A niacin-based skincare cosmeceutical regimen combined with intense pulsed light (IPL) treatments offers better skin rejuvenation outcomes than IPL alone, a new study suggests.
Dr. Gold, assistant clinical professor in the Department of Medicine,Vanderbilt University, Nashville, co-authored a study examining whether use of four NIA 24 products before, between and after IPL treatments for photodamage would make a difference in patients' small wrinkles and fine lines, hyperpigmentation, erythema and secondary endpoints of skin texture, skin roughness, pore size and overall skin appearance.
"Over the last several years, we have looked at using appropriate cosmeceuticals that have medical evidence behind them. NIA 24 has a pretty big track record of clinical improvement in actinically damaged skin, improving lines and wrinkles. We asked the question that if NIA 24 is useful for actinic damage, and light sources rejuvenate the skin, would the combination improve results?" he says.
Thirty subjects with photodamage participated in a 12-week randomized, blinded, placebo-controlled study. Twenty subjects received daily treatment with NIA 24 products, including the NIA 24 Gentle Cleansing Cream and Sun Damage Prevention 100 percent Mineral Sunscreen SPF 30 every morning, followed by nighttime use of the NIA 24 Skin Strengthening Complex.
The treatment group also used the NIA 24 Physical Cleansing Scrub twice a week for the 30 days prior to the first IPL treatment and was instructed not to use the scrub the first week after each IPL treatment, resuming after that first week. The treatment group applied the NIA 24 regimen twice daily for four weeks prior to the first IPL treatments, during the four weeks between treatments and four weeks after the second treatment.
The authors of the study did not find statistically significant changes in any of the outcomes. But, Dr. Gold tells Dermatology Times, that was only part of the story.
"Although it would have been nice, what you look for in this kind of study is not necessarily a 0.0001 significant increase (because the study is small)," he says. "We saw across-the-board improvements in the subjects using NIA 24 versus those using placebo. (Treatment subjects') erythema improved; their wrinkle score and pigmentation improved. Of all the individual parameters, skin texture changes was the area of greatest improvement."
Dr. Gold says NIA 24 is now a skincare regimen he recommends for IPL and other patients.
"I am comfortable now that I have tested it," he says. "I look at this product in two different ways: For people who have actinic damage and are interested in rejuvenating the skin, this is perfect. Then we have a group of patients who are just interested in cosmetic texture change and wrinkle improvement, and this is one of the products that dermatologists can be comfortable choosing that has the right science behind it."
According to company literature, NIA 24 is a topical cream containing Pro-Niacin, a patented delivery system made up of a lipophilic molecule that penetrates the stratum corneum. It transports niacin across the skin barrier into the epidermis, where it is converted to nicotinic acid, which is then converted to the bioactive form of niacin, or nicotinamide adenine dinucleotide.
In June 2007, Jacobson EL et al reported in the journal Experimental Dermatology that myristyl nicotinate (MN), a nicotinic acid derivative designed to deliver nicotinic acid to skin without vasodilatation, enhances epidermal differentiation and barrier function in skin. According to the study, this suggests that the nicotinic acid delivery method may be useful in limiting progression of actinic skin damage and possibly in treating other conditions involving skin barrier impairment.