Can I use a niacinamide moisturizer while using tretinoin?

What does the moisturizer add?

Niacinamide is a form of vitamin B3 that supports the skin barrier, the outer layer that helps keep water in. Topical niacinamide is generally well tolerated. A niacinamide moisturizer used alongside tretinoin has improved the condition of that outer layer and reduced treatment related side effects.12

Daily moisturizing also helps skin tolerate drying acne medicines, including tretinoin. A moisturizer's job here is moisture support, which leaves the jar mercifully little reason to audition as another treatment. If you use tretinoin for acne, oily skin is not a reason to skip moisturizer: skin can feel oily while still needing help with treatment related dryness.3

How should I use them together?

Use moisturizer daily and keep tretinoin on your prescribed schedule. Tretinoin is usually applied at bedtime. Applying moisturizer after the treatment is a general layering approach; follow any different instructions supplied with your prescription.45

1. 1Wash your hands and face with a mild cleanser. Let your skin dry as directed before applying tretinoin.
2. 2Apply a thin layer of tretinoin to the treatment area. Keep it away from your eyes, mouth and the corners of your nose, and avoid sunburned skin or areas affected by eczema.
3. 3Apply your niacinamide moisturizer afterwards to help with dryness.
4. 4During the day, use sunscreen and protective clothing, and avoid unnecessary or prolonged sun exposure.

You can also use the moisturizer in the morning or whenever your skin feels dry. After washing, applying moisturizer while some water remains on the skin helps trap moisture, which gives water a supporting role without requiring its own serum bottle. Keep that damp skin moisturizing step separate from tretinoin application, which requires letting skin dry as directed.34

Which moisturizer should I choose?

For acne, look for a moisturizer labelled "oil free", "noncomedogenic" or "won't clog pores". These descriptions mean the product is unlikely to cause acne. Choose a nonmedicated moisturizer rather than a product packed with extra treatments.34

Avoid products containing lots of alcohol, menthol, spices or lime, which can sting during tretinoin use. Do not add topical medicines such as benzoyl peroxide or salicylic acid unless your doctor directs you to.4

What should I expect?

Tretinoin can cause redness, peeling and dryness, particularly in the first few weeks. Moisturizing supports tolerability, but irritation can still happen. Sensitive skin needs particular care: topical retinoids can worsen eczema because of their drying effect.16

Keep the moisturizer's role separate from the treatment timeline. Acne improvement with topical retinoids can take 12 weeks or longer. In acne routines that included medication, cleanser and an acne friendly moisturizer, most patients saw less acne within 4 to 8 weeks. That is a timeline for the whole routine, not a deadline for niacinamide alone.36

When should I contact my doctor?

Contact your doctor if dryness, burning, stinging, peeling, redness or swelling is severe or does not go away. Call immediately for rash, hives, or pain at the treatment area. Do not try to manage a significant reaction by adding more moisturizer.4

If you are pregnant, planning pregnancy or breastfeeding, discuss tretinoin with your prescriber. If you become pregnant while using tretinoin, call your doctor. Adding niacinamide moisturizer does not change those precautions.4