For many years, doctors have searched for simple ways to help people reduce their risk of skin cancer. Skin cancer is one of the most common forms of cancer in the world. In countries with strong sunlight, such as Australia and the United States, millions of people are diagnosed every year.
Most cases are linked to long-term exposure to ultraviolet (UV) radiation from the sun. Because of this, dermatologists usually advise people to protect their skin with sunscreen, wear protective clothing, and avoid too much direct sunlight.
However, scientists have also been exploring whether certain vitamins or medicines might help prevent skin cancer from developing. One compound that has attracted growing interest is nicotinamide, a form of vitamin B3.
Nicotinamide is related to niacin, another type of vitamin B3, but it works differently in the body. It helps cells repair damage to their DNA, including the kind of damage caused by sunlight. Because skin cells are constantly exposed to UV radiation, researchers believe nicotinamide might help protect them from becoming cancerous.
In 2015, dermatologists began recommending nicotinamide to some patients who had already experienced skin cancer. This advice was based on a clinical trial that included 386 people with a history of skin cancer.
The study found that participants who took nicotinamide developed fewer new skin cancers than those who took a placebo. Because nicotinamide is relatively inexpensive and widely available as a supplement, many doctors began suggesting it as an option for people who are at high risk.
Despite these promising results, researchers wanted stronger evidence. The earlier clinical trial was relatively small, and scientists needed to know whether the same benefits would appear in a much larger group of people.
Studying nicotinamide in real-world populations has been difficult because the supplement can be bought over the counter. When people purchase it themselves, the information usually does not appear in medical records.
To overcome this problem, a research team used a unique data source from the United States Department of Veterans Affairs (VA). The VA healthcare system keeps detailed records in a large database called the Corporate Data Warehouse.
Unlike many other health systems, nicotinamide is listed on the VA’s official medication list, meaning prescriptions and use are documented.
Using this database, the researchers were able to study a very large group of patients. They reviewed the records of 33,833 veterans who received an initial treatment of nicotinamide.
Each patient took 500 milligrams twice per day for more than 30 days. The scientists then followed these patients over time to see whether they later developed two common forms of nonmelanoma skin cancer: basal cell carcinoma and cutaneous squamous cell carcinoma.
Among the people in the study, 12,287 patients took nicotinamide while 21,479 did not. By comparing these groups, the researchers could estimate whether the vitamin had any protective effect.
Their results showed a clear pattern. Overall, people who took nicotinamide had about a 14 percent lower risk of developing skin cancer compared with those who did not take the supplement.
The results became even more interesting when the researchers looked more closely at different patient groups. For people who started taking nicotinamide after their first skin cancer diagnosis, the risk of another skin cancer was reduced by 54 percent. This suggests that starting the supplement earlier may be especially helpful.
However, the benefit was smaller for patients who had already developed several skin cancers before beginning treatment. In those cases, the vitamin still appeared to help, but the effect was not as strong. The protective effect was particularly noticeable for squamous cell carcinoma, which is one of the most common types of nonmelanoma skin cancer.
The study was published in the medical journal JAMA Dermatology. 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.
According to Dr. Wheless, there are currently no clear guidelines on when people should begin taking nicotinamide to prevent skin cancer.
Traditionally, doctors have suggested it mainly for patients who have already developed multiple skin cancers. However, the findings from this larger study suggest that starting the supplement earlier might provide greater protection.
Even so, the researchers emphasize that nicotinamide is not a replacement for traditional skin protection. People should still avoid excessive sun exposure and use sunscreen regularly. The vitamin may serve as an additional layer of protection, especially for people who are already at higher risk.
When reviewing the findings, the study provides encouraging evidence that a simple vitamin supplement could play a role in preventing certain skin cancers.
The large number of patients included in the research makes the results more reliable than earlier smaller trials. The use of real-world medical data also helps scientists understand how the supplement performs outside controlled laboratory settings.
At the same time, there are still questions that future research needs to answer. Scientists need to determine exactly which patients benefit the most and how long the supplement should be taken. More studies may also explore whether similar benefits appear in different populations, including younger adults and people who have never had skin cancer.
Overall, the study adds important new evidence supporting nicotinamide as a possible tool for skin cancer prevention. While it is not a cure and cannot replace sun safety habits, it may offer a simple and affordable way to reduce risk for many people, particularly those who have already experienced skin cancer once.
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