Nicotinamide Vitamin B3 May Cut Non-Melanoma Skin Cancer Recurrence, Large VA Study Finds
Among veterans with prior skin cancer, taking 500 mg twice daily after diagnosis reduced recurrence by about 54%; researchers urge randomized trials to confirm findings.
Researchers using Veterans Affairs health records found that nicotinamide, a form of vitamin B3 sold over the counter, may reduce the risk of skin cancer returning in people who have already been diagnosed. In a study that compared more than 12,000 patients who took 500 mg of nicotinamide twice daily for at least one month with more than 21,000 who did not take the supplement, Nicotinamide users had a 14% lower risk of developing basal cell carcinoma or cutaneous squamous cell carcinoma overall. The reduction was most pronounced for squamous cell carcinoma, where risk fell by more than 20%. Most striking, among patients with a history of skin cancer, starting nicotinamide after the first diagnosis reduced the chance of recurrence by 54%. The protective effect appeared to wane in individuals who had already experienced multiple bouts of skin cancer prior to taking the supplement.
The findings add momentum to a long-running dermatology message: nicotinamide, the amide form of vitamin B3, may support skin cancer prevention. Nicotinamide is distinct from niacin (nicotinic acid), another form of vitamin B3, and is generally well tolerated at typical doses. Side effects are usually mild and may include nausea, diarrhea, headaches or fatigue. Experts emphasize that this study used veterans’ health records, which can limit generalizability to women and younger populations, and that a randomized clinical trial is still needed to confirm results before broad clinical guidelines are issued.
The study builds on a 2015 clinical trial in 386 patients that found fewer new skin cancers among those taking nicotinamide, but follow-up on a larger scale was difficult because the supplement is widely available over the counter and not always recorded in medical files. To address that gap, researchers pulled data from the VA Corporate Data Warehouse, a national repository that tracks supplement use alongside medical records. The analysis focused on two common non-melanoma skin cancers: basal cell carcinoma and cutaneous squamous cell carcinoma.
“We did not have clear guidelines for when to start nicotinamide in the general population,” said Dr. Lee Wheless, assistant professor of Dermatology and Medicine at Vanderbilt University Medical Center and corresponding author of the study. “These results would really shift practice from waiting for patients to develop numerous skin cancers to starting it earlier.” The researchers caution that the findings may not apply to women or younger individuals and that a randomized trial is needed to confirm the protective effect.
Dermatologists have long noted that nicotinamide may aid cells in repairing UV-damaged DNA and modulate some sun-induced immune effects. “I am going to be more rigorous in recommending it to patients, especially those with their first skin cancer,” said Dr. Sarah Arron, a dermatologist not involved in the study. “The benefit appears strongest when started after the initial diagnosis.” Clinicians advising patients who choose to use the supplement typically recommend the nicotinamide form (ending in “amide”) and caution that it should not replace sunscreen or other sun-protection habits.
Beyond individual patient decisions, the study comes at a time when non-melanoma skin cancers remain common in the United States and are on the rise. The American Cancer Society estimates that about 5.4 million basal cell and squamous cell skin cancers are diagnosed each year in the United States. While nicotinamide may offer a convenient, accessible option for some patients, experts stress that proven sun-protection strategies—such as shielding skin from UV radiation, wearing protective clothing, and using broad-spectrum sunscreen—remain essential components of prevention.
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