As the saying goes, “You are what you eat” and hence, if there is a simple supplement that has no significant side effects and prevents skin cancer, then this is a major practical addition to our skin health regimens. Nicotinamide, also known as Niacinamide is a water-soluble form of Vitamin B3 that has been found naturally in meat, fish, nuts, grains & legumes, and is a key component of the glycolysis pathway, by generating Nicotinamide adenine dinucleotide (NAD) for adenosine triphosphate (ATP) production. It has been known to have beneficial anti-inflammatory effects improving acne, rosacea, melasma and some blistering disorders.
In a landmark study published by The New England Journal of Medicine 2015: 373:1618-26, the authors showed convincingly that over a 12 month period taking Nicotinamide, 386 study patients experienced a 23% reduction in developing nonmelanoma skin cancers (basal cell carcinomas and squamous cell carcinomas) and actinic keratoses (pre-skin cancers) versus those on placebo. The study participants took 500mg twice daily and there did not appear to be any adverse side-effects. However, it is not recommended for those with chronic kidney disease nor those who are pregnant.
Nicotinamide should not be confused with Niacin, sometimes recommended for lower cholesterol which has been associated with flushing, headaches and elevation of liver enzymes.
This skin cancer-reducing supplement is not an oral sunscreen and does not replace other sun protection guidance (sunscreens with an SPF of over 40, protective clothing, hats, yearly skin exams and avoiding the hot, mid-day sun.) These are all the mainstays to protect yourself from the sun and skin cancers. Given the safety profile of Nicotinamide, and its protective effects and positive feedback from our patients, I wholeheartedly recommend since it can significantly reduce the incidence of both actinic keratoses and nonmelanoma skin cancers.
Steven L. Greene MD, Advanced Dermatology and Laser Institute of Seattle.