A new large-scale study has found that nicotinamide, a common vitamin B3 supplement, may significantly reduce the risk of skin cancer recurrence.
Dermatologists have been recommending the supplement nicotinamide to patients with a history of skin cancer since 2015, after a clinical trial involving 386 people found that those taking this form of vitamin B3 developed fewer new cancers.
Until now, evidence from larger populations has been difficult to gather, largely because nicotinamide is sold over the counter and its use typically does not appear in medical records. To overcome this challenge, researchers turned to the Veterans Affairs Corporate Data Warehouse and reported their findings in the Sept. 17 issue of JAMA Dermatology.
Because nicotinamide is part of the VA’s official formulary, they were able to review outcomes from 33,833 patients, tracking whether individuals developed another skin cancer after starting a baseline regimen of 500 milligrams twice daily for more than 30 days. The analysis focused on two common types of skin cancer: basal cell carcinoma and cutaneous squamous cell carcinoma.
Significant Risk Reduction
The researchers compared 12,287 patients who received the treatment with 21,479 who did not. Overall, there was a 14% reduction in skin cancer risk. When nicotinamide was taken after a first skin cancer, the risk reduction rose to 54%, but the benefit declined with treatment initiation following subsequent skin cancers. The risk reduction was much larger for squamous cell carcinoma.
“There are no guidelines for when to start treatment with nicotinamide for skin cancer prevention in the general population. These results would really shift our practice from starting it once patients have developed numerous skin cancers to starting it earlier. We still need to do a better job of identifying who will actually benefit, as roughly only half of patients will develop multiple skin cancers,” said the study’s corresponding author, Lee Wheless, MD, PhD, assistant professor of Dermatology and Medicine at Vanderbilt University Medical Center and a staff physician at VA Tennessee Valley Healthcare System.
The researchers were also able to ascertain the outcomes of 1,334 patients who were immunocompromised due to having received solid organ transplants. Among solid organ transplant recipients, no overall significant risk reduction was observed, although early nicotinamide use was associated with reduced occurrences of cutaneous squamous cell carcinoma.
Reference: “Nicotinamide for Skin Cancer Chemoprevention” by Kimberly F. Breglio, Katlyn M. Knox, Jonathan Hwang, Rachel Weiss, Kyle Maas, Siwei Zhang, Lydia Yao, Chris Madden, Yaomin Xu, Rebecca I. Hartman and Lee Wheless, 17 September 2025, JAMA Dermatology.
DOI: 10.1001/jamadermatol.2025.3238
Wheless received research support from a Department of Veterans Affairs grant (IK2CX002452).
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6 Comments
1000 mg of nicotinamide is 100x the recommended daily allowance…and carries side effects. A study was published by the NIH in 2020: “Possible Adverse Effects of High-Dose Nicotinamide: Mechanisms and Safety Assessment.” From the information in the article (cited pub is not open access), it is not clear that there is a direct link between reduction in skin cancer risk and nicotinamide, nor is a safety cost-benefit included.
Lots of people are taking nicotinamide riboside as a NAD+ precursor. Is this the same thing being referred to?
No. They are both derivatives of niacin, but NR is nicotinamide coupled to riboside. They are both considered NAD+ precursors.
Was it pill form or cream.
Was it pill form or cream.
B3 is Niacin.
So shouldn’t it be Niacinamide instead of Nicotinamide?