INTRODUCTION
Once relegated to metabolic and longevity research, NAD+ (nicotinamide adenine dinucleotide) is now generating considerable interest in aesthetic medicine. While celebrity-endorsed IV drips introduced NAD+ to the public consciousness, today’s spotlight is on intradermal NAD+ injections, which aim to rejuvenate targeted areas such as the face, neck, décolleté, and hands (Conlon et al., 2022; Imai, 2014)
NAD+ : A CELLULAR POWERHOUSE
NAD+ underpins three essential skin-aging defense systems:
Mitochondrial Energy Production
Vital for ATP generation, NAD+ ensures fibroblasts have the energy to sustain collagen production (Imai, 2016).
DNA Repair via PARPs
NAD+ activates PARP enzymes, essential for fixing DNA damage— a decline in efficiency that contributes to cellular aging (Bonkowski et al., 2016).
Sirtuin-Mediated Collagen Preservation
Sirtuins (SIRT1, SIRT6), activated by NAD+ , regulate gene expression that supports collagen integrity and blocks degradative enzymes (Imai, 2016). Restoring NAD+ can re- engage these regenerative processes (Conlon et al., 2022).
EMERGING SCIENTIFIC INSIGHTS ON INJECTED NAD+
Recent investigations are shifting focus toward direct NAD+ delivery into the skin:
In Vitro Fibroblast Studies
NAD+ , especially alongside CD38 inhibition, shields fibroblasts from UV- induced damage and improves aging markers (Kang et al., 2024).
Animal UV Exposure Models
NAD+ demonstrated substantial protection against oxidative stress and inflammation in skin subjected to UV exposure (Li et al., 2023).
These findings suggest direct NAD+ injections may enhance collagen synthesis, reduce oxidative damage, and optimize cellular energy — offering a deeper, longer-lasting impact than topical or systemic treatments.
Before/After direct NAD+ injections
2025 RESEARCH HIGHLIGHTS
A surge in NAD+-targeted research underscores its growing clinical potential:
Combinatorial Injectable Formulations
A 2025 randomized study tested a rejuvenation cocktail of dual-weight hyaluronic acid, NAD+ , liposomal resveratrol, peptides, and mannitol, delivered either by microneedling or five-point intradermal injections. The injection group achieved a 55% rise in hydration and 42% in elasticity, clearly outperforming microneedling (Khademi & Lord, 2025).
As detailed in “Skin Rejuvenation with Hyaluronic Acid and Sirtuin-1 Activators (NAD+ and Resveratrol)” , benefits extended beyond clinical measures: patients reported smoother texture, enhanced radiance, and firmer skin. These results were driven by a synergistic triad:
● HA providing hydration and structure
● NAD+ restoring mitochondrial energy
● DNA repair, and resveratrol activating sirtuin-1 to stabilize collagen and
reduce oxidative stress.
The injections followed a BAP-inspired five-point protocol, (Bio-Aesthetic Points), a technique using five specific injection points on each side of the face, chosen for their safety (low risk of vessels and nerves) and ability to allow the product to diffuse evenly across the skin. It is a well-established method in aesthetic medicine that ensures safe administration and optimal diffusion. This explains why injections delivered deeper penetration and greater bioavailability, producing superior outcomes. The treatment was also well tolerated, with only mild, short-lived redness or swelling — underscoring the clinical feasibility of NAD+-based injectables (Khademi & Lord, 2025).
Metabolic Health Impact
NAD+ restoration was shown to reduce inflammatory markers and improve cardiovascular metrics, including systolic blood pressure and arterial elasticity (Austin MD Clinic, 2025).
Broader Mechanistic Insights
A comprehensive review outlined how NAD+ supports mitochondrial health and counters age-associated metabolic decline, reinforcing translational potential in aesthetics (Yusri et al., 2025).
CLINICAL IMPLICATIONS FOR AESTHETIC PRACTICE
Intradermal NAD+ delivery positions itself as a molecular-level upgrade to
traditional aesthetic tools. By enabling rejuvenation at the cellular core—
boosting energy, repair, and collagen preservation—NAD+ injections have the
potential to enhance outcomes in subtle but structurally meaningful ways,
particularly in early-aging zones where conventional treatments may fall short.
The synergy with hyaluronic acid and resveratrol suggests NAD+ will be most
powerful not as a standalone, but as part of advanced combination injectables
designed to rejuvenate skin in both visible and structural ways.
CONCLUSION
NAD+ is not a passing trend—it is a scientifically grounded agent poised to
transform regenerative dermatology. With its ability to energize mitochondria,
bolster DNA repair, and activate sirtuins, NAD+ represents a multi-faceted tool
for beautifying skin at its foundational level.
As new clinical trials continue to validate both its standalone and synergistic
benefits, NAD+ is emerging as a cornerstone of next-generation injectable
therapies, bridging the gap between beauty and cellular longevity.
Joymed Care is actively monitoring these developments. As clinical trials
advance, we aim to responsibly integrate NAD+–based therapies into our
offerings, grounding innovation in evidence and safety.
KEY REFERENCES
● Conlon NJ et al. (2022). The Role of NAD+ in Regenerative Medicine. Plast. Reconstr. Surg.
● Imai S. (2014). Restoring NAD+ to Counteract Aging. PMC
● Imai S. (2016). NAD+ and Sirtuins in Aging. Nature Aging
● Bonkowski MS et al. (2016). Sirtuins and Aging. PMC
● Kang S et al. (2024). Exogenous NAD+ Protects Fibroblasts Against UV Stress. Cells
● Li X et al. (2023). NAD+ Reduces UV-Induced Skin Damage. Cells
● Khademi A & Lord K. (2025). Skin Rejuvenation with NAD+, Resveratrol & HA: Microneedling vs
Injection Delivery. J Aesthetic Regen Med.
● Austin MD Clinic. (2025). NAD+ IV — Cardiovascular and Inflammatory Effects.
● Yusri et al. (2025). NAD+ Metabolism in Mitochondrial Homeostasis. npj Metab Health Dis.
● Khademi A, Lord K, & al. (2025). Skin Rejuvenation with Hyaluronic Acid and Sirtuin-1 Activators
(Nicotinamide Adenine Dinucleotide and Resveratrol): A Comparative Clinical Study of Microneedling
and Injection Delivery. J Aesthetic Regen Med.
