Medina, Ohio — Niacinamide can be an effective treatment for the inflammation related to rosacea, according to Helen M. Torok, M.D., medical director, Trillium Creek Dermatology & Surgery, Medina, Ohio.
The etiology of rosacea is unknown, although research has shown that symptoms are exacerbated by factors that trigger innate immune responses, such as the release of cathelicidin antimicrobial peptides.
"Niacinamide research has been documented and shows that it provides various benefits," says Dr. Torok, who is also clinical professor of dermatology, Northeastern Ohio Universities Colleges of Medicine and Pharmacy, Rootstown, Ohio. "It has been shown to increase biosynthesis of ceramides and other stratum corneum lipids to improve the epidermal permeability barrier, and niacinamide has also demonstrated in studies a broad array of improvements in the appearance of aging facial skin."
Another study concluded that there were multiple benefits of niacinamide, such as increased synthesis of ceramides, free fatty acids and cholesterol; a more rapid keratinocyte differentiation; stimulatory effect on collagen synthesis; and improved dermal and epidermal cell growth, effective in smoothing the surface structure of the skin and reduction of wrinkles.
"This is no longer available to our patients, but Elorac, a new pharmaceutical company in Vernon Hills, Ill., is looking to bring oral Nicomide back as a prescription," Dr. Torok says.
A new topical niacinamide formulation is CeraVe Facial Moisturizing Lotion PM (Coria). It is formulated with niacinamide, ceramides and physiologic lipids.
"I have incorporated CeraVe PM for the last two months for most of my acne and rosacea patients as an add-on treatment with other topical and oral prescription products," Dr. Torok says.
This product reduces the irritation and inflammation of topical retinoids and benzoyl peroxide products.
"The advantage of this therapy is that patients readily will use it, as it is not an antibiotic, nor a prescription that will give them side effects. They are very receptive to this 'natural' treatment," she says.