Is Nicotinamide adenine dinucleotide (NAD) supplement beneficial for skin health?

From the Guidelines

Oral nicotinamide may reduce the risk for subsequent keratinocyte carcinoma in nonimmunosuppressed individuals with a history of such carcinomas, suggesting a potential benefit for skin health. The evidence for this benefit comes from a small trial, as noted in the guidelines of care for the management of cutaneous squamous cell carcinoma 1. While the research is still emerging, nicotinamide adenine dinucleotide (NAD) supplements, which contain nicotinamide or its precursors, could potentially improve skin appearance by supporting cellular energy production and DNA repair mechanisms.

Key Points to Consider

• NAD+ levels naturally decline with age, contributing to visible aging signs
• Typical dosages for nicotinamide riboside (NR) or nicotinamide mononucleotide (NMN) supplements range from 250-500mg daily
• Topical applications of products containing 2-5% nicotinamide may help improve skin texture and reduce hyperpigmentation
• These supplements work by enhancing mitochondrial function, activating sirtuins, and supporting DNA repair processes that protect skin cells from damage
• Generally considered safe, but some people experience mild side effects like flushing, headaches, or digestive discomfort

Important Considerations for Supplementation

• It's advisable to start with lower doses and consult a healthcare provider before beginning supplementation, especially if you have existing health conditions
• The potential benefits of oral nicotinamide should be weighed against the risks, particularly in the context of other health conditions or medications
• Other agents, including cyclic PDT, oral retinoids, and celecoxib, have limited evidence or significant risks associated with their use for reducing the risk of cSCC in patients with a history of keratinocyte carcinoma, as noted in the guidelines 1.

From the Research

Benefits of NAD Supplement for Skin Health

• NAD supplement has shown promise in preventing nonmelanoma skin cancers 2
• There is some evidence for the role of NAD in decreasing melanoma risk and progression in some individuals 2
• NAD supplementation has been reported to have promising results for the treatment of psoriasis and enhancement of skeletal muscle activity 3
• Nicotinamide, a form of vitamin B3 and a precursor to NAD, has been shown to be effective in treating actinic keratosis, squamous cell carcinomas, basal cell carcinomas, and bullous pemphigoid 4
• Topical niacinamide has been observed to improve the appearance of aging facial skin, including reduction in fine lines and wrinkles, hyperpigmented spots, and skin sallowness (yellowing) 5

Limitations and Future Studies

• The lack of standardized dosing and outcome measures makes comparison across existing studies challenging 2
• The lack of adverse events reporting in the majority of studies limits analysis of supplement safety 2
• Further trials are required to determine the optimal method of raising NAD levels, identifying target conditions, and comparisons to the present standard of care for these conditions 3
• Large-scale randomized controlled trials investigating safety and efficacy are needed before widespread incorporation of NAD supplements into dermatology practice 2, 3