Can Increasing NAD+ Support Skin Health & Aging?

Key Takeaways:

• Skin health is more than surface-deep: Cellular processes like DNA repair, collagen maintenance, and energy metabolism play a central role in maintaining a youthful, resilient complexion.

• NAD+ is essential for skin vitality: This coenzyme supports repair, regeneration, and resilience, but levels can naturally decline with age and environmental stressors like UV exposure, diet, and pollution.

• Niacinamide shows the value of topical NAD+ precursors: It has proven benefits for hydration, fine lines, and overall complexion.

• Nicotinamide riboside (NR) offers an inside-out approach: NR boosts NAD+ systemically, supporting cellular processes and skin health from within.

• Emerging research is promising: Preclinical and clinical studies suggest, NR alone, and in combination with other ingredients, may improve skin resilience, repair, and appearance, and work synergistically with other compounds for enhanced protection.

From toners and topicals to masks and moisturizers, anti-aging skincare is everywhere—but does true skin vitality depend on more than what we apply to our face each night?

The growing interest in longevity among health-conscious consumers is not just about reaching the age of 100 and beyond. It’s about vitality and protecting our bodies on a cellular level—and a growing number of people are realizing that this also includes our body’s largest organ, the skin.

Advances in skincare are moving toward an integrated approach—combining topical therapies with cellular-level interventions that support the skin’s intrinsic repair and renewal mechanisms. Surface treatments alone cannot fully address the complex biology underlying skin health.

As leaders in the beauty industry, like Hope Dworaczyk Smith, CEO of skincare company MUTHA, say, 

“2025 is all about next-level science, sustainability and personalization, and I’m here for it. We’re moving beyond surface-level fixes to true skin rebuilding. PRP, NAD and exosomes are changing the game, boosting collagen, accelerating repair and improving skin health at the cellular level. The future isn’t just anti-aging—it’s pro-regeneration.”

 This perspective reflects a growing trend in skincare: targeting skin health from the inside out. One key player in this approach is nicotinamide adenine dinucleotide (NAD+), a vital molecule for energy production, repair, and resilience at the cellular level.

In this article, we’ll explore how external signs of aging are influenced by cellular health, including the connection with NAD+ and how precursors like nicotinamide riboside (NR) may help support skin health from within.

Why Skin Health Is More Than Skin Deep: How NAD+ Decline May Drive Visible Aging

As our largest organ and first line of defense against pathogens and environmental threats, the skin consists of three complex layers that are constantly repairing, renewing, and protecting our internal organs. Each of these cellular processes requires a continual supply of energy to support DNA repair and maintain skin health and resilience.

When DNA repair or skin cell renewal becomes inefficient, this can lead to fine lines and wrinkles, hyperpigmentation, uneven texture, and delayed wound healing. Combined with reduced collagen and elastin production, this also contributes to loss of elasticity and volume.¹

Dozens of external stressors can influence these visible signs of aging—including UV exposure, pollution, smoking, excessive alcohol use, poor diet, and lack of sleep. These factors trigger oxidative stress: a buildup of damaging free radicals, or reactive oxygen species (ROS), that overwhelm the body’s antioxidant defenses.²

Healthy NAD+ levels are fundamental for energy metabolism and cellular repair—including in the skin—which is why declining levels of this essential molecule may accelerate skin aging and reduce our ability to repair environmental damage.

NAD+ levels have been shown to decline in human skin with age, as seen in a study analyzing skin samples from newborns to elderly adults.³ Alongside the reduced NAD+ stores were elevated markers of oxidative stress, including MDA (malondialdehyde), and greater activity of NAD-consuming enzymes called PARPs.

Environmental stressors—like excess sun exposure, smoke, or pollution—can further deplete NAD+ by activating PARPs, which consume NAD+ to repair DNA, and by reducing NAD+ availability for sirtuins, limiting their protective functions in the skin.

Interestingly, studies suggest that nicotinamide phosphoribosyltransferase (NAMPT)—a key enzyme in NAD+ metabolism—helps protect skin cells called epidermal keratinocytes from UVA and UVB damage by preventing NAD+ depletion.⁴

Healthy skin begins at the cellular level—and maintaining NAD+ stores may be a critical strategy for supporting skin vitality, resilience, and repair, no matter your age.

What is NAD+ and Why Is It Important for Skin Health?

As an essential coenzyme, every cell in our body needs NAD+ to function effectively—including skin cells, which require NAD+ for cellular energy production, DNA repair, mitochondrial function, and overall cellular resilience.

However, NAD+ levels tend to decline significantly with age,³ largely due to accumulated oxidative damage and ongoing metabolic stress. Low or inadequate NAD+ levels are associated with many hallmarks of aging,⁵ including mitochondrial dysfunction and impaired cellular health. 

There is growing evidence suggesting that NAD-dependent processes are linked to skin health and that declining NAD+ is tied to external signs of skin aging.⁶ Several mechanisms underlie this link, including inefficient DNA repair, dysregulated collagen maintenance, and cellular senescence. 

The skin’s sophisticated DNA repair mechanisms (such as PARPs) rapidly repair DNA damage from UV irradiation or other stressors before it becomes harmful and leads to signs of aging. But as these mechanisms depend on NAD+ to function, a decline in NAD+ can result in a problematic loss of these repair processes.

Collagen is another vital component of skin health. This fibrous protein is part of the extracellular matrix, a structural component of the dermis. With age, collagen becomes fragmented, reducing skin elasticity. Maintaining collagen structure relies on NAD-dependent sirtuins like SIRT6, which are needed to preserve and produce collagen.⁶

Cellular senescence also contributes to skin aging. In this state of irreversible cell cycle arrest, fibroblasts and keratinocytes stop functioning but remain in the tissue. These so-called “zombie cells” cause inflammatory damage to nearby cells, leading to thinning of the epidermis and reduced barrier function. Low NAD+ accelerates senescence by diminishing SIRT1 activity.⁶

Given NAD+’s critical roles in skin health, replenishing its stores has become a key strategy for supporting skin from the inside out. In a mouse model, researchers found that NAD+ administration significantly decreased UVC-induced skin damage⁷—an effect that may have implications for human skin aging, though more clinical studies are needed. 

Current methods for increasing NAD+ in the skin include niacinamide—a topical product that many skincare enthusiasts are likely already familiar with. Topical niacinamide is a widely used and well-studied product—and it’s also a precursor to NAD+. 

But topical niacinamide isn’t the only option. Emerging research shows that oral NAD+ precursors like NR may offer a more efficient approach to skincare, starting from the inside out.

Could Nicotinamide Riboside Offer Superior Benefits to Niacinamide in Skincare?

Niacinamide has decades of safe use in skincare. At concentrations of 4-5%, it provides clinically supported benefits, including improvements in fine lines, wrinkles, hyperpigmentation, texture, sallowness, hydration, elasticity, photoprotection, and overall complexion.⁸

As a form of vitamin B3, niacinamide also serves as an NAD+ precursor, providing a mechanistic rationale for its broad skin benefits. However, it is not the most efficient way to boost NAD+ levels systemically. In contrast, nicotinamide riboside (NR), another NAD+ precursor, is clinically proven to effectively raise NAD+ levels throughout the body.⁹

NR also has a unique advantage when it comes to sirtuins—enzymes that depend on NAD+ and support key skin processes like collagen maintenance and cellular repair. While high doses of niacinamide can inhibit sirtuins, NR activates these enzymes.¹⁰ This dual action—raising NAD+ and activating sirtuins—suggests that NR may provide superior support for skin vitality over niacinamide.

While niacinamide remains an excellent topical treatment, NR offers an “inside-out” approach, targeting skin health at the cellular level. As emerging research continues to highlight its potential, skincare experts and scientists are increasingly exploring boosting NAD+ internally as a next-generation strategy to support skin from within.

Nicotinamide Riboside and Skin Health: What the Science Shows So Far

As environmental stressors, oxidative stress, and aging deplete NAD+ levels³—contributing to wrinkles, hyperpigmentation, and other visible signs of aging—boosting NAD+ internally with precursors like NR is emerging as a promising strategy to support skin health.

Recent preclinical studies suggest that NR promotes skin resilience through multiple mechanisms. In a mouse model of systemic sclerosis, NR supplementation dramatically increased NAD+ levels in the skin and reduced fibrosis, improving skin thickness, collagen accumulation, and the activity of scar-forming cells.¹¹ Other studies in aged or genetically compromised mice have shown that NR enhances skin repair, reduces DNA damage, mitigates UVB-induced injury, and accelerates wound healing.¹²

NR may also help protect against visible signs of aging. In mice, NR inhibited enzymes involved in melanin production, reducing UV-induced hyperpigmentation.¹³ In cultured skin cells, NR lessened cellular damage and preserved structural proteins. Emerging research in human skin cells suggests that NR can work synergistically with small extracellular vesicles and natural compounds like vitamin C and resveratrol to provide enhanced protection against skin aging.¹⁴

Clinical studies of NR in combination with other ingredients in humans support these preclinical findings. In one study, an oral supplement containing NR, grape seed extract, vitamin C, vitamin E, and rosehip extract improved facial skin in female participants over 28 days, including enhanced moisture, firmness, spot-fading, and smoothing with reduced wrinkle appearance.¹⁵ More than 88% of participants reported improvements in skin recovery, as well as daily energy and mood.

Other research has explored synergistic approaches combining NR and bioactive compounds. A topical application of small extracellular vesicles—tiny particles with regenerative properties—loaded with NR, NAD+, and resveratrol to the hands improved skin moisture by 19%, increased elasticity by 104%, and reduced mean pore volume by 51%.¹⁶ In cultured human skin cells exposed to UVB, these loaded vesicles reduced oxidative stress more effectively than the individual ingredients or vesicles alone, highlighting the enhanced protective potential of this combined approach.

Oral NR alone has also shown promise. In patients with Werner syndrome—a genetic condition that accelerates aging—NR reduced skin ulcer size and appeared to prevent heel pad thinning.¹⁷ Building on these findings, ongoing clinical trials are exploring topical creams containing NR, pterostilbene, and silibinin to prevent or reduce radiation-induced skin damage, including acute radiodermatitis, a common and painful side effect of radiation therapy.

While further research is needed, NR is becoming a promising tool in next-generation skincare, shifting the focus beyond topical treatments toward an inside-out, cellular-based approach.

The Future of Skincare: Why NAD+ and NR May Support Cellular-Level Skin Health

NAD+ is fundamental for skin vitality—including repair, regeneration, and structural support—but its levels naturally decline with age and are further depleted by environmental stressors such as UV exposure, alcohol consumption, pollution, and poor diet.

Topical NAD+ precursors like niacinamide have already demonstrated the value of supporting skin health through NAD+, including improving fine lines, hydration, and overall complexion. Nicotinamide riboside (NR) represents a new, systemic approach, boosting NAD+ from within and supporting skin at the cellular level.

Supporting NAD+ internally helps maintain critical processes like DNA repair, collagen production, sirtuin activation, and a reduction in cellular senescence. Combined with topical treatments or other bioactive compounds, NR offers a safe and promising strategy to preserve skin resilience and vitality with age.

These findings reinforce the notion that skin health is more than just surface-deep, and many cellular processes play a central role in maintaining a youthful, resilient complexion. While further research is needed—particularly in diverse populations—this growing body of science highlights an exciting intersection of NAD+ biology, skincare innovation, and dermatology.

If you are interested in contributing to research in this field, we encourage you to reach out via our Contact page at AboutNAD.com to explore opportunities or research on NR and skin health.

References 

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