Ingredients

NAD+ for skin: creams, capsules and drips

Three delivery routes with three different evidence bases and one shared story. The cheapest relative has decades of skin data the others lack.

Article in one pictureThree routes, three evidence bases
  • TopicalA trial registered, no published result yet
  • OralReal trials, mostly measuring blood not skin
  • IntravenousExpensive, and no skin evidence at all
Sold as one idea. A cream, a capsule and a drip have almost nothing in common here.
On this pageWhat NAD+ does, in plain words5

The bottom line

NAD+ is a molecule every cell needs for energy and repair, and its levels fall with age. That much is solid. What follows is not. Creams claiming to raise NAD+ in skin have a registered trial underway and, at the time of writing, no published result. Oral precursors have real trials, but almost all measure blood markers or general health rather than skin, and reviews comparing them are careful about how much translates. Intravenous drips are expensive, unregulated in most places, and have no skin evidence at all. The unglamorous note: niacinamide, a cheap relative of the same vitamin, has decades of dermatological evidence for barrier function and pigmentation, and it is already in products you can buy for very little.

Three things worth remembering

  1. A trial of a topical NAD+ precursor for facial ageing is registered, with skin biological age among its outcomes, and no published result yet.[1]
  2. Oral precursor trials mostly measure blood levels or general health. Reviews comparing longevity supplements are cautious about how much reaches skin.[2][3]
  3. The clearest randomised evidence comes from a rare genetic ageing condition, which is a poor guide to what happens in healthy adults.[4]

What NAD+ does, in plain words

Every cell uses NAD+ to convert food into usable energy and to run repair machinery, including the enzymes that fix damaged DNA. Without enough of it, cells work less well.[3][2]

Levels fall with age, and ultraviolet damage consumes it faster because repair enzymes draw on it heavily. That is the whole basis of the interest in skin, and it is a reasonable one.[3]

The leap is from "levels fall" to "raising them helps". That step needs evidence, and it is where the story thins.[2][5]

The three routes, and what each has behind it

They are sold as one idea and they are not comparable. What is known differs substantially between them.[2][3]

How the delivery routes compare on evidence
RouteWhat existsWhat is missing
Topical precursorA registered trial in facial ageingPublished results; nothing yet to judge[1]
Oral supplementReal trials, mostly on blood markers and general healthSkin outcomes in healthy adults[2][4]
Intravenous dripCost, and enthusiastic marketingAny skin evidence whatsoever[2][5]
NiacinamideDecades of dermatological evidenceNothing; it is simply not marketed as longevity[3]

What the supplement trials actually found

Oral precursors do raise NAD+ measured in blood. That part is consistent and not in dispute. What those trials mostly did not measure is skin.[2][3]

The strongest randomised evidence involving skin comes from a trial in Werner syndrome, a rare genetic condition causing accelerated ageing, where supplementation was associated with reduced skin ulcer area among other changes. That is a serious study in a very unusual group.[4]

Applying a result from a rare accelerated-ageing condition to ordinary adults is exactly the kind of leap that produces disappointing supplements. Reviews comparing these compounds make that point directly.[2][4]

The cheap relative nobody markets

Niacinamide sits in the same vitamin family and feeds into the same pathway. Unlike the newer precursors, it has been studied on skin for decades, with reasonable evidence for barrier function, pigmentation and redness.[3][5]

It is also inexpensive and already in a great many moisturisers. If the underlying idea appeals, this is the version of it with actual dermatological evidence attached.[3]

What to do meanwhile

Use niacinamide if you want something in this family, and treat topical precursors as an experiment worth watching rather than buying. The registered trial will produce a result, and that is the moment to reconsider.[1][3]

Skip the drips. There is no skin evidence, they are expensive, and injecting something for a cosmetic reason carries risks that a cream does not.[2][5]

Turn this into a practical plan

Choose the guide that best matches what you see. Each one starts with what to try, how long to wait and when to get help.

Related questions