Thus, we suggest redness to be an additional suitable parameter for the evaluation of melasma lesions.
... 57,58 Niacinamide is currently used in many different cosmetic formulations including treatments for melasma, 59 hyperpigmentation, 8 rosacea, 60 wrinkles, 61 and acne vulgaris. 62 In a study of 50 female subjects with clinical signs of fine lines, wrinkles, poor texture, and hyperpigmented spots, 5% niacinamide was applied to half of the face while a vehicle control was applied to the other half twice daily for 12 weeks. Overall, this study showed that 5% niacinamide had a significant effect on improving facial elasticity and decreasing wrinkles. ...
Article
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Background Due to the periorbital region’s high susceptibility to damage from external factors, along with its tendency to demonstrate early signs of aging, periorbital skin is a common target for antiaging therapy. Objective This review aims to evaluate the efficacy of active ingredients commonly found in eye creams, particularly focusing on their impact on periorbital skin concerns. Methods A comprehensive review of the literature on active ingredients in eye creams, including retinoids, vitamins C and E, peptides, ceramides, hyaluronic acid, caffeine, and niacinamide, was conducted. Clinical studies assessing the efficacy of these ingredients in addressing periorbital concerns were examined. Results Studies demonstrate the potential of these ingredients to improve various aspects of periorbital skin, including hydration, elasticity, collagen synthesis, and reduction of inflammatory mediators. Ingredients such as retinoids, vitamin C, and caffeine show promise in addressing wrinkles and hyperpigmentation, while peptides and hyaluronic acid aid in collagen production and hydration. Niacinamide and ceramides offer benefits in reducing wrinkles and enhancing the skin barrier function. Limitations The lack of clinical trials specifically targeting eye cream formulations and periorbital skin is a notable limitation. Furthermore, the variability in study designs, sample sizes, and concentrations of active ingredients across studies complicates direct comparisons. Conclusion The reviewed studies highlight the potential of active ingredients in eye creams to address various periorbital concerns. Further research, particularly large-scale clinical trials focusing on eye cream formulations and their efficacy on periorbital skin, is warranted to establish their significance and comparability with other dermatologic products.
... En este periodo, un paciente de 38 años experimentó prurito, mientras que tres participantes tuvieron ardor leve. 7 Es importante destacar que los efectos secundarios de la niacinamida son considerablemente más seguros en comparación con los antibióticos, y su uso no genera patógenos resistentes a estos medicamentos. ...
Article
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Niacinamide, the amide form of vitamin b3, precursor of numerous metabolic reactions, especially the production of atp, is a component widely used in cosmetic dermatology, due to its versatility and safety profile in skin care. Some of its effects are a decrease in inflammation and pigmentation, sun protection and improvement in the skin’s protective barrier. Here we will review the evidence supporting the use of niacinamide for various dermatological indications, including acne, atopic dermatitis, rosacea, melasma, photoaging and photocarcinogenesis.
... In this sense, it has been suggested that repeated applications of AzA preparations could maintain the follicular concentration of AzA at biologically active levels [17]. On the other hand, Nic is a newly approved anti-acne drug with a potent anti-inflammatory effect, that is extremely well-tolerated by facial skin [18]. However, Nic suffers from poor skin retention and permeation (~1% after 72 h) [19] because of its high aqueous solubility and low partition coefficient [20]. ...
Article
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Combined therapies emerge as an interesting tool to overcome limitations of traditional pharmacological treatments (efficiency, side effects). Among other materials, metal-organic frameworks (MOFs) offer versatilities for the accommodation of multiple and complementary active pharmaceutical ingredients (APIs): accessible large porosity, availability of functionalization sites, and biocompatibility. Here, we propose topical patches based on water-stable and biosafe Fe carboxylate MOFs (MIL-100 and MIL-127), the biopolymer polyvinyl alcohol (PVA) and two co-encapsulated drugs used in skin disorders (azelaic acid (AzA) as antibiotic, and nicotinamide (Nic) as anti-inflammatory), in order to develop an advanced cutaneous combined therapy. Exceptional MOF drug contents were reached (total amount 77.4 and 48.1 wt.% for MIL-100 and MIL-127, respectively), while an almost complete release of both drugs was achieved after 24 h, adapted to cutaneous delivery. The prepared cutaneous PVA-MOF formulations are safe and maintain the high drug-loading capacity (total drug content of 38.8 and 24.2 wt.% for MIL-100 and MIL-127, respectively), while allowing a controlled delivery of their cargoes, permeating through the skin to the active target sites. The total amount of drug retained or diffused through the skin is within the range (Nic), or even better (AzA) than commercial formulations. The presented results make these drug combined formulations promising candidates for new cutaneous devices for skin treatment.
... Combination therapy is expected to improve adherence to acne therapy. 18 In a report of results on a multicentric study in Spain evaluating treatment adherence of patients with mild-to-moderate AV, Kircik et al 19 recommended adjuvant therapy be given to improve treatment adherence. In a review conducted by Chee Leok Goh et al, 20 combinations of adapalene, nicotinamide, and zinc components examined in some previous in-vivo studies decreased sebum production activity. ...
Article
OBJECTIVE: We investigated the efficacy and tolerability of nicotinamide cream plus an antibacterial adhesive agent and zinc-pyrrolidone carboxylic acid compared to placebo in patients with moderate acne vulgaris (MAV) in Indonesia. METHODS: This was a multicenter, double-blind, randomized, placebo-controlled, parallel-group study conducted in five teaching hospitals in Indonesia from August 2016 to January 2017. Eligible participants included 140 patients with MAV, aged 12 to 50 years, who were enrolled and randomly divided into two groups to receive either adapalene and the study formulation or adapalene and a placebo cream twice daily for six weeks. Clinical response and treatment efficacy were assessed through acne lesion counts, presence of side effects, and patient satisfaction at the second, fourth, and sixth weeks after the first visit. RESULTS: A total of 140 subjects from five different centers (28 subjects in each center) were enrolled. One hundred twenty-seven subjects completed the study, including 63 subjects in the study group and 64 subjects in the placebo group. A significant decrease in the number of noninflammatory lesions in the second week was noted in the study group compared to in the placebo group. There were no significant differences in adverse effects between the two groups in the second and fourth weeks. CONCLUSION: Treatment using nicotinamide plus an antibacterial adhesive agent and zinc-pyrrolidone carboxylic acid was effective in reducing noninflammatory lesions by the second week of therapy. ClinicalTrials.gov registration no. NCT0326298.
... Soon after, by a soft massage and the use of a light LED device, it has been possible to remove and modulate more easily both FFA and dead cells from clogged pores, increasing also the penetration of the emulsion's active ingredients [22]. An emulsion based on chitin-lignin micro/nanoparticles entrapping niacinamide [23][24][25][26], phosphatidylcholine [27,28] and azelaic acid [29], was applied together with a water solution of specific plant's active compounds, such as Chirthmum maritimum and the witch/hazel extracts [30]. The same home treatments and the use of the sunscreen are mandatory for all. ...
... The experimental treatment was a combination of multiple herbal extracts and 4% niacinamide, which has anti-inflammatory properties, inhibits melanosome transfer to keratinocytes and promotes skin barrier function. [8][9][10][11] These two compounds were expected to support each other in acne treatment through their actions in many pathophysiological processes. The components and properties of the experimental treatment are as follows. ...
Article
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Background Although there is a standard guideline for the treatment of acne, it is still a common skin disease, and suboptimal medication adherence is a major reason for treatment failure. Herbal extracts are an interesting alternative medicine because they consist of a variety of active ingredients. Moreover, herbal extracts may have improved therapeutic efficacy because of the combination of various herbs. Objectives To evaluate the effectiveness of herbal extracts for the treatment of mild to moderate acne vulgaris. Methods A total of 77 patients were randomized to receive either an herbal extract or 2.5% benzoyl peroxide, which were applied for a period of 12 weeks. Acne lesion counts, adherence, porphyrin counts, the Dermatology Life Quality Index, satisfaction and side effects were assessed. Result At the 12‐week point, the acne lesion counts decreased, with statistically significant differences from the baseline values in both groups and for all types of acne (P‐value < 0.001). The adherence rate was significantly higher in the patients using the herbal extract than in the patients using 2.5% benzoyl peroxide (P‐value = 0.002). There was no statistically significant difference in terms of porphyrin counts, spot scores, the Dermatology Life Quality Index or satisfaction with efficacy between the groups; however, satisfaction with drug administration was significantly higher in the patients using the herbal extract (P‐value = 0.001). Conclusion Herbal extracts could be beneficial for anti‐acne pharmaceutical preparations and may be used as an alternative medicine for patients with mild to moderate acne vulgaris who do not adhere to benzoyl peroxide treatment.
... Soon after, by a soft massage and the use of a light LED device, it has been possible to remove and modulate more easily both FFA and dead cells from clogged pores, increasing also the penetration of the emulsion's active ingredients [22]. An emulsion based on chitin-lignin micro/nanoparticles entrapping niacinamide [23][24][25][26], phosphatidylcholine [27,28] and azelaic acid [29], was applied together with a water solution of specific plant's active compounds, such as Chirthmum maritimum and the witch/hazel extracts [30]. The same home treatments and the use of the sunscreen are mandatory for all. ...
... Soon after, by a soft massage and the use of a light LED device, it has been possible to remove and modulate more easily both FFA and dead cells from clogged pores, increasing also the penetration of the emulsion's active ingredients [22]. An emulsion based on chitin-lignin micro/nanoparticles entrapping niacinamide [23][24][25][26], phosphatidylcholine [27,28] and azelaic acid [29], was applied together with a water solution of specific plant's active compounds, such as Chirthmum maritimum and the witch/hazel extracts [30]. The same home treatments and the use of the sunscreen are mandatory for all. ...
... However, some of the extracts (Centella asiatica, Moringa oleifera, galangal, willow bark, aloe, fucoidan, sea buckthorn oil) had low or no activity, may be due to the extraction methods used to prepare the samples. [17][18][19][20] The other samples may not be active as antioxidants, such as kojic acid dipalmitate and nobiletin which are being used as skin whitening agents, 21,22 niacinamide as anti-bacterial and anti-inflammatory 23 and pullulan as a natural polymer to enhance delivery of drugs or cosmetic agents. 24 Comparison of sample's potency, expressed as IC 50 (Figure 1), showed four samples (amla, green tea, mango, pomegranate) to have lower IC 50 compared with Trolox in both assays. ...
... [56,57] These agents are found to have anti-inflammatory, moisturizing, and soothing properties. [22] Gel (4%); mild to moderate acne (n=41) [118] 8 weeks; investigation study Significant efficacy in reduction of inflammatory and noninflammatory lesions Topical (2%); (n=100; n=30) [40] 2 clinical trials: 4 weeks; double-blind, placebo-controlled comparison between two independent balanced groups 6 weeks; randomized split-face study Effective in lowering the sebum excretion rate and casual sebum levels Nia (4%) versus Clin (1%); moderate inflammatory acne (n=80) [43] 8 weeks; randomized, double-blind clinical trial ...
Article
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Acne is a chronic inflammatory skin disease that involves the pathogenesis of four major factors, such as androgen-induced increased sebum secretion, altered keratinization, colonization of Propionibacterium acnes, and inflammation. Several acne mono-treatment and combination treatment regimens are available and prescribed in the Indian market, ranging from retinoids, benzoyl peroxide (BPO), anti-infectives, and other miscellaneous agents. Although standard guidelines and recommendations overview the management of mild, moderate, and severe acne, relevance and positioning of each category of pharmacotherapy available in Indian market are still unexplained. The present article discusses the available topical and oral acne therapies and the challenges associated with the overall management of acne in India and suggestions and recommendations by the Indian dermatologists. The experts opined that among topical therapies, the combination therapies are preferred over monotherapy due to associated lower efficacy, poor tolerability, safety issues, adverse effects, and emerging bacterial resistance. Retinoids are preferred in comedonal acne and as maintenance therapy. In case of poor response, combination therapies BPO-retinoid or retinoid-antibacterials in papulopustular acne and retinoid-BPO or BPO-antibacterials in pustular-nodular acne are recommended. Oral agents are generally recommended for severe acne. Low-dose retinoids are economical and have better patient acceptance. Antibiotics should be prescribed till the inflammation is clinically visible. Antiandrogen therapy should be given to women with high androgen levels and are added to regimen to regularize the menstrual cycle. In late-onset hyperandrogenism, oral corticosteroids should be used. The experts recommended that an early initiation of therapy is directly proportional to effective therapeutic outcomes and prevent complications.
... Acne vulgaris is purported to improve following topical nicotinamide application, 11 owing to a combination of anti-inflammatory action and reduction of sebum production, both critical in controlling the disease. Several trials have used topical nicotinamide (at doses of 2-4% with duration of treatment of 4-8 weeks) compared with placebo or topical clindamycin. ...
Article
Full-text available
Nicotinamide (niacinamide) is the water-soluble, amide form of vitamin B3. We review the evidence underlying the use of nicotinamide for various dermatological indications, including nonmelanoma cancer prophylaxis, blistering disorders, acne vulgaris and cosmetic indications, and speculate upon its future role in dermatological practice.
... [11,12] Some of the studies showed that the nicotinamide gel is effective in decreasing the severity of acne. [13] Many patients express difficulty in application of ointments, creams, gels as local forms of drugs. It results in noncompliance and inert therapy. ...
Article
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Background: Staphylococcus epidermidis is a part of the skin's normal flora that can cause acne. This study was designed to evaluate the efficacy of nicotinamide as a stick in eradication of staphylococcus. Materials and Methods: For evaluating of Anti-microbial effect on S. epidermidis used well plate method. We chose five plates for nicotinamide and five for mupirocin. The zones of inhibition were measured and compared. Results: The results showed nicotinamide stick had anti-microbial effects, but in comparison to mupirocin it was significantly less (P = 0.003). Conclusion: Nicotinamide stick was made and evaluated. This study showed that nicotinamide had anti-microbial effect on staphylococcus.
Article
Purpose: Acne has potential to cause psychological distress and significantly diminish one's quality of life. Although washing and over-the-counter cleansers are commonly used in the treatment of acne vulgaris, clinical evidence supporting their effectiveness is still limited. The main focus of this research is to explore anti-acne effectiveness and mildness of a cleanser containing salicylic acid, gluconolactone, and niacinamide.Methods: We recruited two groups of participants. One group consisted of 43 individuals with oily acne-prone skin, and we measured their inflammatory lesions, non-inflammatory lesions, and sebum content after 4 weeks of product usage. The other group included 39 individuals with sensitive skin, and we assessed objective irritation parameters and subjective irritation parameters after 2 weeks’ product usage.Results: After 4 weeks of using cleanser containing retinol, niacinamide and ceramides on oily acne-prone skin, significant reductions were observed in both inflammatory acne lesions count and non-inflammatory acne lesions count, while there was also a significant decrease in skin sebum content. After two weeks of use on sensitive skin, significant improvements were observed in both subjective and objective irritation parameters.Conclusion: In summary, a cleanser containing salicylic acid, gluconolactone and niacinamide can effectively improve acne symptoms while being gentle enough for use on sensitive skin.
Article
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Inflammatory skin conditions are prevalent in the general population and are a source of much concern for those who suffer from them. Acne is an extremely common condition and can significantly impact the quality of life of affected patients. Rosacea is another common dermatological disorder that often affects the face and can present with flushing, irritated skin, and pimples. In addition to being key for acne and rosacea, inflammation can also play a role in prematurely aging skin and contributes to the formation of wrinkles. Given the prevalence and patient impact of dermatological conditions on the face, such as those previously described, there is a demand for personalized medicines to manage these conditions when commercially available options are unsuitable, unavailable, or insufficient to fully resolve the condition. When designing an appropriate personalized therapy for a patient, both the vehicle and the active pharmaceutical ingredient choices are key to the success of the treatment. Cleoderm™ is a topical cream designed for use as a vehicle for the preparation of dermatological treatments by compounding pharmacies. Its ingredient profile was specifically curated to be gentle on the skin, allowing its use as a vehicle for compounded preparations that may be applied to sensitive and affected skin. In this bracketed study, benzoyl peroxide, cyproterone acetate, estriol, metronidazole, niacinamide, progesterone, retinoic acid, spironolactone, and tranexamic acid were selected, due to their known applications for dermatological skin conditions. To evaluate the compatibility and stability of Cleoderm™ in these formulations, high-performance liquid chromatography, followed by antimicrobial effectiveness testing, were performed for 180 days. For most formulations, a beyond-use date of 180 days was observed when stored at room temperature, except for retinoic acid, which had a beyond-use date of 30 days. Through the outcomes of this study, we concluded that Cleoderm™ presents increased convenience for both the compounding pharmacist and the patient, suggesting that it is an adequate candidate vehicle for compounding different dermatological formulations with adequate stability, presenting itself as a good alternative to commercially available treatments that cannot be personalized.
Chapter
Many patients with hidradenitis suppurativa (HS) do not achieve adequate symptom coverage with conventional therapies and often resort to complementary and alternative medicine (CAM) in hopes of achieving relief. Current evidence suggests CAM use is popular among HS patients. This chapter discusses the various types of CAM as well as their demonstrated or potential utility for the treatment of HS in conjunction with current conventional therapies. While there has not been high quality level of evidence for CAM therapies in HS, the benefits and the favorable side effect profile of these modalities that have been seen in other inflammatory conditions can be considered in HS. Future investigations are needed to elucidate the mechanism, efficacy, and safety of CAM in HS.
Chapter
The complicated and multifactorial nature of acne pathophysiology provides a multitude of opportunities for vitamins and minerals to disrupt the inflammatory cascade. In their traditional roles as dietary necessities, vitamins and minerals participate in keratinocyte proliferation and maturation, modulation of lipid production in human sebocytes, and inhibition of pro-inflammatory cytokines, matrix metalloproteinases, and antimicrobial peptides, as well as act as antioxidants. Not surprisingly, then, there is considerable in vitro and preclinical data predicting their efficacy in acne. Although conclusive clinical evidence is currently lacking for many of them, more vigorous trials are being conducted with increasingly convincing in vivo data. At this time, data for vitamin A analogs, zinc, and niacinamide is most compelling. It may well be that combination therapy will be more efficacious than monotherapy. Fortunately, due to their large safety margin, we can afford to be generous with our recommendations while awaiting more definitive results.
Article
Safe and effective treatment options for acne vulgaris are needed to address side effects and increasing rates of antibiotic resistance from current treatments. Nicotinamide is a vitamin with potent anti-inflammatory properties that could offer a potential treatment option. We aim to summarize the relevant literature on the role of nicotinamide in acne vulgaris and discuss the next steps necessary to move this approach into clinical practice. We searched PubMed for clinical studies using nicotinamide for treatment of acne vulgaris. We summarized the 10 studies that met our search criteria. Six of eight studies using topical nicotinamide led to a significant reduction in acne compared with the patient's baseline or performed similarly to another standard-of-care acne treatment. Both studies using an oral supplement containing nicotinamide resulted in a significant reduction in acne compared with baseline. No major adverse side effects were noted. Our review suggests that topical and oral nicotinamide has an unclear effect on acne vulgaris due to the limited nature of the available literature. Additional studies are needed comparing nicotinamide to other first-line acne treatments and evaluating the efficacy and side effect profile of nicotinamide over an extended period of time.
Article
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Background and Design: To investigate the efficacy and safety of topical 4% naicinamide gel cream in the treatment of mild to moderate acne vulgaris and to assess the quality of life of acne patients. Material and Method: Twenty-nine female patients aged 16-38 (mean: 23.57±5.42) years with mild to moderate acne vulgaris who presented in dermatology outpatient clinic were enrolled in the study. All patients applied 4% niacinamide gel cream (Vivatinellacnecinamide gel cream®) on their faces twice daily for eight weeks. The number of lesions (inflammatory and non-inflammatory) was counted at 0, 2, 4 and 8 weeks. The side effects (erythema, desquamation, burning and dryness) were recorded. The Skindex-29, a quality-of-life measure for patients with skin disease, was administered to the subjects at the beginning and the end of treatment. Results: The decrease in the mean number of inflammatory lesions was statistically significant at the end of the treatment (pre-treatment vs. post-treatment: 12.24 vs. 6.14; p =0.000). However, there was no statistically significant decrease in the number of non-inflammatory lesions at the end of the eight weeks. The niacinamide gel cream was generally well tolerated. There was statistically significant improvement in the Skindex-29 scale scores (p =0.000) at the end of the treatment. Conclusion: Topical 4% niacinamide gel cream may be an alternative treatment for inflammatory lesions of mild to moderate acne vulgaris.
Article
Nicotinamide, also known as niacinamide, is the amide form of vitamin B3. It is a precursor of essential coenzymes for numerous reactions in the body including adenosine triphosphate (ATP) production. Nicotinic acid, also known as niacin, is converted into nicotinamide in the body. The use of topical nicotinamide in the treatment of acne vulgaris; melasma; atopic dermatitis; rosacea; and oral nicotinamide in preventing nonmelanoma skin cancer is discussed. The possible side effects and consequences of excessive nicotinamide exposure are reviewed, including suggestions nicotinamide might have a role in the development of diabetes, Parkinson's disease, and liver damage.
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Topical treatment for mild acne Benzoyl peroxide 2.5-10% once daily Azaleic acid 20% twice dailyTretinoin 0.1-0.25% once dailyIsotretinoin 0.05% once or twice dailyClindamycin 1% twice dailyErythromycin 2% and 4% with zinc acetate 1.2% twice dailyTetracycline 4% twice daily Summary points Summary pointsAcne is as common as it was 20 years ago but is now less severe in teenagers and affects more people in their 20s and 30s, who have high expectation of treatmentTopical treatments are effective for mild to moderate acne, and oral antibiotics (and anti-androgens for women) are helpful for moderate acneFor severe acne high dose oral antibiotics can be used, but oral isotretinoin has a rapid effect and a high rate of long term remissionIsotretinoin is only available through hospital dermatologists because of its side effectsEarly treatment and regular review are necessary to prevent scarring Acne severity Severity of acne can be graded for therapeutic studies according to the Leeds grading scale,6 but in the general treatment of acne vulgaris most doctors would divide the condition into mild, moderate, and severe. Mild disease consists of open and closed comedones and some papules and pustules, while moderate acne encompasses more frequent papules and pustules with mild scarring. Severe disease contains all of the above plus nodular abscesses and leads to more extensive scarring which may be keloidal in some cases. Treatment of mild acne Topical preparations are the mainstay of treatment for mild acne vulgaris (see box). These are popular with patients, but their slow benefit needs careful explanation to encourage good compliance. Benzoyl peroxide is a potent oxidising agent with antibacterial and keratolytic properties. It does not induce any change in the resistance pattern of aerobic bacteria to antibiotics; it also prevents such resistance when used concomitantly with topical erythromycin.7 Benzoyl peroxide is applied daily in lotions or creams …
Article
Twenty six patients with moderately severe acne were treated for 12 weeks with topical clindamycin hydrochloride 1% (12 patients) and the vehicle (14 patients). A good or excellent reduction was seen in the non-inflammatory acne lesion count in 3 (25%) of the patients on topical clindamycin and in none of the patients who used the vehicle (control).While 9 (75%) of the patients using topical clindamycin hydrochloride showed a good to excellent response in their inflammatory acne lesion count, only 2 (14.29%) of the control group showed a similar response. The response of the non-inflammatory acne to topical clindamycin hydrochloride 1% was comparable to that of the vehicle, (p> 0.05) while the response of inflammatory acne lesions to topical clindamycin hydrochloride 1% was superior to that of the vehicle (p < 0.05)
Article
Among many important physiological functions played by NADH (the reduced form of beta-nicotinamide adenine dinucleotide) its antioxidative properties are remarkable. Acting directly as an antioxidant, NADH can effectively protect the cell and its membrane from destruction by free radicals. NADH can be stabilized as a suspension in hydrophobic ointments prepared in a way that prevents contact with atmosphere containing oxygen and water. We present the first report of NADH as a treatment for some inflammatory dermatoses. It was found that topical application of 1% NADH diluted in Vaseline ointment can be very effective in the treatment of rosacea and contact dermatitis. Since no adverse effects were observed, therapy with NADH can be viewed as a potential alternative to other established treatments.