Skin cancer risk may be reduced by using vitamin B3 tablets: Australian study

An affordable, over-the-counter vitamin may be a simple but potent answer to lower the risk of common skin cancers, according to a new University of Sydney research.

The study, published in the New England Journal of Medicine, found that a year of treatment with nicotinamide, a form of vitamin B3, significantly reduced the risk of non-melanoma skin cancer in high-risk patients.

“This is the first clear evidence that we can reduce skin cancers using a simple vitamin, together with sensible sun protection. We hope that these findings can be immediately translated into clinical practice. However, people at high risk of skin cancer still need to practice sun safe behaviour, use sunscreens and have regular check-ups with their doctor,” says the study’s senior author, Dr. Diona Damian, a professor of dermatology at the University of Sydney and Royal Prince Alfred Hospital.

Skin cancer, the most common form of cancer in fair-skinned populations worldwide, is primarily caused by sun exposure. Despite intensive sun protection campaigns, the incidence of skin cancer continues to increase worldwide. In Australia, this condition affects more than half of the population, and is reported to be four times as common as all other cancers combined. Skin cancer costs Australia more than $500 million annually.

For the study, the researchers involved 386 individuals who had at least two non-melanoma skin cancers in the last five years, making them at high risk for additional skin cancers. The participants were randomly assigned to take nicotinamide or placebo twice a day for 12 months.

After the trial, the research team found that the rate of new non-melanoma skin cancer was 23 percent lower in the nicotinamide group compared to the placebo group. The average number of pre-cancerous sun spots or actinic keratoses in the nicotinamide group was also noted to be consistently lower during treatment, ranging from an 11 per cent reduction at three months, to 20 percent at nine months.

Nicotinamide was also found to have comparable efficacy in preventing the most common types of non-melanoma skin cancer, which are basal cell carcinoma and squamous cell carcinoma.

According to the researchers, the new study supports a decade of evidence from preclinical and early clinical studies that shows nicotinamide enhances the repair of DNA in skin cells damaged by sunlight. Nicotinamide is also reported to protect the skin’s immune system from UV radiation by providing skin cells an extra energy boost when they are in repair-mode after sun exposure.

Damian and the team note that the study was not designed to test whether nicotinamide would benefit people in the general population who have not had skin cancer, or whether it could be effective in reducing melanoma. While the researchers hope to investigate further in the future, there is currently no evidence that nicotinamide should be used in these settings.

In the new study, the researchers found that nicotinamide was very well tolerated by the participants, with no difference in adverse events, blood results or blood pressure. The team notes that nicotinamide is a different form of vitamin B3 to nicotinic acid, or commonly known as niacin.

As a treatment, taking niacin can reportedly improve cholesterol levels and lower cardiovascular risks. Several studies have shown that it can boost levels of good cholesterol while modestly lowering bad cholesterol. However, niacin commonly causes headaches, flushing and low blood pressure, which are side effects that are not associated with nicotinamide.

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