By Sarah E. Schram, MD / Mohs Surgeon, Cosmetic Dermatologist

There is new hope to those at high risk of developing the most common types of skin cancer and the key may be an over-the-counter vitamin supplement that costs less than $10 a month. Nicotinamide (a form of Vitamin B3) has been shown in recent studies to reduce the risk of both actinic keratoses (precancers) and non-melanoma skin cancers. Ultraviolet light causes damage to the DNA of our cells, necessitating repair that depletes cellular energy. Nicotinamide helps to replenish this energy, thus improving the rate of DNA repair and decreasing cellular immunosuppression. Taking nicotinamide 500mg by mouth twice daily led to a 35% reduction in actinic keratoses in one study (Surjana et al. 2012). Another study showed that in patients who have had at least two non-melanoma skin cancers in the last five years, there was a 23% reduction in development of new basal cell and squamous cell carcinoma compared to the placebo (Chen 2015).

While there is not enough data yet to suggest that all people should take nicotinamide, if you have a history of skin cancer, it may be helpful to decrease the risk of developing more.  Nicotinamide is contained in many foods such as beans, meat, fish, eggs, milk and cereals but to reasonably get to the doses reported in the study, a supplement would need to be used.  The dosing recommended by the study is 500mg twice daily.  At this dose, very few side effects were reported.

Surjana D, Halliday GM, Martin AJ, Moloney FJ, Damian DL. Oral Nicotinamide reduces actinic keratoses in phase II double-blinded randomized controlled trials.  J Invest Dermatol  2012;132: 1497-500.
Chen AC, Martin AJ, Choy B, et al. A phase 3 randomized trial of nicotinamide for skin cancer chemoprevention.   N Engl J Med 2015;373:1618-26.