What Is Niacinamide?
Niacinamide is a form of vitamin B3, a safe, inexpensive, over-the-counter supplement with strong evidence supporting its ability to reduce the risk of certain skin cancers and precancerous lesions in high-risk patients.
Evidence-Based Protection
Clinical studies in high-risk patients (those with a history of skin cancer or multiple actinic keratoses) have shown:
- 23% fewer non-melanoma skin cancers (reduction in new NMSC)
- 11% fewer actinic keratoses (AKs) (reduction in new AKs)
- Well-tolerated, with no significant toxicity
Source: Chen AC, et al. A Phase 3 Randomized Trial of Nicotinamide for Skin-Cancer Chemoprevention. NEJM 2015.
Recommended Dose
Niacinamide 500 mg, taken twice daily.
- Take 500 mg in the morning and 500 mg in the evening, with or without food.
- This is NOT niacin (nicotinic acid). Niacinamide does not cause the flushing or liver concerns associated with niacin. Make sure the label says “Niacinamide” or “Nicotinamide.”
It Must Be Taken Continuously
Niacinamide only works while you are taking it. Research shows that the protective benefit disappears within months of stopping. There is no lasting residual effect, so protection requires continuous daily use.
Choosing a Quality Supplement
Because dietary supplements are not FDA-regulated for potency or purity, we recommend choosing a product that has been independently verified. Look for one of the following on the bottle: third-party tested, GMP certified, or CL (Consumer Lab tested). Brands we like include Thorne, Pure Encapsulations, and NOW.
Who Should Consider Niacinamide?
This supplement is most beneficial for patients who are at elevated risk for non-melanoma skin cancer, including those with:
- A history of basal cell carcinoma (BCC) or squamous cell carcinoma (SCC)
- Multiple or recurrent actinic keratoses (AKs)
- Fair skin with significant cumulative sun damage
- Immunosuppression (for example, transplant recipients)
What This Supplement Does Not Replace
- Daily broad-spectrum sunscreen (SPF 30 or higher)
- Protective clothing, hats, and sun avoidance during peak hours
- Regular full-body skin exams with your dermatology provider
Have questions about niacinamide or skin cancer prevention? You can book online or call the office at 423-528-8833. This page is for general education, not a substitute for a personal exam.