Abstract

Atopic dermatitis (AD) is a chronic inflammatory skin disease associated with impaired skin barrier function, inflammation, and pruritus. Niacinamide has gained attention as a topical therapeutic agent due to its anti-inflammatory properties and its role in enhancing epidermal barrier integrity. This systematic review evaluated the effectiveness of niacinamide-containing emollients and cleansing gels in the management of adult atopic dermatitis. A comprehensive literature search was conducted in MEDLINE, EMBASE, Google Scholar, and the Cochrane Central Register of Controlled Trials (CENTRAL) in accordance with PRISMA guidelines, with the study protocol registered in PROSPERO (CRD42024583712). Randomized controlled trials, cohort studies, and controlled clinical trials involving adults aged 18-65 years were included. Disease severity, pruritus, quality of life, and skin barrier function were assessed as primary outcomes. Of 411 identified studies, three met the inclusion criteria, including two randomized controlled trials and one observational study, with a total of 490 participants. Niacinamide-containing formulations were associated with significant improvements in disease severity, demonstrated by a 25% reduction in SCORAD scores, and enhanced skin barrier function, reflected by a 15% reduction in transepidermal water loss. One study also reported increased nicotinamide adenine dinucleotide levels and improved markers of epidermal differentiation. Meta-analysis was not feasible due to methodological and clinical heterogeneity. Overall, niacinamide-based topical treatments appeared to be effective and well tolerated; however, the limited number of studies and variability in study design precluded definitive conclusions regarding their superiority over standard emollient therapy. Further large-scale randomized controlled trials are required to confirm these findings.

Key words: Effectiveness, niacinamide, emollients, cleansing gel, atopic dermatitis, systematic review