Nicotinamide reduces incidence of skin cancer: Study

A new analysis in JAMA Dermatology reports that nicotinamide, a form of vitamin B3, was associated with a meaningful reduction in incident skin cancers among U.S. veterans with a prior history of the disease. The findings point to an inexpensive, orally administered chemopreventive option that could help clinicians manage an especially high‑risk population.

The study drew on data from more than 12,000 veterans followed over 25 years who had previously received nicotinamide and had at least one documented skin cancer.

Investigators evaluated demographics and tumour counts to assess subsequent risk, allowing for a long-term view of real-world nicotinamide exposure in routine care. “Not only did we find an overall 14 per cent reduced risk of developing new skin cancers… but we also discovered that patients who started nicotinamide after their first skin cancer saw a 54 per cent reduction in the rate of new skin cancers,” said Lee Wheless, MD, PhD in a press release. Dr. Wheless is a VA Tennessee Valley Healthcare System staff physician and an assistant professor of dermatology at Vanderbilt University.

Veterans, as a group, carry a substantially elevated burden of keratinocyte carcinoma, with prior work suggesting roughly a 70% higher risk of skin cancers compared with non‑veterans, Dr. Wheless noted. Many have occupational or service-related histories that include prolonged sun exposure or other carcinogenic risk factors, translating into years of cumulative damage to sun‑exposed skin. Dr. Wheless added that veterans represent a particularly high‑risk cohort for chronic, recurrent dermatologic disease.

“This is an important study for veterans given the large number who work in jobs that have significant sun exposure or other risk factors for skin cancer,” Vanderbilt’s Associate Chief of Staff of Research and Development Dr. Stokes Peebles said. “There are very few interventions which can reduce the risk of recurrent cancer by such a large percentage.”

For practicing dermatologists and primary care physicians, the potential reduction in procedures and morbidity is considerable. “We have patients that can get over 100 skin cancers, and that’s a lot of individual cancers to be treating, a lot of surgeries, and a lot of time healing,” Dr. Wheless said. “If we can reduce the rate of skin cancers by 50 per cent, if a patient normally is getting, say 10 skin cancers per year… That’s five fewer surgeries and a major impact on that patient’s life.”

Dr. Wheless said future work will focus on embedding nicotinamide into more individualized prevention strategies, aligning use with patient-specific risk profiles and treatment histories. “We’re really hopeful that we can reduce the number of skin cancers that we see,” he added.