A common dietary supplement may help reduce the risk of developing new skin cancers, according to a large new study.
Nicotinamide, a form of vitamin B3, has been recommended by dermatologists since 2015 after a clinical trial with 386 people showed that it lowered the number of new skin cancers.
But until now, scientists had little information about how well it worked in larger, real-world populations.
Researchers publishing in JAMA Dermatology found a way to fill this gap by analyzing health records from the Veterans Affairs (VA) system, which keeps detailed data on patients.
Because nicotinamide is included on the VA’s official formulary, researchers were able to track which patients received the supplement and compare their outcomes to those who did not.
The study followed 33,833 veterans who were given nicotinamide at a dose of 500 milligrams twice a day for at least 30 days.
Their risk of developing new skin cancers—including basal cell carcinoma and cutaneous squamous cell carcinoma—was measured against those who did not take the supplement.
The results were encouraging. Among the 12,287 patients who received nicotinamide, there was a 14% lower risk of developing another skin cancer compared to the 21,479 patients who did not.
For patients who began taking the supplement after their very first skin cancer diagnosis, the protective benefit was much greater—risk dropped by 54%.
However, the benefit decreased for people who started the treatment only after developing multiple skin cancers. The strongest reduction was seen for squamous cell carcinoma.
“There are currently no official guidelines for when to begin nicotinamide to prevent skin cancer,” explained lead author Dr. Lee Wheless, assistant professor of Dermatology and Medicine at Vanderbilt University Medical Center and physician at the VA Tennessee Valley Healthcare System.
“These results suggest that starting the supplement earlier—after the first skin cancer—may be more effective than waiting until patients develop many. The challenge now is to identify which patients will benefit the most.”
The study also looked at 1,334 patients who had received solid organ transplants and were taking immune-suppressing medications, which put them at higher risk for skin cancer. For this group, there was no overall significant reduction in risk.
However, when nicotinamide was started early, it did seem to lower the likelihood of developing squamous cell carcinoma.
While more research is needed to refine recommendations, this large study supports earlier use of nicotinamide as a safe, inexpensive, and widely available option for reducing the risk of skin cancer.
For people with a history of skin cancer, it may provide an important extra layer of protection alongside sun safety and regular checkups.
Source: Vanderbilt University Medical Center.
