The Effectiveness of Retinoids in the Treatment of Acne
6 December 2024 / 8 minutes read /
Moisturizers and emollients are often viewed only in the context of their ability to increase epidermis (outer skin layer) hydration, relieve dry skin, or improve the skin's softness and suppleness. However, a growing body of evidence suggests that these products may also be helpful therapeutic adjuvants (substances that enhance the body's immune response to an antigen) in treating various skin conditions such as acne, rosacea, and hyperpigmentation.
It is niacinamide in particular, also known as niacin or vitamin B3, that gained in popularity among researchers. That is because the initial studies proofed niacinamide to have anti-inflammatory properties. Marking it as a potential treatment for conditions such as acne and rosacea.
This article will answer the questions:
Hakozaki et al. performed two studies demonstrating the effect of niacinamide on skin hyperpigmentation.¹ In the first study they found that the application of a moisturizer containing 5% niacinamide reduced spot pigmentation within 8 weeks.
Their second study compared an SPF 15 moisturizer with an SPF 15 moisturizer containing 2% niacinamide. They found that the SPF 15 moisturizer containing 2% niacinamide performed better than the SPF 15 moisturizer alone. Image analysis showed a more significant reduction in spot pigmentation and improved skin lightness within a 6 week period.
A third study by Chiu et al. investigating the effects of 4% niacinamide in an Asian population showed similar results.² Marking an improvement in hyperpigmentation, blotchiness, and hydration status with an average improvement range of 16-63% compared to at the beginning of the study.
The results of these studies seem to confirm the finding of Boissy et al., who found that a 5% Niacinamide moisturizer is able to reduce the transfer of melanosomes by 35-68%.³ Melanosomes are specialised subunits of a cell that contain the natural pigment melanin.
In people with hyperpigmentation, the production of melanosomes is increased causing dark spots to appear. In such cases, treating the skin with Niacinamide would be beneficial because of its ability to reduce the transfer of melanosomes as the study above has pointed out.
To conclude: the studies above proof Niacinamide to be an effective treatment for hyperpigmentation in concentrations of 2% and 5%.
Lately, the use of niacinamide has also gained popularity among dermatologists and practisioners for treating acne. Citing a combination of efficacy and bacterial-resistance as an argument for its use.
Applying a moisturiser with 4% niacinamide provides anti-inflammatory effects which are useful in treating acne.⁴ More specifically, they found that after 8 weeks of usage, 82% of the subjects with acne improved. They noted a significant reduction in papules / pustules (–60%) and acne severity (–52%).
In two double-blinded clinical studies, Bisset et all studied the effects of niacinamide in skin ageing.⁵ In particular, they evaluated the effects of 5% niacinamide on skin texture and hyperpigmentation. Image-analysis showed an improvement in skin texture after 4 weeks and hyperpigmentation after 8 weeks of use.
These results were confirmed by a second study in which the effects of 5% niacinamide on skin texture were evaluated over the course of 8 weeks. Same as in previous study, the authors found a significant improvement in skin texture.
The results of the previous studies are consistent with a study of Matts & Solechnick, who also evaluated the effects of 5% niacinamide on skin texture.⁶ This time, over the course of 10 weeks. Same as with the previous studies, they found an improvement in skin texture caused by a shift in skin texture towards finer, anisotropic features. Which are consistent markers of younger skin.
The skin of patients with rosacea is often hyperirritable compared with that of healthy patients. Experiencing symptoms such as itching, stinging and dry skin.
Facial redness, also know as facial erythema, is the hallmark of rosacea, particularly in the early stages of the disease. Considering the many advantages niacinamide has on the skin, some have argued that it might also be of benefit for treating rosacea.
One study that investigated this is the study done by Draelos et al.⁷ Their results showed that a moisturiser containing 4% niacinamide decreased the severity of erythema over a 4-week period. They also found niacinamide to improve skin hydration and to decrease inflammatory lesion counts.
To put the results in numbers: image-evaluation showed a noticeable improvement in 79.2% of the subjects after 2 weeks. After 4 weeks, this was increased to a total of 95.7% of the subjects.
Niacinamide has the ability to increase the antioxidant capacity of the skin after topical application by increasing the reduced forms (NADPH), which have potent antioxidant properties. 53–55 This is probably the most well-studied anti-aging effect of niacinamide.
As people age, the skin tends to become yellow. Or at least, “more yellow” than before. This is likely the result of the glycation of proteins in the skin. Scientists refer to this phenomena as the “Maillard reaction”.
It describes the oxidative reaction between protein and sugar in which they eventually end up as cross-linked proteins. These cross-linked proteins are yellowish in colour. With the years these proteins start to accumulate into the skin matrix, with the result that the yellowish colour becomes more and more visible.
To make it more specific: studies show that the amount of cross-linked proteins increase five-fold from the age of 20 to 80. Smoking, UV-light and diet are factors that contribute to this process.
A scientific review showed however that niacinamide, when applied on the skin, has the ability to inhibit this oxidative process by increasing the amount of NADH and NADPH.⁸ Two powerful antioxidants with, as the name suggests, anti oxidative properties.
The development of fine lines and wrinkles are the result of a decrease in the amount of epidermal cell layers, caused by a reduction in protein and collagen synthesis.
Studies in the lab show that the addition of niacinamide to ageing cells, stimulated collagen synthesis and that of proteins such as keratin and involucrin. The proteins found in the epidermal layer of the skin.⁹
A separate study found niacinamide to also increase collagen production in the dermal layers of the skin.¹⁰
Finally, a third study found that a niacinamide to reduce fine lines and wrinkles and to improve skin elasticity. This study used a moisturiser with a 5% niacinamide concentration.¹¹
The topical use of niacinamide has a wide variety of benefits making it an attractive treatment for skin conditions such as acne, rosacea and hyperpigmentation.
When used in concentrations of 5%, it has been shown to improve skin elasticity and skin hydration, and to increase collagen synthesis in the dermal layers of the skin. It has also been found to protect the cells against oxidation and to protect the skin against skin ageing by increasing the amount of NADH and NADPH.
In conclusion: niacinamide provides a multiplicity of effects and benefits making it an ideal choice for young and old alike in treating various skin conditions when used in a minimum concentration of 2%.
6 December 2024 / 8 minutes read /
6 December 2024 / 8 minutes read /
6 December 2024 / 8 minutes read /
6 December 2024 / 8 minutes read /
6 December 2024 / 8 minutes read /