It’s official: Nicotinamide may help stave off skin cancer.
The vitamin B3 derivative has been recommended by dermatologists for people with a history of skin cancer since 2015, when a clinical study with 386 participants showed that those who took it developed fewer new occurrences. However, data to validate those findings in a larger study group has been lacking because nicotinamide can be purchased over the counter without being entered into patients’ medical records.
Now, in a new study published in JAMA Dermatology, researchers found a way to get that data by analyzing records from the Veterans Affairs Corporate Data Warehouse. Nicotinamide is on the VA’s official formulary, so the researchers checked the outcomes of 33,833 patients for their next skin cancer diagnosis following baseline treatment with 500mg of nicotinamide twice daily for longer than 30 days.
They looked for occurrences of basal cell carcinoma and cutaneous squamous cell carcinoma.
When researchers compared 12,287 patients who received the treatment with 21,479 who did not, they found a decreased risk of skin cancer among patients treated with nicotinamide, with the greatest effect seen when initiated after the first skin cancer.
Overall Reduction in Skin Cancer Risk
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,” says the study’s corresponding author Lee Wheless, MD, PhD, an Assistant Professor of Dermatology and Medicine at Vanderbilt University Medical Center in Nashville, TN 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.
