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Topical peptides are useful for certain applications (GHK-Cu copper peptide has reasonable evidence for topical activity), but for the major therapeutic peptides growth hormone secretagogues, BPC-157, Epithalon systemic delivery is required to produce the effects seen in the research literature

Nicotinamide prevents NAD + depletion and protects neurons against excitotoxicity and cerebral ischemia: NAD + consumption by SIRT1 may endanger energetically compromised neurons

And because they generally dont take medications, their body (Im thinking of their liver enzyme systems) is not used to new medications, even in small doses

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Chan et al., 1990

Molecules 26:6042 Lingasamy P, Teesalu T (2021) Homing peptides for cancer therapy