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There is a synthetic version which doctors can prescribe, but which can cause liver damage, serious psychiatric effects and heart and respiratory problems if taken without medical oversight

What the clinical data say, in brief Barrier and texture: Nicotinamide improves barrier metrics, elasticity, and hydration in randomized controlled studies

Formulation matters a lot: Copper peptides become inactive in the presence of strong chelating agents or low-pH acids

It also suppresses the oxidation of low-density lipoprotein, quenches hydroxyl and other reactive oxygen species, and chelates iron in a manner that blocks iron-driven lipid peroxidation

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Setting realistic expectations is crucial: improvement rather than total cure is the typical outcome