Renewed Interest in Vitamin B3
A simple over-the-counter supplement, nicotinamide — a non-flushing form of vitamin B3 — is attracting serious attention as a tool for skin cancer prevention. Dermatologists have recommended it for high-risk patients since 2015, when a clinical trial of 386 people found fewer new cancers among those taking it. Now, a far larger study suggests the benefit may extend even further.
What Researchers Found
The new research, published in JAMA Dermatology on September 17, drew from the medical records of more than 33,800 U.S. veterans. Because nicotinamide is listed on the Veterans Affairs formulary, investigators could track outcomes among those prescribed the vitamin.
Patients who took 500 milligrams of nicotinamide twice daily for more than a month showed striking results:
- Across all participants, there was a 14% reduction in new skin cancers.
- Among people who started after their first skin cancer diagnosis, the benefit was much greater — a 54% reduction in risk.
- The protective effect was strongest against squamous cell carcinoma, one of the most common and potentially serious forms of non-melanoma skin cancer.
Dr. Yousuf Mohammed, Senior Research Fellow at the Frazer Institute, called the findings a breakthrough: “Nicotinamide, a simple vitamin B3 derivative, is showing real promise as a practical tool for skin cancer prevention.”
How Nicotinamide Works
Scientists believe nicotinamide helps by supporting the body’s natural defenses against sun damage. It boosts DNA repair in skin cells and reduces immune suppression caused by ultraviolet light. Unlike some prescription drugs used for skin cancer prevention, nicotinamide is considered safe, inexpensive, and well tolerated. “For clinicians, the appeal of nicotinamide lies in its accessibility,” Dr. Mohammed noted.
Who Benefits the Most
The benefit was most evident in people who began taking the vitamin soon after their first cancer. Those who delayed treatment until they had multiple cancers saw less protection. Timing, it seems, is critical.
Interestingly, among the 1,334 solid organ transplant recipients studied — a group at very high risk because of immune-suppressing drugs — no overall significant reduction was seen. Still, some early use hinted at fewer squamous cell cancers, suggesting that more research is needed for this vulnerable population.
What Doctors Are Saying
Dr. Lee Wheless, the study’s lead author and a dermatologist at Vanderbilt University Medical Center, said the findings may change clinical practice: “These results would really shift our practice from starting it once patients have developed numerous skin cancers to starting it earlier. We still need to do a better job of identifying who will actually benefit, as roughly only half of patients will develop multiple skin cancers.”
Other dermatologists agree that the evidence is growing. Sarah Arron, a Mohs surgeon in California who was not involved in the study, said the findings “provide stronger evidence and add more clarity” for doctors who have been uncertain about when to recommend the supplement.
A Practical Tool, Not a Cure
While the results are encouraging, experts caution that nicotinamide is not a replacement for sun protection or routine skin checks. Sunscreen, protective clothing, and regular dermatology visits remain essential.
Still, for many patients, a simple pill taken twice daily could offer a safe and affordable layer of added protection. As Dr. Mohammed emphasized, “These findings highlight that timing matters; starting earlier may be the key to stronger protection.”
