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This vitamin B3 supplement, nicotinamide, has been found to significantly reduce the risk of developing new skin cancers, particularly for patients who have already experienced a prior skin cancer. A recent large-scale study involving over 33,000 U.S. veterans indicated that taking nicotinamide could lower the risk of new keratinocyte skin cancers by 14%, with an even more pronounced 54% reduction when started after a first skin cancer diagnosis. The findings reinforce previous smaller trials and experts suggest nicotinamide as a promising, low-cost adjunct to traditional skin cancer prevention strategies with important public health implications.
Major Study Findings
A 2025 retrospective cohort study published in JAMA Dermatology analyzed electronic health records from 33,822 veterans. Participants who took 500 mg of nicotinamide twice daily for at least 30 days showed a 14% reduction in overall skin cancer risk compared to those who did not take the supplement. Those who began nicotinamide treatment after their first skin cancer diagnosis experienced the largest risk reduction: 54% lower chance of developing subsequent skin cancers, especially squamous cell carcinoma (SCC). The protective effect diminished with multiple cancers and was not statistically significant after the seventh skin cancer diagnosis. The reduction was more evident for SCC than basal cell carcinoma (BCC).
Expert Commentary
Dr. Lee Wheless, a lead researcher from Vanderbilt University, highlighted the significance of the results, noting that nicotinamide intake was associated with a 53% drop in skin cancer risk for patients post-first diagnosis. Dermatologist Dr. Sarah Arron, not involved in the study, confirmed that the new evidence makes her more comfortable recommending nicotinamide supplements to suitable patients. She emphasized that this supplement helps skin cells repair UV-induced DNA damage and preserves immune surveillance compromised by sunlight exposure.
Dr. Hannah Kopelman, a dermatologist, explained nicotinamide’s mechanisms, stating it replenishes cellular energy crucial for DNA repair and reduces inflammation, both of which are vital in preventing mutated skin cells from progressing to cancer. However, she urged that nicotinamide should complement, not replace, sun protection measures such as sunscreen, protective clothing, and regular skin checks. Immunosuppressed patients like transplant recipients may see more mixed benefits, so recommendations should be tailored.
Context and Background
Nonmelanoma skin cancers, primarily BCC and SCC, are the most common cancers globally. Their incidence has risen alarmingly in recent years, with more than 5 million skin cancer cases diagnosed annually in the United States alone. Patients with a history of skin cancer are at higher risk for developing new lesions, creating a critical need for effective preventive strategies. Nicotinamide, a vitamin B3 derivative already available over-the-counter, had shown promising results in earlier, smaller clinical trials before the 2025 VA veterans cohort study validated its preventive potential on a larger scale.
Implications for Public Health
This study’s findings suggest nicotinamide could be a valuable, cost-effective intervention to reduce skin cancer recurrence, particularly in high-risk populations. Since nicotinamide is widely available and has a low side effect profile, its addition to existing skin cancer prevention protocols could ease healthcare burdens related to recurrent skin cancer treatment. The important caveat remains that nicotinamide is most beneficial when started early after a first skin cancer diagnosis. It should be paired with rigorous UV protection practices for maximal benefit.
Limitations and Balanced Perspective
While the evidence supports nicotinamide’s preventive role, the study was observational, so causality cannot be definitively established. The reduced risk was mainly for keratinocyte carcinomas (SCC and BCC), with no significant effect seen for melanoma skin cancer. Additionally, the protective effect waned after multiple cancers, suggesting diminishing returns in late-stage preventive use. Experts caution that nicotinamide should not replace fundamental sun safety measures. They also advise personalized consultations for immunosuppressed patients due to varied responses.
Practical Guidance for Readers
People with a history of skin cancer may consider discussing nicotinamide supplementation with their healthcare providers as part of a comprehensive skin health strategy. The commonly studied dose is 500 mg twice daily. Regular sunscreen use, protective clothing, and routine dermatological check-ups remain indispensable. Nicotinamide offers a biochemical boost by enhancing the skin’s ability to repair UV damage and maintain immune defense, effectively reducing the risk of new nonmelanoma skin cancers when combined with standard preventive habits.
Medical Disclaimer:
This article is for informational purposes only and should not be considered medical advice. Always consult with qualified healthcare professionals before making any health-related decisions or changes to your treatment plan. The information presented here is based on current research and expert opinions, which may evolve as new evidence emerges.
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