Does niacinamide (vitamin B3) visibly benefit your skin?

Niacinamide (vitamin B3) works on several levels within the skin: it replenishes NAD+, a compound that cells need for energy and the repair of damaged DNA. It also reduces oxidative stress and suppresses inflammatory signals. That explains why it is used so broadly.

The evidence for visible improvement is concrete. In a double-blind study (n=50), women applied a cream containing 5% niacinamide to one half of their face and a dummy cream to the other half for twelve weeks¹. The niacinamide side scored significantly better on fine lines, wrinkles, pigmentation spots, redness and skin elasticity. The study was small, however, and included only white women with sun-damaged skin, so how universally these findings apply is not certain.

A comprehensive 2024 review confirms that niacinamide cream has clinically supported benefits for a broader population: evening out skin tone, a stronger skin barrier in dry or sensitive skin, and conditions such as acne, dermatitis and actinic keratosis (sun damage that can be a precursor to skin cancer)²,³. For acne, niacinamide likely performs comparably to topical antibiotics such as clindamycin, but the available studies were small and barely measured patient-reported improvement⁴.

For people at elevated risk of skin cancer, the evidence for niacinamide in tablet form is more robust. In a phase 3 trial involving 386 high-risk patients, 500 mg twice daily for twelve months resulted in 23% fewer new skin cancers and 11 to 20% fewer actinic keratoses compared with placebo⁵. Once people stopped taking it, the effect disappeared. A large study of more than 33,000 people found an even greater risk reduction of 54% among people who began taking the tablets after their first skin cancer⁶. That latter study is observational rather than experimental, so not all confounding factors can be ruled out.

Regarding safety: oral use of up to 3 grams per day is considered safe, and no serious side effects occurred in the studies. For the skin, 5% is the most thoroughly studied concentration, both for anti-aging and for an even complexion.