Update--Good news! A girl recently e-mailed me a web site she found that sells topical niacinamide without a prescription. The site www.lifelinknet.com sells a 5% niacinamide gel. The product is called Metazene and the size is 2 oz. for $19.95. I plan on ordering it myself to see how it compares to the niacinamide cream that is sold now by prescription only at www.progesteronepower.com/doctorsformulas/. I've ordered and used Metazene and it works well. It's in a base of aloe vera gel so it absorbs into the skin quickly. It's very similar to my homemade version of niacinamide gel that I make with aloe vera gel as described near the bottom of this page.
Update--A girl named Leah e-mailed me about the site www.acnemiracle.com which also sells a 5% niacinamide gel without needing a prescription. It is 2 oz. for $15.97, which is a very reasonable price. The product also contains organic jojoba oil and emu oil and is described as fast absorbing. This niacinamide product sounds like a good one to try.
4% niacinamide cream is the best topical treatment for acne I've ever used. Like pantothenic acid, I first ran across a summary of a study on the GNC (www.gnc.com) site a few years ago. On that site, click on the Health Concerns link then click on either the acne vulgaris or acne rosacea link. A page of natural acne remedies will appear which includes information on the study that used 4% niacinamide gel twice a day which substantially reduced acne. I didn't pay much attention to this at the time, not knowing where to find it. Here is a link to the niacinamide study for acne. Nicotinamide is another name for niacinamide. I later ran across a link to the complete study on the site www.pureremedies.com. Click on Archives, then click on Skin Archives. You'll find the link toward the bottom of the page. The site http://acneinfo.cjb.net also has a link to that study.
The study compared 4% topical niacinamide (also called nicotinamide) gel compared to the drug clindamycin gel for the treatment of acne. Both were applied twice a day for 8 weeks. 82% of people treated with niacinamide gel improved compared to 68% of people using clindamycin gel. This caught my attention, a natural vitamin cream working better than a prescription drug for acne. And the best part is that the acne bacteria cannot become resistant to niacinamide since it's a vitamin. But bacteria does become resistant to the antibiotics commonly used to treat acne, like clindamycin. So I started searching on the Internet for a niacinamide gel.
I found a web site that sells a 4% niacinamide cream for acne. It's www.progesteronepower.com/doctorsformulas/. This site is run by Dr. Gerald I Sugarman. I ordered the cream by sending a check through the mail (where I live it costs $15 including shipping). You can order online using a credit card. If you want to order with a check through mail, you need to contact them to find out the total including shipping. It varies depending on where you live. Make the check out to Gerald I. Sugarman M.D. the mailing address is 1540 W. Branch, Arroyo Grande, CA 93420. There is an e-mail address and phone # on the bottom of their web page. I received the cream in less than 2 weeks.
Update--Unfortunately, on 4-5-02 Dr. Gerald Sugarman M.D. (see above) informed me that due to new FDA regulations, he can no longer sell the 4% niacinamide cream without a prescription. This really pisses me off. The FDA likely caught on that 4% niacinamide cream is highly successful at treating acne and decided it can no longer be sold over the counter. It's not a drug, just a simple vitamin cream, and the FDA is putting money over helping people. 4% niacinamide cream is absolutley the best topical acne treatment. Dr. Sugarman said if you can get a doctor to write you a prescription for it, he will tell you how to obtain it. The problem is most dermatologists probably haven't heard of 4% niacinamide gel or cream being used to treat acne. Anyway, they usually decide what drug you'll be taking. The odds of someone walking into a dermatologist and asking for a prescription for 4% niacinamide cream are slim. I recommend that you print a copy of the niacinmaide study and show it to your doctor; this may help convince him. The price for the niacinamide cream sold through Dr. Sugarman is very reasonable, so good luck in getting a prescription from a doctor. The following is a description of the 4% niacinamide cream sold through Dr. Sugarman at www.progesteronepower.com/doctorsformulas/.
Update--Someone recently e-mailed me about a web site they found that sells a 4% niacinamide gel for acne, and they may not require a prescription. Look for information toward the bottom of this page about www.communitydrug.com.
I first applied a thin layer of the cream to my face at night. The cream is yellow but goes on your skin colorless. When I used to get it during cold weather it would be kind of creamy and whitish-yellow. But the label on the jar says not to refrigerate. So once I let it warm to room temperature it actually isn't creamy, but becomes a yellow, thicker consistency. If you hold the jar upside down with the lid off, it won't fall out. I put a small amount on my finger and rub it onto my skin, spreading it out in a circular direction covering a part of my face. I then repeat this process several times until my whole face is covered with a thin layer. I don't apply it to my forehead since I have hardly no acne on it. Now here's a few important things to know about the cream. It's sticky and your face looks shiny and sticky when you put it on. You don't want to lay down to go to sleep right away because your face will stick to the pillow and some of the cream will come off. You must wait for it to absorb into your skin. I wait at least 1.5 to 2 hours. By that time, I can touch my face and it won't feel sticky anymore. So until it absorbs, don't touch your face. But your skin will still look shiny. When you wake up in the morning, for whatever reason, the skin no longer looks shiny. It looks normal (dry). I don't wash my face in the morning. I wait until the next night to repeat the process again This way the niacinamide stays on my skin for almost 24 hours at a time. The reason you don't want to put the cream on in the morning is that your face will probably look shiny all day (even after the cream has absorbed) and you won't want to been seen out like that. If you're not going to leave the house for the day you could put it on in the morning. You can't always stay inside so it's best to use at night. I suppose you could put it on at night and wash it off each morning, but then you're only having niacinamide work for you half the time. I'm a guy so I don't deal with makeup like women do. I don't know wht happens when you're asleep to make the shiny appearance go away, but it's really convenient to just wake up in the morning and not have to wash my face and just go on with the day, letting the niacinamide work all day.
This cream started to work only after 5 days of using it, and it's continued to work ever since. It really seems to shrink the pores down and "tighten" the skin, like pantothenic acid. But niacinamide further enhances this effect. It makes the skin look very smooth. It's hard to put into words, it's like it covers the skin with an invisible coating that keeps acne away. Any pimples that do develop are very small and usually go to whiteheads quickly, instead of staying as a large red bumps for weeks. And they fade away after a couple of days. There's only a few small ones on my face at any given time. Some days my face is virtually clear. Even though the study done using niacinamide had the patients apply it twice a day, I get great results using it just once a day. This saves me money and makes the 2 ounce jar last longer. Using it once a day, the 2 oz. jar lasts about 6 weeks. Dr. Sugarman gets the cream from the Key Pharmacy, a compounding center in S. Kent, WA. The phone # on the niacinamide label for the Key Pharmacy is 1-800-878-1322 in case you want to try ordering it through them. I also found the Key pharmacy web site which is www.keynutritionrx.com. You could contact them through e-mail to find out about the niacinamide cream and gel. A woman posted on a message board that Dr. Sugarman also sells a niacinamide 4% gel, as used in the study. She says they don't list it on their web site but they told her about it in an e-mail. She ordered it and said that it doesn't leave a shiny/sticky look on your face so you can go out after using it. I e-mailed them about it and they said that the gel form also lasts much longer than the cream. This makes the gel more convenient, but it does cost more ($25 including shipping to where I live). You may want to e-mail them to find out about the cost. I may switch to the niacinamide gel in the future, but since the cream is working good for me, I don't want to fix what isn't broken. The cream causes me no irritation and is gentle to my skin. I recommend you not use any other topical acne medications or products at the same time as niacinamide cream since they might interfere. I would say this works as well as pantothenic acid for acne. I've seen a few people post messages about using Dr. Sugarman's cream, and wish more people who are looking for something to help would try it. Even Dr. Andrew Weil (www.drweil.com) mentions on his site that some doctors are now using niacinamide to treat acne. I remenber a ways back finding one other web site that sold niacinamide cream, but it was more expensive than the one offered by Dr. Sugarman. You might try searching for others, but the price offered by Dr. Sugarman is very reasonable.
I was recently informed that the site www.communitydrug.com also sells a 4% niacinamide gel for acne. It looks like you don't need a prescription for it. I e-mailed them and they said to order it through mail it would cost $43 (that includes $5 for shipping) and that it's only 1 ounce. This is way more expensive then the niacinamide cream sold by Dr. Sugarman (see above) but the gel form would last longer than the cream form. CommunityDrug also sells a product called Topical Nicotinamide which does require a prescription; it's description says it's used to manage acne. This is strange and kind of confusing since niacinamide gel is a form of topical nicotinamide. So make sure you request the 4% Niacinamide Gel which apparently does not require a prescription.
Update--On April 12, 2002 the site www.communitydrug.com changed its 4% niacinamide gel to also require a prescription. This company seems so confused. I encourage you to try to get a prescription from a doctor for 4% niacinamide gel or cream since there is no other topical product that comes close to it in effectiveness. You may want to print a copy of the niacinamide study and take it to your dermatologist to convince him. If you can't get a prescription for it, you can try making a homemade version of it. You can crush up niacinamide tablets into powder or buy niaciamide capsules to get the powder. You can also buy niaciamide powder at a very good price at www.beyond-a-century.com. Then you can mix this powder into 100% aloe vera gel to make your own version of it. You can order online a base cream that pharmacies use to compound topical creams and gels. It's called Vanicream and can be found at www.psico.com. This might work better than aloe vera gel. Since it should be 4% niacinamide, if you have 2 ounces of gel (or base cream), 4% by weight would be about 2.4 grams of niacinamide. One ounce is 28 to 30 grams. So you would add the powder from five 500 mg capsules or crushed up tablets to 2 oz. of the gel or cream to make an approximate 4% niacinamide product.
I would like to point out that niacinamide gel products absorb into the skin very quickly as opposed to the niacinamide cream sold by Dr. Sugarman as described above. Niacinamide gel products don't have to be used only at night. Since they absorb into the skin right away and won't leave your face appearing shiny or sticky, you can apply it in the morning after you wash your face or take a shower. My homemade version of niacinamide gel is made with 2 ounces of aloe vera gel and five 500 mg crushed up niacinamide tablets that I mix into the gel. I use the niacinamide tablets sold at www.puritan.com. Their niacinamide does not appear on the face in white patches after the gel dries as long as you apply a thin layer to the skin. Their niacinamide tablets are also very affordable.
The company www.naturallyclear.com sells products made with niacinamide. They have a niacinamide scrub and spray. I've seen more people post about using this company's products. I ordered the spray and scrub myself. I thought they were ok but not nearly as effective as the niacinamide cream. Naturally Clear won't say what percentage of niacinamide is in their products, so you can't be sure if it's at least 4%.
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Immediately take a deep breath and cough twice, as hard as you can. Wait a couple of seconds, take another deep breath, and again cough twice. This will contract your diaphragm, compressing the heart and causing it to pump. It's a simle form of self-CPR.
Keep repeating the process until your heart begins to beat normally (or until help arrives). Once your heart is stabilized, chew and swallow one asprin. Then take 2 cayenne pepper capsules or a tablespoon of Tabasco sauce. The aspirin will thin your blood and prevent platelets from sticking...while the Tobasco or cayenne will dilate your blood vessels so that blood can flow freely.
This simple technique can dramatically increase your chances of survival. Please share it with your friends and loved ones. It can save their lives!
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