NAD+ patches are transdermal products marketed to boost cellular nicotinamide adenine dinucleotide levels through the skin, with claims ranging from anti-ageing to enhanced energy. As NAD+ levels decline with age, commercial interest in supplementation has grown substantially. However, these patches are not authorised medicines in the UK, and scientific evidence supporting their efficacy remains extremely limited. No peer-reviewed human trials have demonstrated that NAD+ patches effectively increase cellular NAD+ levels or deliver meaningful health benefits. This article examines the evidence, safety considerations, and regulatory status of NAD+ patches to help you make informed decisions about their use.

What Are NAD+ Patches and How Do They Work?

NAD+ (nicotinamide adenine dinucleotide) patches are transdermal delivery systems marketed to increase cellular NAD+ levels through the skin. NAD+ is a coenzyme found in all living cells that plays a crucial role in energy metabolism, DNA repair, and cellular signalling. As we age, NAD+ levels naturally decline, which has led to commercial interest in supplementation strategies.

These patches claim to contain NAD+ or its precursors, most commonly nicotinamide riboside (NR) or nicotinamide mononucleotide (NMN). The theoretical mechanism involves:

• Transdermal absorption of molecules through the stratum corneum (outer skin layer)

• Conversion to NAD+ within cells via salvage pathways

• Claimed sustained release over several hours, potentially avoiding first-pass hepatic metabolism

• Potential localised or systemic effects depending on absorption efficiency

Manufacturers claim that transdermal delivery offers advantages over oral supplements, including better bioavailability and more consistent blood levels. However, the skin barrier presents significant challenges for molecule penetration. NAD+ itself is a large, charged molecule (molecular weight ~663 Da) that cannot readily cross intact skin without penetration enhancers. Even smaller precursors like NR (molecular weight ~255 Da) face absorption limitations through intact skin.

The patches are marketed for various purposes including anti-ageing, energy enhancement, cognitive function, and metabolic health. They are typically applied to clean, dry skin and left in place for 8-12 hours.

It is important to note that there are currently no NAD+ patches authorised as medicines by the Medicines and Healthcare products Regulatory Agency (MHRA) in the UK. The regulatory classification of these products is determined case-by-case based on their claims and mode of action, and may be considered medicines, medical devices, or consumer products depending on their specific characteristics and marketing.

Scientific Evidence: Do NAD+ Patches Actually Work?

The scientific evidence supporting NAD+ patches specifically is extremely limited, with no peer-reviewed human clinical trials identified to date examining their efficacy. Most research on NAD+ supplementation has focused on oral formulations, and even this evidence base remains preliminary.

Current evidence limitations include:

• Lack of transdermal studies: No published randomised controlled trials have specifically evaluated NAD+ patches versus placebo in humans

• Bioavailability questions: Research has not established whether NAD+ precursors can achieve therapeutically relevant absorption through intact skin

• Absence of pharmacokinetic data: There are no published studies measuring blood NAD+ levels following patch application

• Extrapolation concerns: Evidence from oral NAD+ precursors cannot be directly applied to transdermal delivery

Some research on oral NAD+ precursors (NR and NMN) has shown modest increases in blood NAD+ levels in small human studies. A 2018 study in Nature Communications (Martens et al.) demonstrated that oral NR supplementation increased NAD+ metabolites in healthy adults. However, whether these biochemical changes translate into meaningful clinical benefits remains uncertain.

Critical considerations when evaluating manufacturer claims:

• Most product websites cite general NAD+ research rather than patch-specific data

• Testimonials and before-after comparisons are not scientific evidence

• The placebo effect can be substantial for subjective outcomes like energy and wellbeing

• Independent third-party testing of patch products is rarely available

There are no authorised health claims for NAD+, NR or NMN on the Great Britain Nutrition and Health Claims register. The Medicines and Healthcare products Regulatory Agency (MHRA) has not approved any NAD+ patches for therapeutic indications in the UK. Consumers should approach marketing claims with appropriate scepticism and recognise that 'clinically proven' statements require robust, published evidence from well-designed trials specific to the product format.

Safety Considerations and Potential Side Effects

The safety of NAD+/NR/NMN patches is not established, and their adverse effects profile is uncertain. Safety data specific to transdermal NAD+ delivery is lacking, with most information extrapolated from oral NAD+ precursor studies, which may not reflect the safety profile of patch products.

Potential adverse effects that may be associated with NAD+ patches include:

• Skin reactions: Localised irritation, redness, itching, or contact dermatitis at the application site

• Flushing: Some users report facial flushing (primarily associated with nicotinic acid/niacin rather than NR/NMN)

• Gastrointestinal symptoms: Nausea or stomach discomfort (less likely with patches than oral forms)

• Headache: Reported occasionally in supplement trials

Important safety considerations:

Lack of long-term data: The effects of chronic NAD+ elevation through supplementation remain unknown. Some researchers have raised theoretical concerns about potential effects on cancer cell metabolism, as NAD+ is involved in cellular proliferation.

Quality control issues: As these products are not MHRA-authorised medicines, they are not subject to the same manufacturing standards as pharmaceutical products. Product composition, purity, and actual NAD+ precursor content may vary significantly between brands.

Drug interactions: NAD+ metabolism intersects with numerous biochemical pathways. Whilst specific interactions have not been documented, theoretical concerns exist for patients taking medications affecting cellular metabolism.

Practical advice:

• Apply to intact, clean skin only

• Rotate application sites

• Discontinue use if persistent skin irritation occurs

• Be aware that adhesive components may cause contact dermatitis in sensitive individuals

When to seek medical advice:

• If you develop persistent skin reactions (redness, swelling, blistering) at the application site

• If you experience unexpected symptoms after starting patches

• Seek urgent medical help for severe allergic reactions (breathing difficulty, facial swelling, widespread rash)

• Before using patches if you have chronic health conditions, particularly cancer, liver disease, or metabolic disorders

• If you are pregnant, breastfeeding, or planning pregnancy

Patients should inform their GP about all supplements they use, as this information may be relevant for diagnosis and treatment decisions. If you suspect an adverse reaction to a NAD+ patch, report it to the MHRA Yellow Card scheme (yellowcard.mhra.gov.uk).

What UK Health Authorities Say About NAD+ Supplements

UK regulatory bodies have not issued specific guidance on NAD+ patches, but their oversight falls under existing frameworks for consumer products, medical devices, or medicines depending on their specific claims and mode of action.

Regulatory status in the UK:

The Medicines and Healthcare products Regulatory Agency (MHRA) assesses products case-by-case. Products making medicinal claims (treating or preventing disease) or functioning through pharmacological means would require marketing authorisation as medicines. Currently, there are no MHRA-authorised NAD+ patch medicines in the UK.

Transdermal patches are not regulated as food supplements, as they are not taken orally. For oral NAD+ precursors, nicotinamide riboside chloride has been authorised as a novel food ingredient by the Food Standards Agency (FSA), but this authorisation does not extend to transdermal applications. Nicotinamide mononucleotide (NMN) is not currently authorised as a novel food in Great Britain.

Health claims regulation:

For consumer products, the Advertising Standards Authority (ASA) regulates marketing claims through the CAP Code. Health claims must be substantiated with robust evidence, and medicinal claims (preventing or treating disease) are prohibited without MHRA authorisation.

For food products, the Great Britain Nutrition and Health Claims (NHC) register lists authorised health claims. There are no authorised health claims for NAD+, NR, or NMN. Phrases like 'supports healthy ageing' or 'boosts energy' are carefully worded to avoid making specific medical claims whilst implying health benefits.

NICE guidance:

The National Institute for Health and Care Excellence (NICE) has not issued guidance on NAD+ supplementation. There are no NHS-funded programmes involving NAD+ patches, and they are not available on prescription.

NHS dietary advice:

The NHS notes that a balanced diet provides adequate vitamin B3 (niacin) and its precursor tryptophan for most healthy individuals. These are found in foods like milk, fish, meat, eggs, mushrooms, and green vegetables. There is no established nutritional deficiency that NAD+ patches address.

Consumer protection advice:

Consumers who believe products make unsubstantiated claims can report them to the ASA or Trading Standards via Citizens Advice. When considering NAD+ patches, individuals should critically evaluate marketing claims, recognise that CE/UKCA marks do not evidence clinical efficacy, and discuss supplementation with their GP, particularly if they have underlying health conditions or take regular medications.

Frequently Asked Questions