Nicotinamide is a water-soluble compound found in the body as part of the vitamin B complex. According to MedicineNet.com, people with low levels of nicotinamide, zinc or folic acid have a higher risk of developing specific forms of acne. Nicotinamide, zinc and folic acid are available in combination anti-inflammatory medications that are effective against some forms of acne.
The U.S. Federal Drug Administration has approved nicotinamide in the form of pills that also contain zinc and folic acid to treat acne vulgaris, a common form of acne that often runs in families. Acne vulgaris begins during adolescence and produces a variety of lesions, most often on the face, but also on the chest, shoulders and back. Nicotinamide is also approved for the treatment of acne rosacea, which can cause small red bumps and red cysts, or pus pockets, on the face.
According to Drugs.com, nicotinamide works at different points along the inflammatory pathway. It acts directly to reduce the inflammatory response that causes the skin lesions of acne. It also blocks the inflammation caused by iodide compounds in the diet that can cause acne symptoms or make them worse.
Nicotinamide comes in 750 mg tablets combined with 25 mg of zinc oxide, 1.5 mg of cupric oxide and 500 mcg of folic acid. The usual adult dose of nicotinamide is one pill taken once or twice a day.
Nicotinamide can cause nausea and vomiting, especially if an individual takes more than the recommended dose. There have been rare occasions of allergic reactions associated with the folic acid in the combined pill. More serious side effects of nicotinamide include dizziness, headache, high blood glucose levels, blurred vision, flushing and rash. Nicotinamide can also cause liver toxicity and elevate liver function test results.
According to Drugs.com, nicotinamide interferes with the body’s ability to clear primidone and carbamazepine, drugs that are prescribed to treat seizures. The drugs will stay in the body at higher concentrations for a longer period of time, increasing the risk of side effects.
Since nicotinamide can damage the liver, it should be used with caution in people who have a history of liver disease or jaundice, a yellowing of the skin. Nicotinamide should be used with caution in people who have diabetes, since it raises blood glucose levels. Drugs.com cautions against large doses of nicotinamide for pregnant women and older adults, and reports that its safety and effectiveness have not been established for children.