What Derms Want You to Know About Decreasing NAD Levels

If you consider yourself well-versed in the world of skin care, you likely know the dreadful fact that your collagen levels begin to steadily decrease every year once you hit your 20s. While stocking up on collagen-boosting skin care early and giving your skin a head start against the great collagen decline can do wonders for your skin, have you ever considered how fluctuating levels of other buzzy bioindicators—like NAD—could be impacting your skin health and radiance?

At AbbVie’s recent Science of Skin and Scalp summit, I learned from Ellicott City, MD dermatologist Chesahna Kindred, MD, that NAD levels significantly drop every year once you hit 36 years old—a fact I’d never known and was immediately curious to know more about. What happens when your NAD levels start to drop? Can you help support the skin through this decline? If these are questions also swirling through your mind, read on for an expert guide to navigating the NAD decrease.

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How does a decrease in NAD impact the skin and scalp?

According to Dr. Kindred, multiple studies have demonstrated decline in NAD production in both men and women once they reach the age of 36, but that decline has been seen to be greater and more gradual in men, while it tends to fluctuate in women. “I am looking forward to the results of ongoing NAD research, but early theories suggest estrogen may play a role in reducing the decline of NAD in women compared to men,” Dr. Kindred says.

So, what happens to your skin and scalp when your NAD levels start to drop? “NAD, or nicotinamide adenine dinucleotide, is a coenzyme essential for cellular energy production and DNA repair,” says Omaha, NE dermatologist Joel Schlessinger, MD. “The decline of NAD is part of normal aging, though the exact age varies by individual,” he says, flagging that by age 40, NAD levels can drop by up to 50 percent.

“NAD is a crucial molecule for maintaining healthy skin and scalp,” says Dr. Kindred. “It helps preserve collagen and elastin, protects skin from DNA damage and is essential for the repair and recycling of damaged skin cells.” All of these mechanisms, Dr. Kindred points out, are contributing factors to the appearance of sagging, wrinkled and dull skin.

“When NAD levels drop, we see decreased collagen production, impaired DNA repair from UV damage and reduced cellular turnover,” adds Omaha, NE dermatologist Daniel Schlessinger, MD. “This manifests as thinner skin, increased wrinkle formation, uneven pigmentation and slower wound healing.” Dr. Daniel Schlessinger also highlights how the skin’s barrier function also weakens, which can exacerbate increased dryness and sensitivity.

How can you support the skin and scalp when NAD decreases?

Luckily, just like collagen, NAD has become an increasingly popular ingredient in skin-care products and supplements alike. As a result, there are several effective ways to combat the effects of NAD decreases in the skin. “Topically, niacinamide (vitamin B3) is excellent,” Dr. Joel Schlessinger says. “It’s a precursor to NAD and has proven benefits for skin barrier function, pigmentation and anti-aging.” For optimal results, Dr. Joel Schlessinger recommend serums with 5 to 10 percent niacinamide for most patients. “Some newer formulations combine niacinamide with NAD+ precursors like nicotinamide riboside for enhanced benefits,” he adds.

While New York dermatologist Marisa Garshick, MD, flags that “more research is needed to determine the best ways to supplement and support the skin and scalp,” she promotes several lifestyle changes to help mitigate the effects of lower NAD. “Lifestyle factors like enhanced UV protection and managing stress can help to preserve NAD,” Dr. Garshick says. “Antioxidants can be helpful to reduce the oxidative stress that contributes to reducing NAD levels.”

“Dermalogica Dynamic Skin Sculptor ($98) serum contains a Pro-NAD+ complex, which is a blend of ingredients that will be the precursors to help boost NAD+ production (like a pro-vitamin), to help tone and tighten skin for a more sculpted appearance,” Dr. Joel Schlessinger says in regards to specific NAD-preserving products. “Aramore NAD+ Cell Energizing Supplement ($55) also contains NAD+ precursors,” he adds.