Tag Archives: Skincare

Oral and topical niacinamide for rosacea

Rosacea can be a challenging condition to live with. The unpredictable flushing, uncomfortable dryness, random pimples, and the frustrating sensitivity of the skin would make anyone desperate to find a cure.


While there is no treatment that can permanently correct rosacea, there are many treatments, skincare, and lifestyle measures that can help decrease flare-ups. One that is gaining popularity is a vitamin called niacinamide. With its high safety profile, economic accessibility, and ease of use, it has earned a place in many a rosacea patient’s routines.


What is niacinamide?

Niacinamide, also known as nicotinamide, is none other than Vitamin B3. Specifically, it is the form of Vitamin B3 that is actively used by the body for various processes; the most basic of which is cellular metabolism. Each and every cell in our body requires NAD(H) and NADP(H) to use and harness energy. In fact, the “n” in the acronym stands for nicotinamide. Without these molecules, cells will not be able to function normally. These also have antioxidative properties that help repair damage to cells.


The entire body benefits from this vitamin, but let’s take a closer look at what it does for the skin. Studies suggest that niacinamide plays an important role in maintaining the skin barrier by upregulating the production of ceramides and collagen. Ceramides are lipids that prevent transepidermal water loss, helping keep the skin soft and supple. Meanwhile, collagen is a structural protein that provides for elasticity and tensile strength.


In addition, niacinamide has potent immunomodulatory properties. It inhibits the production of some cytokines, the chemical messengers that trigger inflammation. In fact, niacinamide has been used to successfully treat inflammatory dermatoses, including bullous pemphigoid and is sometimes used as part of acne treatments.


How does niacinamide help rosacea patients?


The skin of rosacea patients is much more sensitive than those of people who do not suffer from the condition. Flare-ups are triggered by anything from sunlight to windburn, spicy food to alcohol, cosmetics to strong emotions. The skin reacts disproportionately to the perceived threat, becoming red, blotchy, rough, and swollen. Unfortunately, angry skin is not great at protecting itself from further irritation, and so the cycle continues.


Niacinamide throws a wrench into this process by making the skin more resilient against threats. It does this by improving the structure of the epidermis to prevent moisture loss, improve tensile strength and suppleness. With niacinamide, the cells that make up the layers of the skin have the sufficient building blocks to produce NAD(H) and NADP(H), allowing them to do their jobs optimally. It also helps to modulate the overactive immune response associated with rosacea.


Topical use

With niacinamide’s many mechanisms of action for improving skin condition and texture, many products have begun to incorporate this vitamin into their formulas. Serums, moisturisers, foundations, creams–you name it.


However, if it is used as a supportive treatment for rosacea, you should pay attention to the concentration. Using a moisturiser containing 2% niacinamide was shown to decrease blotchiness, flakiness, and bumps in rosacea patients after 4 weeks of use. Other studies that focus on this vitamin’s effect on other skin conditions like acne, wrinkles, and pigmentation use products that have up to 10% niacinamide.


Discuss with your practitioner what product they would recommend for your condition. Always be sure to patch-test before applying on your whole face to see how your skin will react to it. Many rosacea patients love niacinamide and most skin types will tolerate it well, but each body is different. It’s better to err on the side of caution and check first, especially if you have sensitive, rosacea-prone skin.


Oral use

In the quest for the ultimate cure to rosacea, oral treatments have been considered. These include low-dose antibiotics and isotretinoin. Initial studies on oral niacinamide for rosacea show promise, though there is still much research needed to find out exactly how it works. Likely, its effect has something to do with the vitamin’s ability to inhibit the chemical triggers for vasodilation, provide energy for cellular repair, and modulate inflammation.  This translates to a decreased likelihood of flare-ups and improved ability of the skin to regenerate after irritation.



Purpose of this information

The information presented on this website and in this article is for general information and example purposes only, does not contain health advice specific for users and must not be relied on for that purpose.  Please see your GP, dermatologist or other health care professional for specific advice.



Draelos, Z. D., Ertel, K., & Berge, C. (2005). Niacinamide-containing facial moisturizer improves skin barrier and benefits subjects with rosacea. Cutis, 76(2), 135–141.


Fivenson D. P. (2006). The mechanisms of action of nicotinamide and zinc in inflammatory skin disease. Cutis, 77(1 Suppl), 5–10.


Levin, J., & Momin, S. B. (2010). How much do we really know about our favorite cosmeceutical ingredients?. The Journal of clinical and aesthetic dermatology, 3(2), 22–41.


Matts, Paul & Oblong, John & Bissett, D.L.. (2002). A Review of the range of effects of niacinamide in human skin. Int Fed Soc Cosmet Chem Mag. 5. 285-289.


Niren N. M. (2006). Pharmacologic doses of nicotinamide in the treatment of inflammatory skin conditions: a review. Cutis, 77(1 Suppl), 11–16.








Gentle Skincare in Rosacea

Gentle is the way in Rosacea Management


Rosacea is a skin condition that causes various types of sensitivity and inflammation of the skin. These hallmarks of inflammation need to be soothed and calmed, and to do that, one must practice gentle skincare.

Gentle skincare is all about minimising irritation that otherwise can cause the skin to flare up. It’s important to remember that this includes avoiding both chemical and mechanical irritants. It’s not just the products you use, but also how you apply them.


Here are some tips to help you practice gentle skincare.


Look at the ingredient list.

You can tell which products are more likely to irritate your skin by checking its formulation. Avoid those that have ingredients such as menthol, alcohol, camphor, fragrances and sodium lauryl sulfate. Now here is something that may shock you.  Avoid essential oils! Dermatologist Dr Chris Jalilian says to avoid ingredients that contain ‘botanicals’.  “These are more likely to do more harm than good”.  Go for products that are labelled as “mild”, “gentle”, “non-irritating”, or “for sensitive skin”. Run away from toners, even if it’s suggested that they may be OK to use in sensitive skin. Rosacea needs no toning!


You should apply these guidelines to anything that touches your face. For example, sodium lauryl sulfate is often found in shampoos and toothpaste. The residue from these products could cause redness in the forehead or around the mouth for example.


  “Avoid menthol, alcohol, camphor, fragrances, sodium lauryl sulfate and essential oils. These are more likely to do more harm than good”.


For more product suggestions, you can check out the rosacea products page of our partner pharmacy.


Consider the two staple ingredients for rosacea skincare, Vitamin B3 (niacinamide) and Vitamin A (retinols). Our favourites are Propaira Skin Defence serum with 10% niacinamide and The Skincare Company’s Vitamin A which glides on the skin so elegantly.  As for a gentle moisturiser, our pick is La Roche Posay Toleriane Ultra Light Sensitive Moisturiser.


Do a patch test

Each person’s skin is different from the next. So what will work for one person may not necessarily work for you. To make sure that the product you are purchasing is right for your skin, do a patch test first. Place a small amount on your jawline or somewhere that is not so obvious. Leave it on for 5-10 minutes to see if it will cause a reaction. If it causes redness, itching, or dryness, best leave it on the shelf.


Cleanse twice a day

To complement your prescribed rosacea treatment, it is important to cleanse twice a day. It’s best to use products that have a slightly acidic or neutral pH to mimic the skin’s natural state.


“Blot your skin dry rather than rubbing and use a soft towel to dry your skin then allow your face to air dry for a further 5 to 10 minutes before you put on your creams”.


The goal is to remove oil and residue from the face as gently as possible. Avoid using washcloths or face brushes as they can be abrasive. Instead, use your fingertips and gently move it against your face in circular motions using a light touch. Wash away the cleanser with lukewarm water as temperature extremes can trigger rosacea. “Blot your skin dry rather than rubbing and use a soft towel to dry your skin” says Dr Chris Jalilian.  “Then allow your face to air dry for a further 5 to 10 minutes before you put on your creams”.



Moisturise regularly

People who suffer from rosacea have skin that is sensitive and easily damaged. Proper moisturisation helps repair that barrier and protect the skin, which results in improved skin appearance and increased comfort.


When you find a gentle, non-irritating moisturiser that works for you, apply it as often as you want. With clean hands, dab it gently onto your face and enjoy the relief from dryness.  You don’t need a lot of moisturiser to cover your face, just enough for a thin coat.



Apply sunscreen everyday

Sunscreen is one of the cornerstones of rosacea management. Use a broad-spectrum product with at least SPF 30+. Physical filters such as zinc oxide and titanium dioxide may not be easy to blend into the face, but these are less likely to irritate the face, making them the active ingredients to look out for when shopping for sunscreen.


Make sure to apply every 2-3 hours during the day when outdoors, regardless of the weather or your location.



Combining gentle products with gentle application can significantly improve the effectiveness of medical rosacea treatments. But as with any skincare routine, consistency is key. Make it a habit to take care of your skin by cleansing, moisturising, and applying sunscreen, and you’re sure to see (and feel!) the results.


Purpose of this information

The information presented on this website and in this article is for general information and example purposes only, does not contain health advice specific for users and must not be relied on for that purpose.  Please see your GP, dermatologist or other health care professional for specific advice.








Levin, Jacquelyn & Miller, Richard. (2011). A Guide to the Ingredients and Potential Benefits of Over-the-Counter Cleansers and Moisturizers for Rosacea Patients. The Journal of clinical and aesthetic dermatology. 4. 31-49.


Santoro, F., Lachmann, N. An Open-Label, Intra-Individual Study to Evaluate a Regimen of Three Cosmetic Products Combined with Medical Treatment of Rosacea: Cutaneous Tolerability and Effect on Hydration. Dermatol Ther (Heidelb) 9, 775–784 (2019). https://doi.org/10.1007/s13555-019-00331-4








Tips for Healthy Winter Skin


As the temperature drops and the nights grow longer, your skin may shift to a dry and flaky texture in winter. The low temperature and humidity of this season causes our skin to become more dry, resulting in poor barrier function of the skin, flares of eczema and dermatitis, increased sensitivity and itch, and more prominent appearance of fine lines and wrinkles (if that matters).  

But there are ways to counter the skin changes brought on by the cold. With these simple skin hacks, you can keep your skin supple and healthy despite the freeze.


Moisturise, moisturise, moisturise

Counter the dry winter chill with a heavy-duty moisturiser. Shift from your airy, lightweight summer moisturiser to something with a thicker and creamier consistency. This will leave your skin feeling supple for longer, putting up a worthy fight against the cold and dry environment. 

Moisturisers in their chemical properties come as three types;

  1. Humectants which draw water to the skin
  2. Occlusives which prevent water escape from the skin, and
  3. Emollients which fill in the cracks between your skin.

Commercially available moisturisers come in different chemical makeup and good ones will have all three types ticked off.  The key is to try different moisturisers until you find one that you like best.  If you need a moisturiser that is just right for you in its texture and moisturising properties, this can be made for you in an affordable manner at some compounding pharmacies specialising in skin.

Consider a humidifier at home

If a humectant moisturiser is Batman, a humidifier would be Robin.

The hygroscopic (water absorbing) property of a moisturiser is maximised only when the air around you contains moisture. Winter air is dry, add to this the use of heaters indoors and you have a great set of conditions for dry air in your house, classroom or workplace. 

Consider adding a humidifier in the indoor spaces you spend the most time in, such as your bedroom or office. Use a product with humectant ingredients and give your skin relief from arid conditions. 


Avoid irritating ingredients

The biting cold is already a handful for our skin to manage, so let’s not give it any other reason to stress out. Irritating ingredients like alcohol in some serums, astringents in some creams, soaps and strong fragrances can push our already damage-prone skin over the edge.

Instead, go for products that are labelled as

  • “gentle”
  • “mild”,
  • “soap-free”,
  • “non-irritating” or;
  • “for sensitive skin”.

This will give your skin the TLC it deserves for protecting us against the elements.


Protect your skin from abrasive clothing

Chemical ingredients in skincare products aren’t the only things that cause our skin additional distress. Abrasive fabrics can rub against our skin, leading to friction that could irritate your skin.

Wear a layer or two of light, comfortable clothes, ideally made from cotton, that sit directly on your skin. Then pile on however many layers of heavy-duty winter clothing you need to stay warm.

And the same principle goes for mittens. Wearing glove liners made of silk or cotton under your wooly mittens can protect dry hands from further irritation.


Protect your skin from snow-reflected UV rays

An overcast winter day might make you think that you don’t need sunscreen, but the snow that falls down from it is definitely a reason to worry. Fresh snow can double a person’s UV exposure because it is just so good at reflecting the sun’s rays.

Thankfully, the winter chill has your body covered with heavy clothing that prevents UV rays from seeping in, but you have to protect every other part of your body left exposed–including your eyes!

Snow blindness, also known as photokeratitis, is basically getting your eyes sunburned. It is as painful as it sounds. To avoid this, wear UV-protective sunglasses or winter goggles with a UV rating.


Don’t turn up the heat too high

If the cold makes our skin dry and irritated, then turning up the heat will make it all better–right?


Our attempts to compensate for the low temperature by cranking it up could be doing more harm than good. 

A long, hot bath may sound luxurious, but your skin would much prefer a quick, lukewarm shower. Keeping your heater to a comfortable 20-22°C keeps you from shivering without shocking your skin.


Some last thoughts

As a dermatology practice, we see a rise in patients seeking assistance with eczema, hand dermatitis and psoriasis in the winter months.  With cold and low levels of humidity, we need to counter-act the drying effects of these conditions by avoiding irritants getting to our skin and being liberal and frequent with the use of moisturisers. 

Interestingly, what we see less of in winter is patients seeking skin checks for skin cancers.  The saying ‘out of sight, out of mind’ may explain this phenomena well, however skin cancers don’t just wait for warmer weather to appear.   Check your own skin regularly for any new or changing lesions and see your GP or dermatologist if you have a concern.

Look after your skin in all seasons of the year, at all times.


The information presented on this website is for general information and example purposes only, does not contain health advice specific for users and must not be relied on for that purpose.  Please see your GP, dermatologist or other health care professional for specific advice.