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Skin cancer ranks as the most prevalent type of cancer in many countries, particularly in regions with intense sunlight like the U.S. and Australia. Medical professionals have long advised people to safeguard their skin by using sunscreen, avoiding excessive sun exposure, and performing regular skin checks.
Recently, researchers have started examining whether specific vitamins could help lower the risk of developing new skin cancers. One vitamin of interest is nicotinamide, a form of vitamin B3. This vitamin is related to niacin, another B3 variant that helps produce energy and repair cells. Unlike niacin, nicotinamide doesn’t cause skin flushing or redness. Scientists are interested in nicotinamide because it appears to enhance the body’s ability to fix DNA damage caused by ultraviolet light from the sun.
When UV rays damage DNA inside skin cells, those cells may sometimes turn cancerous. Improving the body’s capacity to repair this damage could potentially decrease cancer development. The idea that nicotinamide might prevent skin cancer first gained traction in 2015 after a clinical trial involving 386 individuals with a history of skin cancer. Participants in this study took nicotinamide supplements regularly, and results showed they developed fewer new skin cancers compared to those who didn’t take the supplement. As a result, many dermatologists began recommending nicotinamide to their patients with a prior skin cancer history.
However, that initial study involved a relatively small population. To verify whether the protective benefits would hold in a larger group, researchers sought a system that could accurately track nicotinamide use. They found such an opportunity within the U.S. Department of Veterans Affairs (VA) health system, where medication use is well-documented in medical records.
In this large database, scientists analyzed data from over 33,800 veterans who had received nicotinamide treatment—typically at a dose of 500 milligrams twice daily for more than a month. They tracked whether these individuals later developed common nonmelanoma skin cancers, such as basal cell carcinoma and cutaneous squamous cell carcinoma, which are frequently linked to long-term sun exposure.
Among the study participants, approximately 12,300 had taken nicotinamide, while 21,500 had not. Comparing the two groups, researchers found that those who used nicotinamide had a 14% lower risk of developing new skin cancers. The reduction was even more significant in patients who started taking the supplement after their first skin cancer diagnosis, with their risk decreasing by about 54%. This suggests that initiating nicotinamide soon after an initial diagnosis might produce the greatest benefit. Conversely, the protective effect was less pronounced in patients who had a history of multiple skin cancers before beginning supplementation.
The study also indicated that nicotinamide was particularly effective in reducing the risk of squamous cell carcinoma, a common and sometimes aggressive skin cancer that can spread if not detected early. Basal cell carcinoma, though more common, rarely spreads.
Led by Dr. Lee Wheless from Vanderbilt University Medical Center and the VA Tennessee Valley Healthcare System, the research underscores the potential of nicotinamide as a preventative measure. Currently, no clear guidelines exist on the best timing to begin taking the supplement, with many doctors recommending it only after multiple skin cancers have appeared. These new findings suggest that earlier intervention could be more beneficial in high-risk individuals.
While the data is promising, some limitations remain. Since many people buy nicotinamide over the counter, without a prescription, its usage isn’t always recorded—making it hard to study long-term effects comprehensively. Using the VA health system’s detailed records provided an invaluable opportunity to analyze outcomes across thousands of patients.
Overall, the findings support the idea that nicotinamide could be a useful addition to skin cancer prevention strategies for those at higher risk. Because the study involved a large number of participants, it offers a strong piece of evidence compared to earlier smaller trials. Nonetheless, since it’s an observational study based on medical records, it shows associations rather than establishing complete causality.
Nicotinamide is affordable, widely accessible, and generally deemed safe at recommended doses. If future research confirms these benefits, it might become a simple and inexpensive tool to help prevent some skin cancers, especially in those with a history of the disease. Still, experts caution that nicotinamide should not replace traditional protection methods like sunblock, protective clothing, and regular skin exams. Instead, it may serve as an additional safeguard for high-risk populations.
For those interested in cancer prevention, recent studies suggest that common anti-inflammatory drugs could help kill cancer cells, and statins might starve cancer cells of nutrients. Additionally, research has pointed to the potential role of certain Indian fruits in slowing down cancer growth.
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