What is the difference between nicotinic acid and nicotinamide?

October 7, 2025 •

4 min read

While both are forms of Vitamin B3, a 2017 study found that nicotinamide degradation consumes more plasma betaine and affects methylation more profoundly than nicotinic acid. This distinction is crucial for understanding what is the difference between nicotinic acid and nicotinamide and choosing the right supplement for your needs.

Quick Summary

Nicotinic acid can impact cholesterol levels and may cause skin flushing, while nicotinamide does not typically affect cholesterol but can support skin health and treat niacin deficiency without the flushing side effect.

Key Points

No Flush vs. Flush: Nicotinamide does not typically cause the skin flushing side effect associated with nicotinic acid.
Cholesterol Control: Nicotinic acid, particularly at therapeutic levels, may impact LDL, HDL, and triglycerides; nicotinamide does not typically have these effects.
Skin Health Benefits: Nicotinamide is a common ingredient in skincare, offering potential benefits for anti-aging, reducing hyperpigmentation, and supporting the skin barrier.
Distinct Metabolism: These forms are metabolized differently; research indicates nicotinamide degradation can consume more methyl-donors than nicotinic acid.
Treatment Choice for Pellagra: Nicotinamide is often preferred for treating niacin deficiency (pellagra) to avoid the flushing side effect.
Medical Supervision: Due to potential side effects, including liver concerns, therapeutic use of either form, especially at higher levels, should be overseen by a healthcare professional.

What is Vitamin B3 (Niacin)?

Vitamin B3, commonly known as niacin, is an essential water-soluble vitamin that plays a critical role in cellular metabolism. It is a precursor to the coenzymes nicotinamide adenine dinucleotide (NAD+) and nicotinamide adenine dinucleotide phosphate (NADP+), which are vital for converting food into energy, supporting the nervous system, and maintaining healthy skin. The term 'niacin' is a general descriptor for a family of compounds, primarily nicotinic acid and nicotinamide, which have distinct effects on the body, especially when used for specific therapeutic purposes.

The two faces of Niacin: Nicotinic Acid and Nicotinamide

While both compounds are equally effective in preventing and treating pellagra, a severe niacin deficiency, their pharmacological effects and side effect profiles differ significantly. These differences are a direct result of their unique chemical structures and metabolic pathways once inside the body.

Nicotinic Acid: Potential Effects on Cholesterol

Nicotinic acid is the form of niacin that has been explored for its potential lipid-modifying properties. When used therapeutically, it has been shown to potentially raise high-density lipoprotein (HDL) cholesterol levels, lower low-density lipoprotein (LDL) cholesterol, and reduce triglycerides. It is thought to achieve this by influencing enzyme activity involved in lipid metabolism.

A notable side effect sometimes associated with nicotinic acid is the 'niacin flush,' a temporary sensation of warmth, itching, tingling, or redness in the skin. This is believed to be caused by the release of prostaglandins. While generally not harmful, this flush can be uncomfortable. Different formulations, such as extended-release types, have been developed, although these may be associated with potential risks. For conditions like hyperlipidemia, nicotinic acid is typically considered when other treatments are not suitable, and its use should always be under the supervision of a healthcare professional.

Nicotinamide: Supporting Skin and General Health

Nicotinamide, also known as niacinamide, is another form of niacin often found in supplements and skincare products. A key difference is that it generally does not cause the prostaglandin-mediated flushing effect associated with nicotinic acid. Unlike nicotinic acid, nicotinamide does not typically have the same significant effects on blood lipid levels and is not used in the same way for cholesterol management.

Nicotinamide's benefits are often linked to its anti-inflammatory properties, its role as a precursor to NAD+, and its contribution to skin health. Applied topically, it is recognized in skincare for several potential functions, such as:

Enhancing skin barrier function by potentially supporting ceramide production.
Potentially improving skin hydration.
Potentially reducing signs of aging, like fine lines and wrinkles, by helping the skin combat environmental damage.
Potentially helping to fade hyperpigmentation.
Potentially calming redness and soothing inflammation, which may be helpful for some skin conditions.
Potentially helping to regulate oil production, which could be beneficial for individuals with acne-prone skin.

Orally, nicotinamide is often used to address niacin deficiency (pellagra) because it typically avoids the flushing side effect. Some studies also suggest it may have other health benefits, such as potentially helping to reduce the risk of certain skin cancers in high-risk individuals and showing promise for supporting joint health. However, consuming very large quantities may lead to side effects like nausea, stomach discomfort, and could potentially impact liver function.

Comparison of Nicotinic Acid and Nicotinamide

To clarify their distinct roles, here is a breakdown of their key differences:


Feature	Nicotinic Acid (Niacin)	Nicotinamide (Niacinamide)
Chemical Structure	Contains a carboxylic acid group.	Contains an amide group instead of the acid group.
Primary Use	Explored for lipid-modifying effects, typically under medical supervision.	General supplementation for niacin deficiency and topical skincare.
Cholesterol Effects	Can impact LDL, HDL, and triglycerides when used therapeutically.	Does not typically have significant effects on cholesterol levels.
Side Effects	May cause 'niacin flush' (flushing, itching). Potential for GI upset and liver concerns.	Does not typically cause flushing. May cause nausea and GI issues at high intakes; very high intakes could pose liver risks.
Skin Benefits	Less commonly used in skincare formulations.	Widely used topically for anti-aging, hyperpigmentation, and barrier support.
Pellagra Treatment	Effective, but nicotinamide is generally preferred.	Often preferred for treating pellagra due to lack of flushing side effects.
Primary Goal	Explored for pharmacological effects on blood lipids.	Nutritional support and topical dermatological use.

Considerations for your Nutrition Diet

The choice between nicotinic acid and nicotinamide depends on individual needs and health goals. For purposes related to cholesterol, and always under medical guidance, nicotinic acid may be considered. If the goal is general vitamin B3 support without the flushing effect, or to address specific skin concerns, nicotinamide is often the focus.

For most individuals, adequate niacin can be obtained through a balanced diet. Both forms are present in various foods; nicotinic acid may be more prominent in certain plant sources, while nicotinamide is often found in animal products. Good dietary sources include meats, poultry, fish, nuts, legumes, and fortified foods. The body can also produce niacin from the amino acid tryptophan. However, those with specific health considerations should always consult a healthcare professional before considering supplementation with either form.

Conclusion

Nicotinic acid and nicotinamide, while both forms of vitamin B3, serve different purposes due to their distinct metabolic effects and side effect profiles. A key difference lies in their impact on blood lipids and the potential for the 'niacin flush,' which is typically associated with nicotinic acid and generally absent with nicotinamide. This differentiation makes nicotinic acid relevant in specific medical contexts under supervision, while nicotinamide is commonly used for general nutritional supplementation, skin care applications, and treating pellagra without the uncomfortable flushing. Understanding these distinctions is important for informed choices regarding niacin intake and supplementation. Additional information on niacin can be found from the NIH Office of Dietary Supplements.

Frequently Asked Questions

No, nicotinamide does not typically have the same effect on blood lipids as nicotinic acid. It is not generally used to significantly lower LDL cholesterol, raise HDL cholesterol, or lower triglycerides. For cholesterol support, nicotinic acid may be considered, but only under a doctor's supervision.

The niacin flush is sometimes caused by nicotinic acid, which is thought to trigger the release of prostaglandins, leading to dilation of capillaries. It is generally not considered harmful but can cause temporary discomfort like redness, warmth, and itching. The flush usually resolves within a couple of hours.

Nicotinamide (niacinamide) is typically considered the better form for skin health. It is frequently used in topical applications for its potential to reduce inflammation, improve the skin's barrier function, and address issues like fine lines and hyperpigmentation.

Both forms are found in various foods. Nicotinic acid is often present in plant-based items like peanuts, legumes, and brown rice, while nicotinamide is commonly found in animal-based products such as meat, poultry, and fish.

While generally less likely to cause flushing than nicotinic acid, consuming very large quantities of oral nicotinamide may lead to potential side effects like nausea, stomach discomfort, and could potentially impact liver function. High-level supplementation should be managed by a doctor.

Nicotinamide is often the preferred treatment for pellagra because it effectively addresses the niacin deficiency without typically causing the uncomfortable flushing associated with nicotinic acid.

Studies have shown differences in how the body processes these compounds. For example, research suggests nicotinamide degradation may utilize more methyl-donors like betaine and could have a different impact on plasma homocysteine levels compared to nicotinic acid.