Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Nicotinamide (also known as niacinamide), a form of vitamin B3, has scientific evidence supporting its use in the treatment and management of eczema (atopic dermatitis), although the body of evidence is moderate rather than robust. Several clinical studies and reviews indicate that nicotinamide possesses anti-inflammatory properties and can help improve the skin barrier function, which are both relevant in eczema, a condition characterized by inflammation and impaired skin barrier integrity. For example, randomized controlled trials have demonstrated that topical nicotinamide can reduce transepidermal water loss and improve hydration in the stratum corneum, suggesting benefits in skin barrier repair. Moreover, its anti-inflammatory effects are thought to be mediated by inhibition of poly(ADP-ribose) polymerase-1 and suppression of pro-inflammatory cytokines. A few small clinical studies have directly compared topical nicotinamide to topical corticosteroids or vehicle cream, showing that nicotinamide is effective in reducing eczema severity, although possibly less potent than standard corticosteroid therapy. Oral nicotinamide has also been evaluated, but most supporting evidence pertains to topical application. While the mechanism of action and early clinical results are promising, more large-scale, high-quality randomized controlled trials are needed to fully establish its efficacy and to define its role relative to other standard treatments. Nevertheless, current evidence justifies its consideration as an adjunctive therapy in eczema, especially in patients seeking steroid-sparing options.

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