Skin cancer is the most common type of cancer in many countries, especially in places with strong sunlight such as the United States and Australia.
Doctors have long encouraged people to protect their skin by wearing sunscreen, avoiding too much sun exposure, and checking their skin regularly.
In recent years, researchers have also been exploring whether certain vitamins might help reduce the risk of developing new skin cancers. One vitamin that has attracted attention is nicotinamide, a form of vitamin B3.
Nicotinamide is related to niacin, another type of vitamin B3 that helps the body produce energy and repair cells. Unlike niacin, nicotinamide does not cause flushing or redness of the skin. Scientists have been interested in this vitamin because it appears to support the body’s ability to repair DNA damage caused by ultraviolet radiation from sunlight.
When sunlight damages the DNA inside skin cells, those cells can sometimes turn into cancer. If the body can repair this damage more effectively, it may reduce the chance of cancer developing.
The idea that nicotinamide could help prevent skin cancer first gained attention in 2015. At that time, researchers conducted a clinical trial involving 386 people who already had a history of skin cancer. In that study, participants were asked to take nicotinamide supplements regularly.
The results showed that people who took the vitamin developed fewer new skin cancers compared with those who did not take it. Because of this finding, many dermatologists began recommending nicotinamide to patients who had previously developed skin cancer.
However, the earlier trial involved a relatively small number of participants. Scientists wanted to know whether the same protective effect would appear in a much larger group of people.
Confirming the benefit has been difficult because nicotinamide is widely available without a prescription. Many people buy it at pharmacies or health stores, which means its use is often not recorded in medical records. Without reliable records, it becomes harder for researchers to study its long-term effects.
To overcome this problem, researchers looked for a healthcare system where the use of nicotinamide could be tracked more carefully. They found such an opportunity in the U.S. Department of Veterans Affairs health system.
Within this system, nicotinamide is listed on the official medication formulary, which means prescriptions and use can be documented in the VA Corporate Data Warehouse. This large medical database allowed scientists to analyze the outcomes of thousands of patients over time.
Using these records, the research team examined data from 33,833 veterans who received treatment with nicotinamide. The typical treatment involved taking 500 milligrams of the vitamin twice a day for more than 30 days.
Researchers then followed the patients to see whether they later developed two common types of skin cancer: basal cell carcinoma and cutaneous squamous cell carcinoma. Both of these cancers are considered nonmelanoma skin cancers and occur frequently in people who have had long-term sun exposure.
Among the patients included in the analysis, 12,287 people had taken nicotinamide, while 21,479 had not taken the supplement. When the researchers compared the two groups, they found that people who used nicotinamide had a lower risk of developing new skin cancers. Overall, the supplement was linked to a 14 percent reduction in skin cancer risk.
The effect was even stronger in people who began taking nicotinamide after their first diagnosis of skin cancer. In this group, the risk of developing another skin cancer dropped by about 54 percent.
This suggests that starting the vitamin early, soon after the first cancer appears, may provide the greatest benefit. However, the protective effect was weaker in patients who had already developed multiple skin cancers before starting the supplement.
The study also showed that the vitamin seemed particularly helpful in reducing the risk of squamous cell carcinoma. This form of skin cancer is one of the most common types and can sometimes spread if not treated early. While basal cell carcinoma is also common, it rarely spreads to other parts of the body.
The research was led by Dr. Lee Wheless, an assistant professor of dermatology and medicine at Vanderbilt University Medical Center and a physician at the VA Tennessee Valley Healthcare System.
Dr. Wheless explained that there are currently no clear guidelines on when people should begin taking nicotinamide for skin cancer prevention. Many doctors have been recommending it only after patients develop several skin cancers. The new findings suggest that starting the supplement earlier might be more effective.
According to the researchers, the results could influence how doctors think about prevention. Instead of waiting until patients have developed many skin cancers, physicians may begin considering the supplement sooner for people who have already had one diagnosis.
However, the researchers also noted that not everyone with a single skin cancer will develop more in the future. In fact, only about half of such patients go on to experience multiple skin cancers. This means doctors still need better ways to identify which patients are most likely to benefit.
Overall, the study provides important new evidence supporting the use of nicotinamide for skin cancer prevention in certain high‑risk patients. Because the research involved more than thirty thousand participants, it offers stronger real‑world evidence than earlier smaller trials.
However, it is still an observational study based on medical records rather than a controlled clinical trial. This means the results show an association but cannot prove with complete certainty that the vitamin alone caused the reduced risk.
Even so, the findings are encouraging. Nicotinamide is inexpensive, widely available, and generally considered safe for most people when used at recommended doses. If future studies confirm these benefits, the vitamin could become a simple tool to help prevent some cases of skin cancer, especially among people who have already developed the disease once.
For now, experts emphasize that nicotinamide should not replace traditional skin protection methods such as sunscreen, protective clothing, and regular skin examinations. Instead, it may serve as an additional layer of prevention for people at higher risk. More research will help clarify who should take it and when treatment should begin.
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