Does Vitamin B3 (nicotinamide) help prevent skin cancer?

One of the eight ​‘B’ vit­a­mins, vit­a­min B3 is an impor­tant nutri­ent need­ed by every part of your body to func­tion prop­er­ly. There are two main chem­i­cal forms of vit­a­min B3 (also called niacin) and each has a dif­fer­ent effect on your body:

Nico­tinic acid: As a sup­ple­ment, nico­tinic acid is a form of niacin used to reduce cho­les­terol lev­els and low­er the risk of heart dis­ease.³

Nicoti­namide or Niaci­namide: Nicoti­namide doesn’t low­er cho­les­terol, but stud­ies show that it may help treat skin con­di­tions such as pso­ri­a­sis and impor­tant­ly, reduce your risk of non-melanoma skin can­cer. ^(1,2)

Nicotinamide/​niacinamide is the form of vit­a­min B3 we’re focus­ing on in this arti­cle: the new ​‘won­der vit­a­min’ in the field of skin can­cer treatment.

For those who have already been diag­nosed with non-melanoma skin can­cers such as BCC and SCC in the past, the ben­e­fits of vit­a­min B3 could, lit­er­al­ly, be life-changing.

In anoth­er land­mark skin can­cer pre­ven­tion clin­i­cal tri­al led by Pro­fes­sor Diona Dami­an for the Can­cer Coun­cil NSW, 386 patients were ran­dom­ly assigned to receive either a twice dai­ly dose of nicoti­namide or a place­bo for one year. All the patients were at high risk of devel­op­ing more can­cers, as all had been diag­nosed with at least two non-melanoma skin can­cers in the pre­vi­ous five years.

The results made inter­na­tion­al head­lines when Pro­fes­sor Dami­an and her team found that after 12 months, the rate of non-melanoma skin can­cers was 23% low­er in the nicoti­namide group than in the place­bo group¹. Not only that, the num­ber of pre-can­cer­ous lesions was also 13% low­er among the peo­ple tak­ing nicoti­namide com­pared to those not tak­ing nicoti­namide¹.

If you’re con­sid­ered high risk because you’ve been diag­nosed with skin can­cers or solar ker­atoses in the past, ask your der­ma­tol­o­gist, gen­er­al prac­ti­tion­er or MoleMap Melanog­ra­ph­er whether nicoti­namide is right for you.

Note that using nicoti­namide to pre­vent skin can­cer is rec­om­mend­ed as a high-dose treat­ment rather than a sup­ple­ment. ​

“This treat­ment is only for peo­ple with a defined med­ical con­di­tion: those who have mul­ti­ple skin can­cers,” says Pro­fes­sor Dami­an. ​“It’s not suit­able for the gen­er­al pop­u­la­tion, as we do not have any evi­dence that it would be ben­e­fi­cial in a low­er risk setting.”

What if I’m low risk and want to take vit­a­min B3 for prevention?

To date, Vit­a­min B3 has not been shown to reduce the risk of skin can­cers in peo­ple who are at low­er risk (i.e. peo­ple who have nev­er had a pre­vi­ous skin can­cer or solar ker­ato­sis)³. Skin can­cer doc­tors don’t rou­tine­ly rec­om­mend it as a skin can­cer pre­ven­tion mea­sure – but there is more research to come on the ben­e­fits of vit­a­min B3 and skin can­cer, so watch this space!

What dosage of Vit­a­min B3 should I take?

The rec­om­mend­ed dose is one 500mg tablet tak­en twice dai­ly¹. How­ev­er – and this is impor­tant — vit­a­min B3 has not yet been shown to reduce the risk of skin can­cer or sun spots in peo­ple who are low­er risk i.e. who haven’t had them before.

Note also that pro­tec­tion from vit­a­min B3 only lasts while it is being tak­en — the ben­e­fit in high- risk skin can­cer patients ends with­in weeks of stop­ping this sup­ple­ment⁵. In oth­er words, for long term reduc­tion of non-melanoma skin can­cer, it needs to be tak­en indefinitely.

Nicoti­namide or niaci­namide is the water-sol­u­ble active form of Vit­a­min B3 (not to be con­fused with its pre­cur­sor, nico­tinic acid). It occurs nat­u­ral­ly in small quan­ti­ties in lean meats, yeast, meat, fish, eggs, milk, nuts, legumes and cere­als and the aver­age dai­ly require­ment is 15 – 20mg.¹

How­ev­er, even a bal­anced diet rich in these foods wouldn’t give you a high enough intake to reduce your risk of ongo­ing skin can­cer — the amount shown to help reduce skin can­cer risk is about 50 times this amount and can’t be achieved by dietary intake alone.

Mul­ti­vi­t­a­mins and B‑complex prepa­ra­tions won’t make a dif­fer­ence either: for the pre­ven­tion of recur­ring SCC, BCC and pre-can­cer­ous sun spots, the rec­om­mend­ed dose of Vit­a­min B3 is as a nicoti­namide 500mg tablet, twice dai­ly.¹

What are the ben­e­fits of vit­a­min B3 creams and moisturisers?

Pro­fes­sor Damian’s team showed that nicoti­namide may be high­ly effec­tive in pro­vid­ing immune pro­tec­tion — either as a top­i­cal lotion or a dai­ly tablet¹.

Top­i­cal creams, lotions and mois­turis­ers that include vit­a­min B3 (niaci­namide) have also been shown to reduce vis­i­ble signs of sun dam­age and age­ing, such as pig­men­ta­tion and fine wrin­kles, as well as reduc­ing blotch­i­ness and increas­ing elas­tic­i­ty, and improve skin’s abil­i­ty to heal after exci­sions.^(7,8,9,10)

Niaci­namide has also been added to some sun­screens, but note that because it’s water sol­u­ble, the ben­e­fits can be lost with expo­sure to water and sweat.

Where can I buy vit­a­min B3 prod­ucts in Australia?

In Aus­tralia, nicoti­namide tablets are avail­able from select­ed phar­ma­cies. Typ­i­cal­ly, they cost less than $20 for a month’s supply.

Nicoti­namide is also includ­ed in many top­i­cal skin prepa­ra­tions, includ­ing Solar care vit­a­min B3 cream. For peo­ple with sun-dam­aged skin and a his­to­ry of BCC, SCC or solar ker­atoses, Sun­Sense Ultra SPF 50+ sun­screen may be help­ful, as it con­tains nicotinamide.

Before taking vitamin B3 (nicotinamide), we recommend checking with your doctor, dermatologist, or MoleMap Melanographer at a skin cancer clinics to see whether it’s suitable for you.

Nicoti­namide is well tol­er­at­ed but very high dos­es (over 3000 mg a day) can cause nau­sea. It’s also very impor­tant that you take the amide form of vit­a­min B3, nicoti­namide — and not the nico­tinic acid form, which has a range of unpleas­ant side effects, includ­ing flush­ing, headache and low blood pressure.

It is impor­tant to remem­ber that vit­a­min B3 does not pro­tect against sun­burn, and should nev­er be used as a sub­sti­tute for a broad-spec­trum, SFP30+ sun­screen and fol­low­ing the lat­est sun­screen guide­lines. Nor is it a sub­sti­tute for hav­ing a reg­u­lar skin check or mole check every year, espe­cial­ly if you’re high risk and/​or have had skin can­cer before (you can check your risk lev­el here).

Stud­ies have also shown that Vit­a­min B3 may also sup­port the treat­ment and man­age­ment of solar ker­atoses (pre-can­cer­ous, scaly sun spots): it may help to not only treat pre-exist­ing solar ker­atoses, but also assist with the pre­ven­tion of new solar ker­atoses⁵.

At a dose of 500mg twice dai­ly, nicoti­namide has been shown to reduce solar ker­atoses by about 35 per cent fol­low­ing two months of treat­ment⁵. A low­er dose of 500mg once dai­ly may also be effec­tive, result­ing in a 29 per cent reduc­tion after four months of treat­ment⁵.

Experts rec­om­mend that peo­ple with advanced or mul­ti­ple solar ker­atoses should take vit­a­min B3 sup­ple­ments along­side oth­er treat­ments such as pre­scrip­tions creams/​ointments.

While the pro­tec­tive effects of vit­a­min B3 should the­o­ret­i­cal­ly also work against melanoma, there isn’t yet evi­dence of this in stud­ies – to date.

Pro­fes­sor Diona Dami­an, who led the pio­neer­ing Uni­ver­si­ty of Syd­ney study, says that the next step for her team is to deter­mine whether the immuno­pro­tec­tive effects of nicoti­namide might help pre­vent melanoma skin can­cers, as well as non-melanoma.

“Lab­o­ra­to­ry stud­ies so far have pro­vid­ed encour­ag­ing results, but we now need a large-scale clin­i­cal tri­al in peo­ple at high risk of melanoma,” she explains. The team will also inves­ti­gate whether nicoti­namide can help peo­ple who are at risk of aggres­sive skin can­cers because they have a chron­i­cal­ly supressed immune system.

In topical treatments, you can expect to see more and more skincare and sunscreen brands including vitamin B3 (niacinamide) in their products – just look for ‘niacinamide’ on the ingredients list. Additionally, it's worth noting that some sunscreens may also contain vitamin D, which plays a crucial role in maintaining skin health.

^{References: 1. Damian, Diona L. Nicotinamide for skin cancer chemoprevention. Australasian Journal of Dermatology. [Online] 20 March 2017. [Cited: 21 May 2019.] https://doi.org/10.1111/ajd.12631 2. Chen, Andrew C, et al. A phase 3 randomized trial of nicotinamide for skin-cancer chemoprevention. The New England Journal of Medicine. [Online] 22 October 2015. [Cited: 19 May 2019.] https://www.nejm.org/doi/full/10.1056/NEJMoa1506197 3. Cancer Council Australia: https://www.cancercouncil.com.au/blog/the-role-of-vitamin-b3-in-reducing-non-melanoma-skin-cancer/ 4. Heathline: https://www.healthline.com/nutrition/niacin-benefits 5. Surjana, D, et al. Oral nicotinamide reduces actinic keratoses in phase II double-blinded randomized controlled trials. Journal of Investigative Dermatology. [Online] May 2012. [Cited: 26 May 2019.] https://doi.org/10.1038/jid.2011.459 6. Snaidr, Victoria A, Damian, Diona L and Halliday, Gary M. Nicotinamide for photoprotection and skin cancer chemoprevention: A review of efficacy and safety. Experimental Dermatology. [Online] 30 January 2019. [Cited: 19 May 2019.] https://onlinelibrary.wiley.com/doi/10.1111/exd.13819 7. Kimball, A B, et al. Reduction in the appearance of facial hyperpigmentation after use of moisturizers with a combination of topical niacinamide and N‐acetyl glucosamine: results of a randomized, double‐blind, vehicle‐controlled trial. British Journal of Dermatology. [Online] 13 January 2010. [Cited: 21 May 2019.] https://doi.org/10.1111/j.1365-2133.2009.09477.x9. 8. Fu, J J J, et al. A randomized, controlled comparative study of the wrinkle reduction benefits of a cosmetic niacinamide/peptide/retinyl propionate product regimen vs. a prescription 0·02% tretinoin product regimen. British Journal of Dermatology. [Online] 15 February 2010. [Cited: 21 May 2019.] https://doi.org/10.1111/j.1365-2133.2009.09436.x 9. Bissett, D L, Oblong, J E and Berge, C A. Niacinamide: A B vitamin that improves aging facial skin appearance. Dermatologic Surgery. [Online] 21 March 2006. [Cited: 21 May 2019.] https://doi.org/10.1111/j.1524-4725.2005.31732 10. Esfahani, S A, et al. Topical nicotinamide improves tissue regeneration in excisional full-thickness skin wounds: a stereological and pathological study. Trauma Monthly. [Online] November 2015. [Cited: 21 May 2019.] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4727459/}