Focused Key Phrase: See if any of these work in yoast: niacinamide for skin cancer, nicotinamide for skin cancer, vitamin B3 for skin cancer, niacinamide for basal cell carcinoma, niacinamide for squamous cell carcinoma
Nicotinamide, also known as niacinamide, is a form of vitamin B3 that has been studied for its potential to reduce non-melanoma skin cancer risk. Its proposed role in enhancing cellular DNA repair and supporting the skin’s response to ultraviolet-induced damage has prompted investigation into whether supplementation may reduce skin cancer incidence in individuals with elevated risk. Current evidence suggests that nicotinamide may represent a safe, accessible, and relatively inexpensive strategy for skin cancer prevention in predisposed populations.
The Studies
A large retrospective study published in 2025 in JAMA Dermatology included 33,822 veterans seen through the Tennessee Valley Healthcare System VA Medical Center with a prior history of non-melanoma skin cancers. Electronic health record data ranged from October 1, 1999, to December 31, 2024. Individuals who used 500 mg nicotinamide twice daily for longer than 30 days were studied. The primary outcome was the time to skin cancer after baseline.
The median number of skin cancers before nicotinamide treatment was 3, with a maximum of 73. There were 12,287 patients in the treatment group compared to 21,479 untreated individuals matched for age and number of cancers.
Overall, there was a 14% reduction in skin cancer risk in treated patients, which was considered statistically significant. When nicotinamide was initiated following a first skin cancer, risk reduction was 54% and declined with initiation following subsequent skin cancers. Risk reduction was seen with basal cell carcinoma (BCC) as well as cutaneous squamous cell carcinoma (cSCC). The largest reduction was for cSCC.
This study confirms previous findings, strengthening the body of evidence with the large sample size and long-term follow-up. In 2015, a double-blind randomized trial was published in the New England Journal of Medicine that included 386 participants who previously had at least 2 non-melanoma skin cancers. Results showed that 500 mg nicotinamide twice daily was associated with a reduced number of new skin cancers. The study lasted only 12 months.
At 12 months, the rate of new non-melanoma skin cancers was lower by 23% overall in the nicotinamide group compared to placebo. BCC incidence was 20% (p=0.12) lower, SCC 30% (p=0.05) lower, and actinic keratoses 13% (p=0.001) lower than placebo. Beginning at 3 months, there was a trend toward lower skin cancer rates with nicotinamide, suggesting that it suppresses progression of preexisting cancers. The benefits were not sustained in the 6-month follow-up after nicotinamide was discontinued.
Since this landmark study in 2015, dermatologists have been recommending nicotinamide. Survey results published in 2021 showed that out of 1,500 members of the American College of Mohs Surgeons, 76.9% recommend nicotinamide for keratinocyte carcinoma prevention.
Conclusions
Initiating 500 mg nicotinamide twice daily, especially after the first non-melanoma skin cancer, may reduce the risk of future cancers. The large sample size and 25-year follow-up in the Veterans study provide stronger evidence to support this recommendation.
For those considering prescribing for patients, it’s important to distinguish between nicotinic acid (niacin) and nicotinamide/niacinamide, which have different clinical effects. Nicotinamide does not cause flushing like nicotinic acid (niacin). There are topical nicotinamide products that have potential aesthetic benefits, but for skin cancer prevention, the studies used oral nicotinamide.
More research is needed to determine the preventive benefit for those never diagnosed with skin cancer, such as those with precancerous skin changes. Additionally, studies are needed to understand if vitamin B3 helps with melanoma risk.
→ Download the Full Text HERE.
Nicotinamide for Non-Melanoma Skin Cancer Prevention: What the Evidence Shows
Focused Key Phrase: See if any of these work in yoast: niacinamide for skin cancer, nicotinamide for skin cancer, vitamin B3 for skin cancer, niacinamide for basal cell carcinoma, niacinamide for squamous cell carcinoma
Nicotinamide, also known as niacinamide, is a form of vitamin B3 that has been studied for its potential to reduce non-melanoma skin cancer risk. Its proposed role in enhancing cellular DNA repair and supporting the skin’s response to ultraviolet-induced damage has prompted investigation into whether supplementation may reduce skin cancer incidence in individuals with elevated risk. Current evidence suggests that nicotinamide may represent a safe, accessible, and relatively inexpensive strategy for skin cancer prevention in predisposed populations.
The Studies
A large retrospective study published in 2025 in JAMA Dermatology included 33,822 veterans seen through the Tennessee Valley Healthcare System VA Medical Center with a prior history of non-melanoma skin cancers. Electronic health record data ranged from October 1, 1999, to December 31, 2024. Individuals who used 500 mg nicotinamide twice daily for longer than 30 days were studied. The primary outcome was the time to skin cancer after baseline.
The median number of skin cancers before nicotinamide treatment was 3, with a maximum of 73. There were 12,287 patients in the treatment group compared to 21,479 untreated individuals matched for age and number of cancers.
Overall, there was a 14% reduction in skin cancer risk in treated patients, which was considered statistically significant. When nicotinamide was initiated following a first skin cancer, risk reduction was 54% and declined with initiation following subsequent skin cancers. Risk reduction was seen with basal cell carcinoma (BCC) as well as cutaneous squamous cell carcinoma (cSCC). The largest reduction was for cSCC.
This study confirms previous findings, strengthening the body of evidence with the large sample size and long-term follow-up. In 2015, a double-blind randomized trial was published in the New England Journal of Medicine that included 386 participants who previously had at least 2 non-melanoma skin cancers. Results showed that 500 mg nicotinamide twice daily was associated with a reduced number of new skin cancers. The study lasted only 12 months.
At 12 months, the rate of new non-melanoma skin cancers was lower by 23% overall in the nicotinamide group compared to placebo. BCC incidence was 20% (p=0.12) lower, SCC 30% (p=0.05) lower, and actinic keratoses 13% (p=0.001) lower than placebo. Beginning at 3 months, there was a trend toward lower skin cancer rates with nicotinamide, suggesting that it suppresses progression of preexisting cancers. The benefits were not sustained in the 6-month follow-up after nicotinamide was discontinued.
Conclusions
Initiating 500 mg nicotinamide twice daily, especially after the first non-melanoma skin cancer, may reduce the risk of future cancers. The large sample size and 25-year follow-up in the Veterans study provide stronger evidence to support this recommendation.
For those considering prescribing for patients, it’s important to distinguish between nicotinic acid (niacin) and nicotinamide/niacinamide, which have different clinical effects. Nicotinamide does not cause flushing like nicotinic acid (niacin). There are topical nicotinamide products that have potential aesthetic benefits, but for skin cancer prevention, the studies used oral nicotinamide.
More research is needed to determine the preventive benefit for those never diagnosed with skin cancer, such as those with precancerous skin changes. Additionally, studies are needed to understand if vitamin B3 helps with melanoma risk.
→ Download the Full Text HERE.
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