Which is better, niacin or nicotinamide?: A Comprehensive Look at Vitamin B3

October 6, 2025 •

4 min read

According to the National Institutes of Health, both niacin and nicotinamide are forms of vitamin B3, yet they differ significantly in their effects on the body and potential side effects. Choosing which is better, niacin or nicotinamide?, depends heavily on your specific health objectives, whether you are targeting cholesterol levels or improving skin health.

Quick Summary

This guide compares niacin (nicotinic acid) and nicotinamide (niacinamide), detailing their unique benefits and side effect profiles. Discover the distinct applications for each form of vitamin B3, from cholesterol management to skin health, to help you make an informed choice.

Key Points

Differentiating B3 Forms: Niacin (nicotinic acid) and nicotinamide (niacinamide) are both forms of Vitamin B3, but they have different therapeutic uses and side effect profiles.
Niacin for Cholesterol: Niacin is primarily used for managing high cholesterol by raising HDL and lowering LDL and triglycerides, but it can cause uncomfortable flushing.
Nicotinamide for Skin: Nicotinamide is a powerful topical ingredient for improving skin barrier function, reducing acne, minimizing pores, and evening skin tone without causing flushing.
Shared Cellular Function: Both forms are converted into NAD+, a key coenzyme for cellular metabolism, energy production, and DNA repair.
Side Effect Differences: The key distinction is that nicotinamide does not typically cause the 'niacin flush,' making it a preferred choice for general supplementation without this side effect.
Choose by Goal: Your health objective determines which form is 'better': Niacin for cholesterol under medical care, and nicotinamide for skin health and general, flush-free B3 supplementation.

What is Vitamin B3?

Vitamin B3, also known as niacin, is an essential water-soluble vitamin required for hundreds of enzymatic reactions in the body. It plays a crucial role in converting food into energy, cell signaling, and repairing DNA. The two most common forms found in supplements and topical products are niacin (nicotinic acid) and nicotinamide (also called niacinamide). While both are precursors to the vital coenzymes NAD+ and NADP+, their specific health applications and side effect profiles are quite different, making the choice between them highly dependent on your desired outcome.

Understanding Niacin (Nicotinic Acid)

Niacin, or nicotinic acid, has been used clinically for decades, particularly for its potent effects on blood cholesterol and lipids.

Cardiovascular Benefits: When used at therapeutic levels, niacin is known to help lower low-density lipoprotein (LDL or 'bad') cholesterol, reduce triglycerides, and, most notably, increase high-density lipoprotein (HDL or 'good') cholesterol. These effects have been used to support heart health, though its use for this purpose has declined due to the emergence of statin medications and research suggesting it may not significantly reduce the risk of major cardiovascular events.
The Niacin Flush: A well-known side effect of taking niacin is the temporary "niacin flush". This involves a reddening, tingling, and burning sensation on the face, neck, and chest, caused by the dilation of blood vessels. This reaction is harmless but can be uncomfortable for many people. It can often be mitigated by taking aspirin beforehand or consuming it with food. Slow-release formulations were developed to minimize flushing but have been associated with a higher risk of liver toxicity.

The Role of Nicotinamide (Niacinamide)

Nicotinamide, or niacinamide, is the amide form of niacin and does not cause the characteristic flushing effect. This lack of flushing makes it a popular alternative for general B3 supplementation and topical applications.

Skincare Applications: Nicotinamide has gained significant popularity in the skincare industry due to its anti-inflammatory and barrier-strengthening properties. It is used in topical serums and creams to:
- Reduce inflammation and redness associated with conditions like acne and rosacea.
- Minimize the appearance of enlarged pores.
- Strengthen the skin's moisture barrier by boosting the production of ceramides, which helps lock in hydration.
- Treat hyperpigmentation and brighten overall skin tone.
Cellular and Other Benefits: Orally, nicotinamide is the preferred treatment for pellagra (vitamin B3 deficiency) because it avoids the flushing side effect. It has also been studied for potential benefits in preventing certain types of non-melanoma skin cancers, particularly in high-risk individuals. Unlike niacin, nicotinamide does not significantly affect cholesterol levels.

Which to Choose: A Practical Guide

The choice between niacin and nicotinamide hinges on your primary health objective. For general dietary supplementation to support overall cellular function and energy metabolism without discomfort, nicotinamide is often the preferred choice. If you are specifically seeking to manage high cholesterol levels under a doctor's supervision, niacin (nicotinic acid) is the appropriate form, despite the potential for flushing. For improving skin health, topical nicotinamide offers targeted benefits without systemic side effects.

Consider your goals: For most people, a general-purpose vitamin B3 supplement is sufficient to prevent deficiency, and non-flushing nicotinamide is often the more comfortable option. However, those with specific medical conditions should always consult a healthcare provider.
Topical applications: If your primary interest is skin health, topical niacinamide is a widely used choice and should be applied directly to the skin. Oral supplements may not be a substitute for topical treatments in this context.
Medical conditions: Niacin for cholesterol should always be taken under a doctor's care due to the potential for side effects and drug interactions.

Niacin vs. Nicotinamide: A Comparison Table


Feature	Niacin (Nicotinic Acid)	Nicotinamide (Niacinamide)
Primary Use	High cholesterol management.	General vitamin B3 supplementation, skin health (topical).
Side Effect	Can cause temporary, harmless skin flushing, itching, and tingling.	Generally does not cause flushing. May cause mild gastrointestinal issues at high levels.
Cholesterol Impact	Can significantly lower LDL, increase HDL, and reduce triglycerides.	Has no significant impact on cholesterol levels.
Skin Benefits	Less commonly used for skin; can cause irritation.	Widely used topically to reduce acne, minimize pores, and improve skin barrier and tone.
Metabolism	Converts to NAD+, but via a different pathway than nicotinamide.	Converts directly to NAD+ via the salvage pathway, which is considered more efficient for recycling cellular NAD+.
Therapeutic Use	Clinical use for cholesterol requires medical supervision.	Used for deficiency, with topical use based on concentration.

Conclusion: Selecting the Right Vitamin B3 for Your Needs

Ultimately, there is no single answer to the question, "Which is better, niacin or nicotinamide?" The best choice depends entirely on your health goals. For managing high cholesterol, niacin (nicotinic acid) is the clinically studied option, though it comes with the potential side effect of flushing. For general vitamin B3 supplementation, supporting skin health, or boosting cellular energy without the discomfort of flushing, nicotinamide is often the preferred and more comfortable option for most people. Both are vital for the body, but they are not always interchangeable and should be selected based on their distinct physiological effects. Always consult a healthcare professional before starting a new supplement regimen, especially for therapeutic use or if you have pre-existing conditions.

Authoritative Outbound Link

For a deeper look into the clinical use of nicotinamide for skin conditions, particularly for skin cancer chemoprevention, you can find research on the U.S. National Library of Medicine's National Center for Biotechnology Information (NCBI).

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Consult with a healthcare professional before making any health decisions.

Frequently Asked Questions

No, their functions are not interchangeable. Niacin is typically used for cholesterol management but causes flushing, while nicotinamide is used topically for skin health and orally for general vitamin B3 support without significantly affecting cholesterol.

Niacin triggers the GPR109A receptor, which leads to the release of prostaglandins that cause blood vessel dilation, resulting in the flushing effect. Nicotinamide does not interact with this receptor, so it does not typically cause flushing.

Yes, 'niacinamide' and 'nicotinamide' are two names for the same compound, which is the amide form of vitamin B3.

While both are forms of vitamin B3, it is generally unnecessary to take both orally. For cholesterol purposes, a doctor may prescribe niacin. For other needs, nicotinamide is typically sufficient. Combining them is not recommended without medical guidance.

With consistent daily use, noticeable improvements in skin tone, texture, and hydration can often be seen within 4 to 12 weeks, depending on the product and individual skin concerns.

While nicotinamide is generally considered safe, it is crucial for pregnant or breastfeeding individuals to consult with a healthcare provider before taking any supplements, including nicotinamide, to ensure appropriate use and safety.

Some studies suggest that oral nicotinamide, particularly in high-risk individuals with sun-damaged skin, may help reduce the risk of certain non-melanoma skin cancers. However, more research is needed to confirm these findings.

Most people in developed countries get enough vitamin B3 from fortified foods and a balanced diet. Sources include meat, fish, eggs, and fortified grains. Supplements are generally considered when there is a risk of deficiency or for specific therapeutic reasons.