Topical niacinamide (vitamin b3) is generally considered safe to use during pregnancy. It can help calm redness and so is suitable for use in rosacea prone skin. It also has barrier repairing qualities, so when used in an emollient moisturizer, it can help repair the skin barrier. During pregnancy, it can help to decrease hyperpigmentation associated with melasma. It's important to consider however that for melasma, niacinamide won't fully treat or prevent it, and that strict sun protection is key! Niacnamide is found in many skincare products, so it doesn't usually need to be added on as a standalone product. I always tell my patients to check their product ingredient lists, as they may already be using a product that contains niacinamide. If they aren't and they would like to work it into their skincare regimen, it can be applied in the morning under sunscreen or at night as a serum under moistuzier.
Niacinamide is typically well-tolerated by pregnant females. There is no substantial clinical evidence in current medical literature showing that dermatologist are more cautious about recommending niacinamide for specific skin conditions like melasma, rosacea or females with barrier sensitivity. Unlike other skin treatments, niacinamide has a good safety profile (its safe for pregnant females) and does not cause birth defects. For the condition of melasma during pregnancy, the recommendation to use niacinamide is actually a very reasonable option. The truth is the melasma goes away after pregnancy in 90% of cases, and using niacinamide while pregnant is actually safe. This is because niacinamide has not shown to cause birth defects while other treatments like hydroquinone, tretinoin, and corticosteroids are have safety concerns and are reserved for use after pregnancy (Erlandson M, Wertz MC, Rosenfeld E. Common Skin Conditions During Pregnancy. Am Fam Physician. 2023;107(2):152-158.). Studies demonstrate niacinamide's efficacy in treating melasma without significant adverse reactions. Studies show that niacinamide is effective in treating melasma and does not cause major side effects (Ghasemiyeh P, Haghighi NF, Dastgheib L, Ranjbar S, Mohammadi-Samani S. Safety and efficacy of niosomal and conventional tranexamic acid/niacinamide vs. hydroquinone creams in melasma: A randomized, double-blind, case-controlled clinical trial. Sci Rep. 2025;15(1):42739. Published 2025 Nov 28. doi:10.1038/s41598-025-26693-8). For rosacea, niacinamide use is typically okay and may be used for its anti-inflammatory properties (Boo YC. Mechanistic Basis and Clinical Evidence for the Applications of Nicotinamide (Niacinamide) to Control Skin Aging and Pigmentation. Antioxidants (Basel). 2021;10(8):1315. Published 2021 Aug 21. doi:10.3390/antiox10081315). Aleksey Aronov AGPCNP-BC Adult Geriatric Primary Care Nurse Practitioner VIPs IV vipsiv.com
Founder & Medical Director at New York Cosmetic Skin & Laser Surgery Center
Answered a month ago
During pregnancy I am generally comfortable with topical niacinamide for melasma or mild redness. I get more cautious when your skin is reactive, like rosacea flares or that new stinging barrier sensitivity some patients notice later in pregnancy. The concern is irritation. High percentages, low pH formulas, fragrance, or layered acids can turn a calm face into a hot one. A recent study describes niacinamide as a small polar molecule with molecular weight 122 g/mol and logD around minus 0.4, and it cites established findings that it reduces transepidermal water loss while improving hydration and pliability. When I recommend it, I start low, patch test, and keep the routine simple. If you burn, we stop and focus on moisturizer and mineral sunscreen.