Can Vitamin B3 (Nicotinamide) Really Help Prevent Skin Cancer?

Skin cancer is the most common type of malignancy in the US. Between 40 and 50 percent of Americans will be diagnosed with either basal cell carcinoma or squamous cell carcinoma by the age of 65. That means that each year, over 5 million people are treated for these skin cancers. (Melanoma is less common but much more dangerous.) Many people will be surprised to learn that nicotinamide (vitamin B3), also known as niacinamide, nicotinic acid or niacin, might help reduce the risk for skin cancer (JAMA Dermatology, Sept. 17, 2025).

Here are the conclusions of this brand new study:

“The results of this cohort study suggest that there is a decreased risk of skin cancer among patients treated with nicotinamide, with the greatest effect seen when initiated after the first skin cancer.”

The Magic of Nicotinamide (Niacinamide aka Niacin) vs. Cancer:

We frequently hear from healthcare professionals that people do not need to take extra vitamins. The mantra repeated over and over is:

“Just eat a well-balanced diet.”

Easily stated, but vague and hard to follow for most Americans. Just walk through any grocery store and you will see that most of the items on the shelves are ultra-processed, tasty treats. Snack foods and bread-based products (including pizza) are familiar favorites.

One of the favorite guests on our nationally syndicated public radio show is Tieraona Low Dog, MD. Her book, Fortify Your Life: Your Guide to Vitamins, Minerals and More (2016), is fabulous.

In it, she describes the role of niacin in protecting the body from damage:

“It promotes cellular health and protects our DNA from damage, and research shows that niacin protects against oral and esophageal cancers. A study of airline pilots, who are exposed to high exposures of radiation, found that niacin, but not other antioxidants, reduced DNA damage. Niacin, both orally and topically, also seems to offer some protection against skin cancer.”

Fast Forward to September 17, 2025:

The article in JAMA Dermatology, Sept. 17, 2025 introduces the latest research about nicotinamide this way:

“Nicotinamide is a vitamin B₃ derivative that is sold as an over-the-counter (OTC) medication and has shown promise in skin cancer chemoprevention, with up to 75% of dermatologic surgeons reporting using nicotinamide for this indication. In 2015, a phase 3, double-blind randomized clinical trial with 386 participants demonstrated that nicotinamide, 500 mg, twice daily was associated with a reduced number of new skin cancers in a population with a history of skin cancer.  Following this study, dermatologists began using OTC nicotinamide for skin cancer chemoprevention, particularly in patients at high risk of skin cancer development.”

The investigators performed a “retrospective cohort study” using health records from the Veterans Affairs between October 1, 1999 through December 31, 2024. There were 12,287 patients who received 500 mg of oral nicotinamide twice a day for more than a month. They were matched to 21,479 VA patients who did not get nicotinamide.

The Results of the Latest Nicotinamide Study:

“In this retrospective cohort study, nicotinamide use was associated with reduced skin cancer risk in those with at least 1 prior skin cancer.

“Our results aligned with the risk estimates previously reported that showed a 30% to 50% reduction in risk of skin cancer. While these reports have been criticized for being underpowered, our study included more than 4 times the number of cases included in a recent systematic review and meta-analysis.”

That “Systematic Review and Meta-Analysis” of nicotinamide was published in the Journal of Cutaneous Medicine and Surgery (Feb. 8, 2022). The authors report a relative reduction in new skin cancers of 50%.

Here are their conclusions:

“Consideration should be given for skin cancer chemoprophylaxis [prevention] with nicotinamide 500 mg per os [by mouth] twice daily for a minimum of 12 months in healthy patients…in particular for BCCs [basal cell carcinomas] chemoprophylaxis and cSCCs [cutaneous squamous cell carcinomas] chemoprophylaxis…Effect of nicotinamide require further evaluation in regard to chemoprevention of AK [actinic keratoses] and melanoma, potential long-term benefits, safety in patients with comorbidities such as chronic kidney disease, and enduring effects after its discontinuation. Low cost and over-the-counter accessibility of nicotinamide support its relevance in tertiary prevention of skin cancers.”

How Can You Take Nicotinamide Against Skin Cancer?

Q. An Australian wrote to you about using nicotinamide for preventing a recurrence of skin cancer. Here in the US, do you need a doctor to prescribe it? Should it be monitored?

I have had a basal cell skin cancer removed as well as a melanoma in situ, so I have annual check-ups. Nicotinamide (vitamin B3) is not indicated for melanoma, but I would like to take it to prevent other skin cancers.

I understand that some forms of B3 may lead to liver problems. But I saw nothing about that in the JAMA Dermatology study you cited. Does it seem to be safe at the doses used in the study? Where would I find it?

A. As you noted, vitamin B3 comes in several different forms, including niacin (aka nicotinic acid), nicotinamide (also called niacinamide) and derivatives such as nicotinamide riboside.

At very high doses from 1 to 3 grams a day, niacin may harm the liver. Nicotinamide generally is safe until doses exceed 3 grams daily. The dose used to prevent skin cancer recurrence is 500 mg twice a day. It is available without a prescription, but you would be wise to ask your doctor to monitor your liver enzymes. That way, if you are especially susceptible, you will find out before you develop a serious problem.

A Reader Shares Her Niacinamide Story to Prevent Skin Cancer:

Q. As a middle-aged, fair-skinned redhead, I have had several run-ins with precancerous and basal skin cell cancers. I see my dermatologist every 6 months, and usually have many ‘rough’ precancerous spots ‘burned’ off, particularly from the back of my hands.

My friend’s son lives in Australia, and she told me about studies there showing niacinamide supplements reduce the incidence of precancerous cell growth. My dermatologist wasn’t really familiar with these studies, but said it can’t hurt to try.

I’ve been taking 500 mg of niacinamide supplements daily for the past year, and have had zero recurrence of these rough spots on my hands. It has been a truly remarkable change for me. Have you heard anything about taking niacinamide to prevent some skin cancers?

Australian Research Shows Niacinamide Can Help Prevent Skin Cancer:

A. Your friend is right that Australian dermatologists and scientists have done most of the studies in this arena. We described such a study that made headlines in 2015.

One review of the research concludes that nicotinamide (another name for niacinamide) holds promise for preventing both melanoma and non-melanoma skin cancers (Minocha, Damian & Halliday, Photodermatology, Photoimmunology & Photomedicine, online July 5, 2017).  Another summary concludes that nicotinamide acts in several ways to reduce actinic keratoses (your rough spots) and nonmelanoma skin cancers (Damian, Australasian Journal of Dermatology, Aug. 2017).  Thank you for letting us know of your success.

People concerned about skin cancer may also want to discuss blood pressure medicine with their physicians. A Danish study suggested that people who take hydrochlorothiazide, a common drug to treat hypertension, are more likely to develop non-melanoma skin cancer. We have reviewed common side effects of HCTZ, including the skin cancer risk, at this link.

Final Words:

There was a time when doctors frequently prescribed niacin to lower cholesterol. Once statins became available, however, that changed. These days most cardiologists do not recommend niacin, even though it is one of the few natural products that can lower the bad actor known as Lp(a). More about that at this link. A downside of niacin, however, is flushing. Many people find this side effect unbearable.

Nicotinamide does not cause flushing, however. (Nor does it lower cholesterol, for that matter.) At the doses described above, we strongly suggest that anyone contemplating taking this B vitamin be under medical supervision.

Doctors occasionally prescribe nicotinamide for skin cancer (basal and squamous cell) prevention. This amide form of vitamin B3 facilitates DNA damage repair and reduces inflammation. Some dermatologists prescribe it for inflammatory skin conditions such as eczema, rosacea and acne (Medicine {Kaunas}, Feb. 1, 2025). Patients dealing with kidney failure and high phosphate levels may also be prescribed nicotinamide to lower this mineral.

Side Effects of Nicotinamide:

Nicotinamide is generally considered “well tolerated,” but it can cause side effects in some people. They include digestive upset (heartburn, nausea, vomiting, diarrhea, flatulence), fatigue, headache or dizziness. Liver enzymes should be monitored periodically. People with diabetes should monitor their blood sugar carefully to make sure it doesn’t get worse. Anyone on an anticoagulant should be tested frequently for a bleeding risk.

The authors of the nicotinamide review in the journal Medicine (Kaunas), (Feb. 1, 2025) offer this summation:

“By facilitating DNA repair, modulating inflammatory pathways, and attenuating oxidative stress, nicotinamide not only assists in preventing cellular damage but also counters processes that drive aging and carcinogenesis…As our understanding deepens, nicotinamide may become a key pillar in integrated therapeutic approaches for a range of skin conditions and systemic diseases, bridging the gap between nutritional supplementation, pharmacological intervention, and preventive healthcare strategies.”

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