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Head-to-head evidence comparison — which supplement is right for you?
Niacinamide wins 1 of 3 categories. Both are solid choices — the best pick depends on your specific goals.
Verdict
Mostly mechanism / observational
Top outcomes
Verdict
Mostly mechanism / observational
Top outcomes
Shared outcomes (1)
Outcomes where both Cysteamine (topical) and Niacinamide have evidence — compare verdict strength side-by-side.
Topical cosmetic. Cysteamine 5% cream is typically applied once daily to areas of melasma as a short-contact treatment (left on for ~15 minutes, then washed off) to limit odor and irritation, with daily sunscreen. There is no oral or systemic use in this context. This library does not provide an ingestion protocol.
any
Cysteamine 5% cream (short-contact application)
Topical cosmetic only. Niacinamide is typically formulated at 2-5% in leave-on serums, creams, or gels and applied to clean skin once or twice daily (AM and/or PM). It layers well under sunscreen and with most other actives. There is no oral, injectable, or systemic dose in this cosmetic context — it is not ingested here. This library does not provide an ingestion protocol.
any
Leave-on topical serum or cream (2-5% niacinamide)
Throughout
8-16 weeks
Throughout
Throughout
Throughout
4-12 weeks
2-12 weeks
2-8 weeks
Evaluation of the efficacy of cysteamine 5% cream in the treatment of epidermal melasma: a randomized double-blind placebo-controlled trial.
Br J Dermatol (2015) · Rct · n=50
First double-blind placebo-controlled RCT of cysteamine 5% cream for epidermal melasma (n=50), nightly for 4 months
Efficacy of cysteamine cream in the treatment of epidermal melasma, evaluating by Dermacatch as a new measurement method: a randomized double blind placebo controlled study.
J Dermatolog Treat (2018) · Rct · n=40
Second double-blind placebo-controlled RCT (n=40), nightly cysteamine 5% for 4 months, with Dermacatch and Mexameter colorimetry
A comparative study of topical 5% cysteamine versus 4% hydroquinone in the treatment of facial melasma in women.
Int J Dermatol (2020) · Rct · n=40
Multicenter evaluator-blinded head-to-head of cysteamine 5% vs hydroquinone 4% (n=40), nightly for 120 days with sunscreen
Niacinamide: A B vitamin that improves aging facial skin appearance.
Dermatol Surg (2005) · Rct · n=50
Double-blind, left-right randomized split-face design: 5% niacinamide vs vehicle applied twice daily for 12 weeks in 50 white women with facial photoaging
The effect of niacinamide on reducing cutaneous pigmentation and suppression of melanosome transfer.
Br J Dermatol (2002) · Rct · n=18
Paired clinical trial: 18 subjects with hyperpigmentation used 5% niacinamide vs vehicle moisturizer (plus a separate facial-tanning arm)
A Double-Blind, Randomized Clinical Trial of Niacinamide 4% versus Hydroquinone 4% in the Treatment of Melasma.
Dermatol Res Pract (2011) · Rct · n=27
Split-face RCT in 27 melasma patients: 4% niacinamide vs 4% hydroquinone (HQ) for 8 weeks, both with sunscreen
Niacinamide has a higher evidence score (6/10 vs 6/10) and wins in 1 of 3 categories.
For even skin tone, Niacinamide has a higher relevance score (75 vs 70).
No known interactions between Cysteamine (topical) and Niacinamide have been documented in our database. However, always consult a healthcare provider before combining supplements.