Skin cells, like every other cell in your body, depend on NAD+ for energy production, DNA repair, and mitochondrial function. Topical NAD+ is designed to penetrate the upper layers of the skin to support keratinocyte and fibroblast function — the cells responsible for skin renewal and collagen production. The compounded formulation is delivered in a base designed to carry NAD+ past the stratum corneum, where most over-the-counter moisturizers stop.

Niacinamide (vitamin B3) is a precursor your skin cells can convert into NAD+ through a multi-step pathway. Direct topical NAD+ skips that conversion and delivers the active coenzyme itself, which is why it’s compounded by prescription rather than sold over the counter. Both can support skin health — NAD+ face cream is designed for patients who want a more direct, physician-prescribed approach to cellular-level skin support.

Apply a thin, pea-sized layer to clean, dry skin once or twice daily as directed by your provider — typically morning and night. Gently pat into the face and neck, avoiding the eye area. Follow with a broad-spectrum SPF 30+ sunscreen during the day, as with any active skincare product. Allow 2–3 minutes before layering other products on top.

Yes. Apply a small amount to the inside of your wrist or behind your ear once daily for 2–3 days before full-face use. Watch for redness, itching, burning, or rash. This is standard protocol for any compounded topical and helps you identify sensitivity before applying to a larger area. If you have a reaction, pause use and message your provider through the Patient Portal.

Most patients notice subtle improvements in skin texture, hydration, and brightness within 4–8 weeks of consistent daily use. More visible changes in tone, fine lines, and overall radiance typically appear at the 3-month mark. Skin cell turnover takes roughly 28 days, so early results reflect that first cycle — layered results build over repeated cycles. Consistency matters more than quantity. Results may vary.

Topical NAD+ is generally well tolerated. The most common side effects are mild, temporary: redness, tingling, or dryness during the first week of use. Discontinue if you develop persistent irritation, rash, or hypersensitivity. Not recommended during pregnancy or breastfeeding without provider approval. Do not apply to broken skin, active acne lesions, or irritated areas. Avoid contact with eyes — rinse with cool water if contact occurs.