Niacinamide, also called nicotinamide, is a form of vitamin B3 found in many serums and moisturizers. It may modestly help acne, mainly inflamed spots and oiliness. It’s gentle, which makes it a useful supporting ingredient. But the evidence comes from a handful of small studies, and niacinamide isn’t an FDA-recognized acne drug. Think of it as a helpful extra alongside proven treatments such as benzoyl peroxide or a retinoid, not a replacement for them.
What niacinamide is, and how it’s regulated
Niacinamide is one of the two main forms of vitamin B3 (the other is niacin, or nicotinic acid). In skin care it’s used in concentrations typically ranging from about 2% to 10%, sometimes higher.
In the US, the active ingredients an over-the-counter product can use to claim it treats acne are set by the FDA’s acne monograph (M006): benzoyl peroxide, salicylic acid, sulfur and sulfur with resorcinol. Adapalene 0.1% gel is available separately through a prescription-to-OTC switch. Niacinamide isn’t on that list, so niacinamide products are cosmetics. They can say they improve the look of skin, but they can’t legally claim to treat acne. That’s also why you won’t find niacinamide in the Drug Facts box.
How it might help acne-prone skin
Lab and small human studies suggest several possible effects:
- Anti-inflammatory activity. Nicotinamide has shown anti-inflammatory effects in lab research, which is the main theory for how it helps red pimples.
- Less oil. A small 2006 study found that 2% niacinamide applied to the face reduced the rate of sebum production over several weeks, with a clearer effect in one group of participants than the other.
- A stronger skin barrier. A 2000 lab study found nicotinamide increased the skin’s production of ceramides and other barrier lipids. A healthier barrier may help skin tolerate drying acne treatments.
- Fading dark marks. A 2002 study found niacinamide reduced the look of hyperpigmentation, likely by reducing pigment transfer to skin cells. That may help with the brown marks acne can leave behind.
These are plausible mechanisms supported by limited data. None of them has been confirmed in large acne trials.
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What the acne studies show
- Shalita et al., 1995. The most cited trial compared 4% nicotinamide gel with 1% clindamycin gel (a topical antibiotic) in people with moderate inflammatory acne over 8 weeks. Both groups improved similarly on inflamed lesions and overall acne severity. It was a useful early result, but it’s decades old and small by modern standards. Clindamycin alone is also no longer recommended as solo treatment because of antibiotic resistance, so it’s not a modern benchmark.
- 2020 Cochrane review. This systematic review of non-antibiotic topicals, including nicotinamide, found the evidence low in certainty. There were few trials, many had risk-of-bias problems, and follow-up was short.
- 2017 narrative review. A review in Dermatologic Therapy concluded nicotinamide is a promising, well-tolerated option, especially for people who want to avoid antibiotics, and called for better-quality studies.
- 2024 AAD guidelines. The American Academy of Dermatology’s guidelines don’t include topical niacinamide among their recommended acne treatments.
Does a higher percentage work better?
There’s no good evidence that it does. The acne and oil-control studies mostly used 2% to 5%. Products with 10%, 15% or 20% niacinamide are popular, but they haven’t been shown to work better for acne. Higher concentrations are also more likely to cause stinging, redness or itching in some people. If you’re buying niacinamide for acne-prone skin, a 4% to 5% product is a sensible, evidence-aligned choice.
Oral nicotinamide supplements
Oral nicotinamide, sometimes combined with zinc and other nutrients, is sold as a supplement for acne. The evidence for acne is limited and mostly low quality, and the 2024 AAD guidelines don’t recommend it. Oral nicotinamide has been studied more for other skin uses, such as reducing new non-melanoma skin cancers in high-risk people, which is a separate question.
Don’t confuse nicotinamide with niacin. According to the NIH Office of Dietary Supplements, high-dose niacin (nicotinic acid) commonly causes flushing and, at high doses, can cause liver problems and other side effects. Don’t take high-dose vitamin B3 supplements for acne without talking to a clinician.
How to use niacinamide in an acne routine
Niacinamide is easy to fit in because it’s gentle and combines well with most things:
- Choose a format you’ll use daily, such as a serum or a niacinamide-containing moisturizer. A moisturizer covers two steps at once.
- Apply once or twice a day to clean skin, before or as your moisturizer.
- Keep your main acne treatment. Pair niacinamide with benzoyl peroxide in the morning or a retinoid at night rather than using it on its own for inflamed acne.
- Give it time. Studies ran for 8 to 12 weeks, and cosmetic changes to oiliness or marks take weeks to show.
| With | Generally OK? | Notes |
|---|---|---|
| Benzoyl peroxide | Yes | A niacinamide moisturizer may help offset dryness |
| Adapalene or tretinoin | Yes | Often paired to improve tolerability |
| Salicylic acid | Yes | Introduce one at a time |
| Vitamin C | Yes | The "cancels out" worry is largely outdated; separate them if they sting |
| Azelaic acid | Yes | Both may help with dark marks |
Three of the most-asked questions about niacinamide have their own guides: can you use niacinamide with vitamin C?, can you use retinol with niacinamide? and can you use niacinamide with salicylic acid?
Reading a niacinamide label
Because niacinamide products are cosmetics, their labels don’t follow the Drug Facts format. A few tips for reading them:
- Percentages aren’t required. Many brands put the niacinamide percentage on the front, but others don’t. Ingredients are listed in descending order by amount, down to 1%, so an ingredient near the top of the list is present in a larger amount than one near the end.
- Look at the whole formula. A niacinamide serum that also contains strong exfoliating acids or a retinol is a different product from a plain niacinamide moisturizer. Account for every active in your routine.
- Be skeptical of acne claims. A cosmetic can say it “helps reduce the look of blemishes,” but it can’t legally claim to treat acne. That’s a regulatory distinction, not a quality score, but it’s a reminder that niacinamide isn’t a proven acne drug.
- Combination products with zinc. Niacinamide is often paired with zinc in serums. Zinc has been studied in acne too, but the evidence for topical zinc is also limited, according to the 2020 Cochrane review.
Side effects
Niacinamide is usually well tolerated. Possible side effects include mild stinging, redness, itching or a warm feeling, which are more likely with higher concentrations or on irritated skin. Stop using it if you get a rash or persistent irritation. As with any new product, the AAD recommends testing it on a small area first.
Who niacinamide suits
Reasonable to try if you:
- have mild acne and want a gentle add-on;
- find benzoyl peroxide or retinoids drying and want a supportive moisturizer or serum;
- have dark marks left by old pimples (see our guide to acne scars and marks);
- have sensitive skin that reacts to stronger ingredients.
Not enough on its own if you have moderate or widespread inflamed acne, nodules or cysts, or scarring. Those need proven treatments. Start with our step-by-step acne treatment guide.
For other gentle options, read about azelaic acid, which has stronger evidence for acne and dark marks and is prescription-strength in the US, and salicylic acid. Our acne skincare routine shows where a supporting ingredient like niacinamide fits.
When to see a dermatologist
See a dermatologist or your doctor if acne is inflamed, painful, widespread or scarring, if a few months of over-the-counter care hasn’t helped, or if you’re pregnant, breastfeeding or under 18 and want to start treatment.