Cosmoderma · May 9, 2026
The emerging potential of nicotinamide adenine dinucleotide (NAD+) precursors in dermatological health and anti-aging: Elixir of life?
By De A, Singh AK, Ahmed SKS
Dear Sir, Nicotinamide adenine dinucleotide (NAD + ) therapy has gained significant traction as a sought-after anti-aging treatment, particularly within esthetics and cosmetology.In recent years, increasing attention has been directed toward the potential role of NAD + precursors in dermatological health and skin aging.A quick internet search on NAD + therapy yields an abundance of results touting its near-miraculous effects on skin rejuvenation.However, despite growing public interest, clinical evidence supporting their dermatological efficacy remains limited.In this concise review, we critically evaluate the current scientific literature on NAD + metabolism, precursor supplementation, and their relevance to skin aging and dermatological health.In this correspondence, we synthesize key findings from recent research on NAD + precursors and discuss their implications for health span, longevity, and clinical applications.Some recent reviews highlight that NAD + plays a central role in metabolic processes, energy production, cellular signaling pathways, DNA repair, and oxidative stress reduction.[1][2][3][4] Its decline with age is linked to a host of pathological conditions, including neurodegenerative diseases, metabolic disorders, and systemic dysfunctions.[1][2][3] Recent advancements in dermatological research have brought attention to the role of NAD + precursors in skin health and anti-aging therapies too.Its depletion, a hallmark of aging, is associated with diminished skin resilience, increased photoaging, and impaired wound healing.[4] Restoring NAD + levels has thus emerged as a promising strategy to combat aging and its associated diseases.NAD + is synthesized through four main pathways: e kynurenine pathway, converting tryptophan to NAD + while producing neuroprotective or neurotoxic metabolites; the Preiss-Handler Pathway, transforming nicotinic acid (NA) into NAD + through enzymatic steps; the Salvage Pathway, recycling nicotinamide (NAM) into NAD + through enzymes like NAMPT; and the NRH Salvage Pathway, utilizing dihydronicotinamide riboside (NRH) as a precursor.[1][2][3] Key NAD + -consuming enzymes include sirtuins, polyADP-ribose polymerases (PARPs), and ADP-ribosyl cyclases (CD38/CD157).[1,2] While these enzymes regulate essential cellular functions, conditions like aging and injury-induced damage can lead to hyperactivation of enzymes such as PARP and CD38, depleting NAD + and causing harm.Supplementation with NAD precursors -such as NAM, NA, nicotinamide mononucleotide (NMN), and nicotinamide riboside (NR) -can help counteract NAD decline.NMN and NR are particularly promising as www.cosmoderma.org