Niacinamide – Our Secret Weapon Against Skin Cancer

At Dermatology Solutions, we’re always looking for evidence-based ways to protect our patients from skin cancer—and one of the most overlooked tools in our arsenal is a simple B-vitamin: niacinamide. 
 
What is Niacinamide, and How Does It Work? 
Niacinamide (also known as nicotinamide) is a form of vitamin B3 that supports skin barrier function, reduces inflammation, and repairs DNA damage caused by UV exposure. It’s not the same as niacin (which can cause uncomfortable flushing) or nicotine (which has an entirely different effect on the body). While all these compounds share a similar root structure, they have vastly different roles—and niacinamide is the one with the skin-protective superpowers. 
 
The Evidence: Niacinamide and Skin Cancer Prevention 
In a landmark randomized controlled trial published in the New England Journal of Medicine in 2015, researchers studied 386 patients with a history of nonmelanoma skin cancer. Participants were given 500 mg of niacinamide twice daily or a placebo for 12 months. 
The group taking niacinamide had a 23% reduction in new nonmelanoma skin cancers (including both basal cell carcinomas and squamous cell carcinomas) compared to the placebo group. They also had fewer actinic keratoses—precancerous lesions that can turn into squamous cell carcinoma. 
 
That’s why we now routinely recommend niacinamide supplementation for our patients with a history of skin cancer. It’s one of the easiest and safest preventive strategies we can offer. 
 
A Note on Flushing 
Niacinamide doesn’t typically cause flushing—that’s a side effect seen with niacin (a different form of vitamin B3). However, a small number of our patients may still experience mild warmth or redness. The patient pictured is one such case—he experiences temporary flushing from it. 
 
If you’re prone to sensitive skin or unsure how your body might react, start with a lower dose (once daily instead of twice daily) or speak with us about prescription guidance. 
 
Our Practice Protocol 
For our skin cancer patients, we typically recommend: 
• 500 mg of niacinamide twice daily, continued indefinitely 
• Avoid use in patients with severe liver disease, although it’s generally very well tolerated 
• Use the nicotinamide form labeled clearly as “niacinamide” to avoid the flushing risk associated with niacin 
 
You don’t need a prescription—it’s available over-the-counter. But many insurances provide coverage for vitamins like niacinamide given its benefits.  
It’s important to discuss and report any new supplements to your provider. 
Whether you’re a skin cancer survivor or simply proactive about skin health, niacinamide might be a small addition to your daily routine with major benefits.  
At Dermatology Solutions, we’re committed to keeping our patients educated and empowered—because when it comes to skin cancer, prevention is everything. 
 

Disclaimer: The photos shown are actual images of our patient, shared with explicit written consent. These images are for educational use only and may not be copied, distributed, or reproduced without permission from our office. 

 
References: 
Chen, Diona J., et al. “A Phase 3 Randomized Trial of Nicotinamide for Skin-Cancer Chemoprevention.” New England Journal of Medicine, vol. 373, no. 17, 2015, pp. 1618–1626.  
https://doi.org/10.1056/NEJMoa1506197