NAD+ (nicotinamide adenine dinucleotide) has become one of the most talked-about molecules in longevity science. It appears in conversations about energy, metabolism, DNA repair, and even wrinkle prevention. But what does it do in the skin, and how strong is the evidence? 

The short answer: NAD+ is essential for cellular function, and declining NAD+ levels are associated with many features of aging, including changes that occur in the skin. The strongest evidence supports a role in DNA repair, mitochondrial function, cellular stress resistance, and maintenance of skin barrier function. 

What is NAD+? 

NAD+ is a coenzyme found in virtually every cell in the body. It acts as a molecular shuttle that helps transfer electrons during energy production. Cells constantly convert NAD+ to NADH and back again. 

Think of NAD+ as a cellular currency: 

As we get older, NAD+ levels tend to decline in many tissues, including skin. 

Why does NAD+ decline with age?  

Researchers have suggested a few possible reasons: 

A landmark review in Cell Metabolism described age-related NAD+ decline as a potentially central feature of aging biology. (1) 

How NAD+ helps cells stay "young" 

1. DNA repair 

Every day, skin cells accumulate DNA damage from sunlight, pollution, and normal metabolic processes. 

NAD+ is required by PARP enzymes, which detect and help repair DNA strand breaks. 

When DNA damage is extensive, PARPs can consume large amounts of NAD+, potentially leaving less available for other cellular functions. 

Why this matters for skin: Efficient DNA repair helps prevent mutations, cellular dysfunction, and the accelerated aging associated with chronic UV exposure. (2) 

2. Activating sirtuins 

Sirtuins are often called longevity proteins. They regulate inflammation, stress resistance, mitochondrial function, and gene expression. 

Importantly, sirtuins require NAD+ to function. 

One of the most studied is SIRT1, which has been linked to: 

In skin models, SIRT1 activity has been associated with reduced UV-induced damage and improved collagen-related pathways. (3,4) 

3. Supporting mitochondrial function 

Mitochondria generate the energy needed for cell repair, collagen synthesis, barrier maintenance, and turnover. 

NAD+ is a central cofactor in mitochondrial metabolism. Lower NAD+ availability has been linked to impaired mitochondrial function and increased oxidative stress. (5) 

In aging skin, mitochondrial dysfunction is associated with: 

4. Reducing cellular senescence 

Cellular senescence occurs when cells stop dividing and begin secreting inflammatory molecules (the SASP: senescence-associated secretory phenotype). 

Senescent cells accumulate in aged and photoaged skin. 

Experimental studies suggest that boosting NAD+ availability may improve mitochondrial health and reduce some senescence-associated dysfunction, although this area is still developing. (6) 

What does this mean for wrinkles + collagen? 

UV exposure activates enzymes called matrix metalloproteinases (MMPs) that break down collagen. 

SIRT1 signaling, which depends on NAD+, has been shown in laboratory studies to suppress some of the inflammatory pathways that drive MMP activation. 

That creates a plausible biological link: 

Higher NAD+ → better SIRT1 activity → less inflammatory signalling → less collagen breakdown 

This does not mean NAD+ is a proven wrinkle cure, but it helps explain why researchers are interested in NAD+ for photoaging. 

NR/supporting NAD+ 

NAD+ is made naturally in the body from vitamin B3-related precursors, including nicotinamide (NAM), nicotinamide riboside (NR), and nicotinamide mononucleotide (NMN). Research has shown that supplements containing NAD+ precursors such as NR and NMN can increase circulating NAD+ in humans. 

There are also simple lifestyle strategies that may help support healthy NAD+ metabolism. A balanced diet provides the vitamin B3 (niacin and nicotinamide) and tryptophan that the body uses to make NAD+, with foods such as poultry, fish, eggs, dairy products, nuts, legumes and whole grains providing useful sources. Regular exercise is also associated with healthier NAD+ metabolism and mitochondrial function, while maintaining a healthy weight and avoiding excessive calorie intake may support NAD+ homeostasis. However, the relationship between lifestyle and NAD+ is complex, and recent human research suggests that NAD+ levels can vary considerably between tissues, so these habits should be viewed as supporting overall metabolic and cellular health rather than as a guaranteed way to increase NAD+ levels in the skin. 

The Bottom Line 

NAD+ plays a fundamental role in keeping skin cells functioning as they should. From powering mitochondria and supporting DNA repair to activating sirtuins and helping cells respond to stress, it sits at the centre of many of the biological processes that influence how our skin ages. 

While the science is compelling, it's important to distinguish between established biology and proven clinical outcomes. Much of the research demonstrating NAD+'s effects on skin health has been conducted in laboratory or animal models. Human studies specifically evaluating NAD+ supplementation for reducing wrinkles, improving skin elasticity, or reversing visible signs of ageing are still limited. 

That said, maintaining healthy NAD+ levels is an exciting area of longevity research. As our understanding of cellular ageing continues to evolve, therapies that support NAD+ metabolism may become an increasingly important part of strategies to preserve skin health from the inside out. 

For now, the most effective approach remains a combination of evidence-based skincare, daily sun protection, a healthy lifestyle, and emerging therapies backed by robust clinical research. NAD+ is unlikely to be a miracle cure for ageing skin - but it is one of the most promising molecules scientists are studying to better understand why our skin ages and how we might support healthier skin as we get older. 

Disclaimer: The information presented in this article is for educational purposes only and is not intended to diagnose, prevent, or treat any medical or psychological conditions. The information is not intended as medical advice, nor should it replace the advice from a doctor or qualified healthcare professional. Please do not stop, adjust, or modify your dose of any prescribed medications without the direct supervision of your healthcare practitioner. 

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