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Chloe, what's actul (brand) name of the topical medicine you have containing niacinamide?

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Matt

Niacinamide is a key ingredient in several of Olay's lines, like Pro-X, Regenerist and their body lotions. I've read it helps even skin tone and strengthen the moisture barrier. Nia 24 is a higher end skin care line that features Niacinamide.

Sam! Long time no see! Hope all is well with you.

It is supposed to make retinoids more tolerable, as it has barrier-building benefits.
http://www.pgbeautygroomingscience.com/niacinamide-shown-to-increase-tolerance-and-effectiveness-of-topical-retinoid-therapy2.html

But-- Zoe Draelos co-wrote the paper. I sometimes have my doubts about her since she will write a paper professing benefits for just about anything if they throw enough money at her.

Since it is water soluble and best near skin-neutral pH it is an easy addition to just about any lotion or cream save the ones that need to be acidic to work.

I bought some niacinamide powder a few years ago from BeyondACentury.com. t was cheap.I sometimes put it in my sunscreens.

Sam,

My uni does not subscribe to Cutis. The abstract is below. It says they used the moisturizer twice a day and the retinoid daily (nightly, I would assume) starting two weeks in.

I would apply the retinoid first, wait half an hour, and then the moisturizer.

But there is no mention of sunscreen in this abstract. I seriously doubt that this moisturizer has anything to offer approaching what a decent sunscreen might offer.

There's always considerably less rigor to these trials than what one might prefer.

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Cutis. 2006 Oct;78(4):275-81.
Facilitating facial retinization through barrier improvement.
Draelos ZD, Ertel KD, Berge CA.
Source
Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA. zdraelos@northstate.net
Abstract
The utility of topical tretinoin as a treatment for improving the appearance of photodamaged skin is limited by irritation that occurs during the early phases of facial retinization. The observed side effects are consistent with stratum corneum barrier compromise. This paired double-blinded study was conducted to determine if preconditioning the skin with a barrier-enhancing cosmetic facial moisturizer before beginning tretinoin therapy and continuing moisturizer application during therapy would mitigate these side effects. Women with facial photodamage were recruited and randomly assigned to apply one cosmetic moisturizer to one side of the face and the other cosmetic moisturizer to the other side of the face twice daily for 10 weeks. One moisturizer contained a mixture of vitamins (niacinamide, panthenol, and tocopheryl acetate) to enhance stratum corneum barrier function, and the other moisturizer contained similar moisturizing ingredients but no vitamins. Daily full-face treatment with tretinoin cream 0.025% commenced 2 weeks into the study. Subjects' facial skin condition was monitored via investigator assessments, instrumental measurements, and subject self-assessments. The results show that improving stratum corneum barrier function before beginning topical tretinoin therapy and continuing use of a barrier-enhancing cosmetic moisturizer during therapy facilitates the early phase of facial retinization and augments the treatment response.
PMID: 17121065 [PubMed - indexed for MEDLINE]

No, it's not a fair assessment.

evidence herein:
http://faculty.washington.edu/andchien/PDFs/evidencebasedretinoids.pdf

It does much more than irritate. It actually prevents and undoes a lot of skin damage. It can make older skin younger, even if it isn't photoaged.

Retinoids prevent upregulation of the matrix metalloproteinases that damage skin collagen. There are four types of retinoid receptors in the skin and binding with them affects several hundred genes and gene products. Garden variety inflammation can't touch this.

But if irritation is your only yardstick, you can mimic some of its effects by anything acidic, or any type of mechanical abrasion. These will by no means cover the entire spectrum of action of the rx retinoids but they (assuming it's something strong enough to smooth away the fine lines, etc.) are better than nothing.

Don't expect a plastic surgeon to be a retinoid guru. Derms know more about it than they do. But even derms can sometimes be less than enthusiastic about them because patients usually won't use them. I guess it's kind of like diet--eventually you stop telling your patients to eat sensibly and just give them statins, insulin, and stents because about 95% won't do it.

No.

You're probably having a cosmetically-induced bout of acne. You could benefit from a significantly less emollient formulation. Look for a gel or your derm could have a pharmacist compound a water-based version for you.

Might be that either ROC or the NIA24 alone would work but both in combination are too greasy for you.

Yes, kosmeds, thank you so much!

Good to be back MissJ. I've been thinking about you all.
Thanks so much for your great help. When things calm down I'll get in touch to see if you have time for some advice on a tweak.
I'll report back on the NIA 24-retinoids combo. Thanks to DC for the NIA suggestion and to Kosmeds for the retinoid advice. I really do learn a lot from this board.
I did a CME on copaxone (an injectable MS drug) today and mesiotherapy for the injection site lipoatrophy. I was thinking that you all would have passed without a doubt.