Vitamin B3, also known as niacin, is one of the 32 essential nutrients in humans. It’s a water-soluble vitamin which is removed from the blood rapidly and must be consumed daily, unlike fat soluble vitamins such as vitamin E.
The main role of vitamin B3 is closely related to other B-vitamins: producing enzymes for energy metabolism. It metabolises both carbohydrates and fat and has side roles in cholesterol synthesis.
In acne, niacin’s history stretches back to 1955, where doctors used it to prevent acne induced by iodine, but it didn’t reach the acne underground until the 1990s. Vitamin B3 is recommend both as a supplement and a topical treatment, compared to zinc which is most popular as a supplement.
The truth is that for one method, niacin is useless for acne, while for the other, niacin is excellent.
The supplemental powers
For acne, a confirmed power of supplemental niacin is vasodilation, or blood flow enhancement. Firstly, vitamin B3 is known to reduce the viscosity of blood.
Secondly, niacin triggers the release of a chemical called prostoglandin D2, which dilates the capillaries. PGD2 triggers vasodilation very effectively in the skin too. This study even found that when supplemented with 100mg of niacin, anxious patients’ faces became redder after they were embarrassed.
The benefit will be more oxygen to the skin and improved blood flow, and more acne nutrients and antioxidants. Vitamin B3 is also needed for proper skin barrier function and can therefore prevent dry, flaky, crusty patches of skin.
For a clear illustation that niacin is important, look no further than the skin disease pellegra. This is a form of extreme vitamin B3 deficiency seen mostly in Africa, rural South America and Indonesia. There are three Ds of niacin deficiency: dementia, death and dermatitis.
Pellegra is Italian for “skin that is rough” but that fails to do it justice. The pictures show snake-like coils of inflamed skin spreading from cheek to cheek. Dry, hard, scaly and cracked skin is a symptom, evolving into blackened scales the more you hack at them. The greater the deficiency, the freakier the symptoms. Itching and burning is common and the rashes resemble a severe sunburn. The rashes are uniquely symmetrical in pellegra, with a neatly defined boundary between the rash and healthy skin.
Pellagra also affects other parts of the body; pellagra was discovered by a physicist named Gaspar Casal back in 1772, and the peasants he observed had pellagra in their hands and feet. Pellagra is yet another of the countless skin conditions in the world and niacin deficiency is exclusively to blame.
Can you take advantage of them?
We can therefore confirm that niacin deficiency is a nightmare for your skin, if not acne, but that’s the real question – is deficiency even common?
The answer is a resounding no, because in the USA, the rate among 19 year olds and older is just 2%. In fact, niacin ranks almost at the bottom. Magnesium deficiency is found in 61% of people while vitamin B1, plentiful itself, is lacking in 7% of people. Zinc stands at 12% while vitamin B6 weighs in at 15%.
Some of the richest foods in vitamin B3 are…
Turkey meat – 34% of the RDA per 100 grams.
Chicken breast – 69% per 100 grams.
Mushrooms – 18% per 100 grams.
Tuna – 66% per 100 grams.
Peanuts – 68% per 100 grams.
When Gaspar Caval first discovered pellegra, he observed that its victims typically ate a high maize diet with very little meat. In the 21st century though, many niacin rich foods are staples, unlike richer foods in magnesium.
Oral niacin has benefits for acne, but they only materialise if you’re very lucky. Factors in the developed world which heighten the niacin deficiency risk include alcoholism, liver scarring, and HIV and cancer.
Unlike vitamin C or vitamin E, niacin megadoses have no hidden benefits for acne. There is one signature effect – the niacin flush. A sudden burst of facial redness and heat from niacin doses of above 100mg, due to a huge exaggeration of niacin’s blood flow enhancing abilities.
The niacin flush is temporary, lasting for 30 minutes to two hours, and is harmless. It feels like a burst of heat or mild sunburn. You can even watch the heat migrating down your body, from your face to your chest and arms.
The question for acne is whether this sudden burst of blood might enhance nutrient and antioxidant delivery. Unpleasant as it might be, the niacin flush might work excellently as a short, sharp shock for breathing life and glow into your skin. That’s just speculation, and you should stick to eating celery and beetroot, but it remains interesting. Disclaimer: I definitely do not recommend the above trick.
Oral niacin has benefits for acne, but its ubiquity removes the opportunity.
Topical niacin – unproven, but promising for acne
Niacin isn’t dead though, because the potential for acne lies entirely with topical application.
You’ll notice that two forms exist: niacin and niacinamide. Niacin is also known as nicotinic acid while niacinamide is also called nicotinamide.
Naturally, niacinamide is an inactive derivative of niacin created by the body when you eat too much dietary vitamin B3. While niacin and niacinamide have minor structural differences, the human body can convert niacinamide into niacin almost instantly. Niacinamide is more commonly used in supplements because it doesn’t cause the niacin flush, although niacinamide megadoses have their own side effect of sweating.
Most importantly, niacinamide is effectively absorbed and effectively fulfills niacin’s duties. It’s not a failed lab experiment like oral zinc oxide. With that dealt with, here’s a bunch of studies on topical niacinamide and acne:
STUDY ONE: the studies began back in 1995 with this comparison of niacinamide and the topical antibiotic clindamycin. The scientists were enraged with the growing resistance of p.acnes bacteria to their antibiotics, and were therefore comparing one to vitamin B3. 76 patients were ordered to apply either 4% niacinamide gel or 1% clindamycin gel daily.
After 8 weeks, both patients experienced significant improvements in acne, with a 82% improvement in the niacinamide group compared to 68% in the antibiotic group.
STUDY TWO: our next study was disappointing. The methods differed as group 1 was given a combination of 4% niacinamide and 1% clindamycin. Group 2 received clindamycin alone, while group 3 consisted of antibiotic-resistant acne patients who received the first combination. After 8 weeks, the addition of niacinamide was judged to have achieved nothing. The raw data showed a very slight improvement in group A, with 17.5% enjoying an excellent response compared to 13.79% in group B.
STUDY THREE: but niacinamide found itself on the road to redemption in yet another confrontation with clindamycin. 5% niacinamide was compared to 2% clindamycin in 60 female patients. Niacinamide decreased acne by 69% in 8 weeks, leading to the glorious conclusion that “five percent nicotinamide gel is as effective as 2% clindamycin gel for treatment of mild to moderate acne vulgaris”.
STUDY FOUR: a final battle resulted in another great study. A 4% niacinamide gel group enjoyed a 32% fall in acne severity after 4 weeks followed by 65% after 8 weeks, while a 1% clindamycin group experienced strangely similar falls of 32% and 64%.
None of the niacinamide patients experienced any side effects. The clindamycin group also experienced none, but the all too real side effects of topical antibiotics show up months down the road – a crippled flora of healthy bacteria and the rise of yeasts like malassezia.
The evidence tilts towards topical niacin being excellent for acne, but the negative study can’t be ignored either. So what was different?
The methods differed slightly, but more importantly, vitamin B3’s precise mechanisms are unknown. Topical niacin is known to have antioxidant powers, and suppress an enzyme called phosphodiesterase which is linked to psoriasis. It inhibits at least two deadly pro-inflammatory chemicals: neutrophils, which churn out free radicals, and the allergy chemical histamine. There’s also one study where topical niacin improved oily skin in Japanese subjects.
As an essential nutrient, niacin has many biological roles, but the killer power for acne is unconfirmed, unlike vitamin E with its fat soluble antioxidant properties.
Therefore, it’s very possible that vitamin B3 will have no effect on your acne in certain lifestyle and dietary circumstances. If antioxidants are the biggest benefit, your opportunity may be limited if you already use grapeseed oil or eat plenty of fruits, herbs and spices. The nature of niacin’s antioxidant properties is also a mystery.
If B3 succeeds by suppressing neutrophils, then your luck has run out if other pro-inflammatory chemicals like TNF-a and interleukin-6 are responsible. The participants of the failed study might have experienced these scenarios.
If we knew the precise weapon that vitamin B3 has, we could account for these factors, but we don’t. Alternatively, the antibiotic might have reduced acne so strongly that adding niacin caused little extra improvement, even though it would have been strong in isolation.
Vitamin B3 is riddled with unanswered questions, but it remains a promising topical treatment for acne.
Proven to smooth out dark patches
The second big skincare power of niacin is reducing hyperpigmentation. Vitamin B3 was once again compared to the mainstay of pharmaceutical remedies – hydroquinone. This widespread treatment reduces accumulation of melanin, pigment and darkness effectively, but has irritating side effects too.
27 people were divided into two groups which applied either 4% concentration niacinamide cream or 4% hydroquinone to dark patches on their skin daily. The niacinamide group improved almost as strongly as the hydroqinone group. Every patient enjoyed some fading of hyperpigmented patches.
The hydroquinone had a slightly higher rate of excellent to good responses, at 55% vs 44%. The hydroquinone was also quicker than niacinamide, taking just one month versus two months.
However, the vitamin B3 caused far fewer side effects such as burning and irritation. Hydroquinone is the mainstay of anti-hyperpigmentation remedies, and vitamin B3 almost matched it.
This time, the power is confirmed: inhibition of melanosome transfer. The melanin that colours your skin is originally manufactured by various enzymes, within cells called melaninocytes. The melanin-containing cells manufactured by melanocytes are called melanosomes. To deposit the melanin in your skin’s layers and provide pigment, the melanosomes must be transferred from melanocytes to keratinocytes, the basic cells which make up the epidermis.
This is the process of melanosome transfer, and according to this study, topical niacin was able to decrease melanosome transfer by 35-68%.
Vitamin B3’s hyperpigmentation powers differ from other natural treatments. Licorice root inhibits the tyrosinase enzyme which converts the amino acid tyrosine into melanin. Argan oil, a secret remedy for hyperpigmentation, inhibits both tyrosinase and another melanin enzyme called dopachrome tautomerase. Meanwhile, niacin had no effect on tyrosinase, so if your dream in life is to get pearly white and even skin, a combination of argan oil and topical niacin could be the ultimate solution.
The natural role of vitamin B3 in skin pigment is interesting, given that it’s an essential dietary nutrient. We can speculate that the human body normally uses vitamin B3 to constrain and control the transferral of melanin into skin cells, but to a limited extent.
Standard dietary vitamin B3 will probably be insufficient to prevent hyperpigmentation caused by too much UV radiation; 98% of people have normal niacin levels, yet it doesn’t save them. However, when you deliver a concentrated burst topically, it clearly is sufficient.
Maybe the human body naturally prevents too much niacin from being funnelled to the skin, since hypopigmentation is also a bad thing, as it weakens your sun defences. Topical niacin might bypass any natural limits.
Speaking of skin quality and tone, niacin is also an effective moisturiser and is proven to improve signs of ageing. This study on 50 women told them all to apply niacinamide daily. Eight weeks later, ageing factors such as skin elasticity, smoothness, wrinkles, and fine lines all improved. While we’re at it, hyperpigmentation faded as well.
It works like the bacteria in natural yoghurt. Niacin doesn’t provide any moisture itself, but does enhance the skin barrier function, decreasing trans-epidermal water loss and locking any existing moisture in.
Vitamin B3 is a rare acne substance where the mainstream opinion is correct. It’s ineffective as a supplement due to being plentiful in the diet anyway, but excellent as a concentrated topical treatment.
Topical treatments are second to diet, and among topical treatments, vitamin E from natural sources like grapeseed oil is superior since its greatness is proven: preventing squalene oxidation and clogged pores. Niacin is more mysterious, but the balance of the studies is excellent.
We don’t know precisely how it clears acne, so we can’t make any tactical recommendations, like with aloe vera being effective for inflammation. However, topical niacin is a confirmed weapon for hyperpigmentation, if you’re a pale skinned person trapped near the equator or stuck in kangaroo land.
Thanks for reading!