If you have a history of skin cancer, you may have heard your dermatologist mention nicotinamide, an oral form of vitamin B3 used as a low-risk chemoprevention strategy. Two studies help clarify how well it actually works.

What the Research Found

A Veterans Affairs study of more than 33,000 patients found that taking 500 mg of nicotinamide twice daily was linked to a 14% overall reduction in non-melanoma skin cancers (basal cell and squamous cell carcinoma). The benefit was strongest for people who’d already had one prior skin cancer, cutting their risk of another by over half. A related study found the protective effect was greatest when nicotinamide was started early, right after a first diagnosis, and gradually weakened the longer treatment was delayed. Benefits were less consistent in organ transplant recipients, likely due to their suppressed immune systems.

Why It May Work

Nicotinamide appears to support DNA repair after UV damage and counteract UV-induced immune suppression, helping the body recognize and clear precancerous cells.

A Few Things to Know

  • Diet isn’t a substitute. Food sources of B3 don’t reach the levels used in these studies.
  • Not all B3 is equal. Niacin, a different form of vitamin B3, hasn’t shown the same benefit.
  • Topical use is unproven. It’s unclear whether nicotinamide in sunscreens or serums offers the same protection as an oral supplement.

Who Might Be a Candidate

This is generally discussed with patients who have significant sun exposure history, numerous precancerous lesions, or a prior skin cancer, as a long-term supplement rather than a short-term fix, and best started with a doctor’s guidance.

References:

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Dr. Jane Yoo Board-Certified Dermatologist and Mohs Surgeon
Jane Yoo, MD, MPP, is a Korean American board-certified dermatologist and fellowship-trained Mohs surgeon based in Midtown Manhattan. She is a Clinical Assistant Professor at the Icahn School of Medicine at Mount Sinai and the founder of Jane Yoo MD, PLLC and the Clinical Research Center of New York. Dr. Yoo holds an undergraduate degree from MIT and a Masters of Public Policy from Harvard's Kennedy School of Government. She completed her Mohs micrographic surgery fellowship at Yale. Her clinical and research focus spans aesthetic clinical trials including injectables and laser technology, skincare formulation and sunscreen science, K-Beauty and skin of color, ultrasound guided filler dissolution, artificial intelligence and beauty tech. Dr. Yoo's research is indexed under ORCID 0000-0002-7112-8963.