Oral Nicotinamide and the Prevention of Skin Cancers

Nicotinamide, a form of vitamin B3, has emerged as a promising supplement for reducing the risk of skin cancers, especially nonmelanoma types like basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Unlike niacin, nicotinamide does not cause flushing and is well tolerated. It works by enhancing DNA repair and reducing UV-related immune suppression, helping the skin recover from sun damage that can lead to cancer.

A landmark clinical trial showed that people with a history of NMSC who took 500 mg twice daily had a 23% reduction in new skin cancers and fewer precancerous actinic keratoses compared to those on placebo. However, in transplant patients on immunosuppressive drugs, nicotinamide did not reduce cancer risk, suggesting it may be most effective in people with normal immune systems. Research is also exploring its potential role in preventing melanoma.

Nicotinamide is safe, affordable, and available over the counter, with mild gastrointestinal side effects reported in some cases. It should be used alongside—not instead of—core sun protection strategies like sunscreen, protective clothing, and shade. Patients at high risk for skin cancer should consult their doctor before starting supplementation to ensure proper dosing and safety.

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