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Research

An Investigation of Efficacy of Topical Niacinamide
for the Treatment of Mild and Moderate Acne Vulgaris

Yeşim Kaymak,1* MD, Meltem Önder, MD

Address: 1Medical Health Center and 2Department of Dermatology, University of Gazi, Faculty of Medicine,
Ankara, Turkey
E-mail: yesimkaymak@yahoo.com
* Corresponding author: Dr. Yeşim Kaymak, Hoşdere Caddesi Şair Baki Sok. 2/5 Ayrancı, Ankara, 06540, Turkey

Published:
J Turk Acad Dermatol 2008; 2 (4):jtad82402a
This article is available from: http://www.jtad.org/2008/4/jtad82402a.pdf
Key Words: niacinamide, acne vulgaris, mild and moderate acne, treatment

Abstract
Objective: Niacinamide is a newly-approved anti-acne drug with a potent anti-inflammatory ef-
fect. In this study, safety and efficacy of topical 4% niacinamide gel in mild and moderate acne
vulgaris was investigated.
Methods: Forty-one patients aged 18-25 (mean: 21.6±2.52) with mild and moderate acne vulgaris
seen in dermatology outpatient clinic were enrolled in the study. All patients were treated with nia-
cinamide 4% topical gel (Vivatinell Acnecinamide Gel) for eight weeks.
Results: 38 patients among 41 were able to complete the treatment. Decrease in the number of
pustules comedones and papules were statistically significant at the end of the treatment com-
pared to onset of treatment (p<0.05). Few side effects such as pruritus (n=1) and mild burning (n=3)
were observed in very small percentage of patients.
Conclusions: Findings of this study indicate that 4% niacinamide containing gel is effective and safe
in alleviating symptoms of mild to moderate acne, with earlier improvement in pustules.

Introduction versally accepted [3]. Systemic antibiotics
have been used for several years to reduce
Acne, a chronic inflammatory disease of the the population of P. acnes. During the last
pilosebaceous units of the face, neck, chest, decade topical antibiotics have become
and back, is the most common skin disor- more acceptable for treating inflammatory
der occurring universally, with an estimated acne vulgaris because they have fewer side
prevalence of 70-87% [1]. It is a pleomor- effects and interactions than oral antibiot-
phic disorder characterized by both non- ics. But wide spread use of these agents is
inflammatory (comedones) and inflamma- becoming increasingly associated with the
tory (papules, pustules, nodules) lesions. emergence of resistant pathogens raising
Grading of acne is mandatory to determine concerns about microorganism resistance
the appropriate therapeutic strategy. Effec- and highlighting the need for alternative
tive treatment can dramatically improve a non-antimicrobial agents for the treatment
person’s quality of life [2]. of acne [4].
These findings indicate the need to develop
The role of Propionibacterium acnes (P. strategies to minimize the use of antibiotics
acnes) in inflammatory acne is almost uni- in acne therapy [5].
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After the evaluation of the tion after the treatment was as follows: treatment by dermatologist. were mild improvement in 10 patients. Comparison of the Effect of Treatment Between Succeeding Months Groups Compared Lesions 0-1 Months 0-1 Months (0-1 Months z (p) z (p) z (p) Comedone 1. the treatment. there 1: mild healing. mechanism of anti-acne treatment.631 (0.pdf Table 1. tion version was used for statistical analysis.044 p:0. Local ing treatment period and two other gave up ethical committee approved the study. using the drug as they thought that treat- None of the patients had received any anti-acne ment is ineffective before the treatment pe- therapy within the last 30 days and none of the riod ended. they are quite satisfied and five said they at the end of eight weeks.575 p:0.528) z:-2.041 p:0. skin that this agent provides several benefi- Statistical Analysis cial effects in reducing sebum production [6. married female patients received any oral contra- ceptive or were pregnant. SPSS 15.org/2008/4/jtad82402a.883 (0. healing in nine patients and complete heal- 4: complete healing. and papules.47 mide 4% topical gel (Vivatinell Acnecinamide Gel) for eight weeks. moderate 38 patients among 41 were able to complete acne was defined as the presence of comedones. One patient was missed dur- papules. 2: moderate healing. After the treatment three patients declared The efficacy of the drug was evaluated at two that they were not satisfied by the treat- times in a every month by counting the acne le. and few pustules on the face [8]. The average ages of patients dermatology outpatient clinic were enrolled in were 21. totally 41 patients in our study.J Turk Acad Dermatol 2008. 14 sions. The patients satisfied by The satisfaction of the patients from the treat. 11 said ment was the reduction of the number of lesions. All the side effects during treatment period were namide is extremely well tolerated by facial noted at each follow up examination.137) 0.489 (0.37+37.6+2. The signifi- 4% niacinamide gel in mild and moderate cance level was set to 0.041* Papule 1.002* z:-4. http://www. drug with a potent anti-inflammatory effect. Reduction of inflammation is a major 3: quite satisfied. ing in five patients. safety and efficacy of topical using Wilcoxon Signed Rank test. found to be ineffective in two patients. 2: moderately satisfied. 7]. ment. More re- cent studies have noted that topical niaci. 4: very satisfied. Mild acne was defined as the months (between 1-120 months). All patients were treated with niacina- the disease duration was 48. the treatment said that treatment dried ment was classified as follows: their skin and the newly erupting lesions 0: not satisfied. prominent 3: prominent healing.05. treatment was 0: ineffective. The criterion for effectiveness of the treat. presence of comedones.010* Pustule z:-2.025 p:0. are very satisfied.855 (0.52 (between 15-25 years) and the study.5) tients 11 had mild and 30 had moderate de- with mild and moderate acne vulgaris seen in gree of acne. Among these pa- Forty-one patients aged 18-25 (mean: 21. moderate healing in 12 patients.060) 1.05 Niacinamide is a newly-approved anti-acne 1: mildly satisfied. 2 (4): jtad82402a.012* z:3.6±2.jtad.514 p:0. Unsatisfied patients Page 2 of 4 (page number not for citation purposes) .000* *: p < 0. Results Materials and Methods There were 33 female and eight male. Dermatological evalua. healed more quickly. said they are moderately satisfied.0 evalua- acne vulgaris was investigated. five said they are mildly satisfied.064) z:-2. Comparison between pre and post treatment groups on continuous variables were conducted In this study.

In: Textbook of Dermatology. eruption of new acnes. http://www. Topical niacinamide has marked anti-inflammatory properties [10]. to our findings they showed that addition of lizing influence on epidermal barrier func. sistant propionibacteria in acne: need for policies to modify antibiotic usage. BMJ 1994. a component of only 68% of cases. And for 8 weeks. is the pyridine-3-carboxylic of those treated showed an improvement in acid amide form of niacin. Both treatments produced a none of these side effects were severe statistically similar reduction in the number enough to necessitate withdraw of therapy. 2. Simpson NB. with earlier improvement in pustules. 1. Antibiotic re- Findings of this study indicate that 4% nia. Draelos 4. 31: 860-865. Eady EA. On ageing skin. 1927-1984. Seventy-six patients were randomly assigned to apply either niacinamide gel 4 Few side effects such as pruritus (n=1) and % or clindamycin phosphate 1 % twice daily mild burning (n=3) were observed. These factors provide a stabi. Jones CE. BMJ 1993. 12]. PMID: 8461769 in alleviating symptoms of mild to moderate 6. PMID: There are few studies investigating effect of 16029679 Page 3 of 4 (page number not for citation purposes) . Tipper JL et al. B Vitamin that improves aging facial skin appear- ance. Guide- namide. Stefanaki C. Niacinamide: A acne. Niacinamide has been proved to in. Cunliffe WJ. reported that clindamycin phosphate 1% and niacinamide gel 4% are Decrease in the number of pustules. lines for treating acne. Katsambas AD. Khanna NV. to onset of treatment (p<0.J Turk Acad Dermatol 2008. acne severity. References phil chemotaxis has been reported for niaci. 308. However only the decrease in the number of pustules A double-blind study was done by Shalita et were statistically significant both in the first al with topical niacinamide gel and topical and second month of treatment compared clindamycin in the treatment of moderate to previous measures (p<0. PMID: 8167492 ally niacinamide has been shown to sup- press cytokine-mediated induction of nitric 3. They found an anti-inflammatory effect which Discussion could be clinically established by the reduc- tion of inflammatory papules. Topical clindamycin hydrochloride 1% in acne vulgaris. In another study Sardesai et al. Dos et al. Dermatol Surg 2005. Simpson N. Indian J Dermatol Venereol oxide synthase in a number of cells.05) (Table 1). Larger samples carcinogenesis [9]. 831-833. Oblong JE. ing in decreased inflammation [11]. facial skin [7]. Disorders of the seba- et al showed that topical niacinamide is ef. 2 (4): jtad82402a. 1998. result. PMID: 15556732 hibit histamine release and to suppress the lymphocyte transformation test. In total. could be more beneficial to explore the effi- There are reports of topical niacinamide cacy and safety of topical niacinamide in providing beneficial effects on reduction in patients with acne. 82 % Niacinamide. Acne vulgaris. In contrast keratinocytes. Healy E. 56: 337-380. of acne lesions and their severity12. Berge CA. acne. niacinamide to clindamycin was of no tion and an improvement in the moisture added advantage [13]. Addition. shows a wrinkle-smoothing ef- this study was that only 38 patient com- fect and has an inhibitory effect on photo- pleted the treatment period.jtad. 306: 555- cinamide containing gel is effective and safe 556.pdf said that the treatment did not stop the topical niacinamide on acne treatment [8. Oxford: fective in lowering sebum excretion rate in Blackwell Science Ltd. 5. come- equally and highly effective in the treatment dones and papules was statistically signifi- of moderate acne either alone or combina- cant at the end of the treatment compared tion [8]. stimulation of ceramide synthesis for the treatment of acne vulgaris and acne and acceleration of the differentiation of resistant to topical antibiotics. Cunliffe WJ. 22: 439-444. Clin Dermatol 2004.05). the vitamin B complex [7]. content of the horny layer. Anti-inflammatory action affecting neutro. Leprol 1990. compared Niacinamide is beneficial because it results of efficacy of topical clindamycin and niaci- in the increased synthesis of proteins and namide combination with plain clindamycin keratin. Lack of control group is one of the limita- niacinamide improves the surface structure tions of this study. Bissett DL.org/2008/4/jtad82402a. Another limitation of of the skin. ceous glands.

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