Nicotinamide, also known as niacinamide, is a form of vitamin B3, that can help reduce the development of actinic keratoses and some skin cancers. Actinic keratoses are precancers that are common on sun-exposed areas in many adults. Some of these lesions will progress to become mature skin cancers that can cause local destruction of tissue and spread elsewhere in the body.
Safe Supplement to Repair Sun Damaged Skin
Treatments for actinic keratoses include freezing the areas with liquid nitrogen, applying creams, and using special types of light therapy. However, these therapies have side effects and do not always completely clear actinic keratoses, or prevent them from recurring. Even regular use of sunscreens and sun protective clothing do not guarantee you will never have actinic keratoses or skin cancer. Fortunately, there is a safe, inexpensive supplement you can take to promote the repair of sun damaged skin: nicotinamide.
Nicotinamide has been shown to help protect the skin against the damaging effects of ultraviolet radiation from the sun. Ultraviolet radiation causes damage to the DNA (genetic material) in the cells of the skin. This damage must be repaired or mutations in the DNA can lead to the development of precancers (actinic keratoses) and skin cancers. It improves DNA repair in the skin. In order to repair DNA, cells use a lot of energy, and nicotinamide also helps restore this cellular energy. Ultraviolet radiation also suppresses the local immune system in the skin, and this helps promote the development of skin cancers. Nicotinamide decreases ultraviolet light-induced immune suppression.
Therefore, it’s not surprising that nicotinamide could be useful in the treatment of actinic keratoses and skin cancers. Surjana and other researchers showed that nicotinamide 500 mg twice-daily reduced the number of precancers in patients by 35% within four months. Chen and his colleagues did a study evaluating nicotinamide use in patients who had multiple non-melanoma skin cancers (basal cell carcinomas and squamous cell carcinomas) in the past and were therefore at a higher risk of developing more skin cancers. These patients also took nicotinamide 500 mg twice daily and after 12 months, they showed a 23% reduction in the development of new non-melanoma skin cancers. More studies are necessary to determine the ideal dose of nicotinamide and to determine if it reduces the development of another type of skin cancer known as melanoma.
Nicotinamide vs. Niacin
It is important to know the difference between nicotinamide, and another well-known form of vitamin B3 called niacin or nicotinic acid. Both nicotinamide and niacin have similar actions as vitamins, but niacin (nicotinic acid) is frequently prescribed to help lower blood fats and sometimes has side effects like flushing, headaches, lowered blood pressure, and itching. If you take vitamin B3 to help your skin, then it is essential that you take the nicotinamide (niacinamide) form to help avoid these side effects. At the recommended doses, nicotinamide is a safe supplement that rarely causes gastrointestinal symptoms like nausea and diarrhea. Patients who have decreased kidney function or have had a kidney transplant may have an increased risk for side effects from nicotinamide and speak with their kidney doctors before taking this supplement. Finally, watch out for drug interactions that can occur between nicotinamide and some medications, like carbamazepine, an anti-seizure medication. Be sure to ask your dermatologist if nicotinamide has any drug interactions with the medications you are taking and if he or she feels nicotinamide is right for you.
Surjana D, Halliday GM, Martin AJ et al. Oral nicotinamide reduces actinic keratoses in phase II double-blinded randomized controlled trials. J. Invest. Dermatol. 2012; 132: 1497–500.
Chen AC, Damian DL. Nicotinamide and the Skin. 2014 Australas J Dermatol. 2014 Aug;55(3):169-75.
Chen AC, Martin AJ, Choy B, Fernández-Peñas P, Dalziell RA, McKenzie CA, Scolyer RA, Dhillon HM, Vardy JL, Kricker A, St George G, Chinniah N, Halliday GM, Damian DL. A Phase 3 Randomized Trial of Nicotinamide for Skin-Cancer Chemoprevention. N Engl J Med. 2015 Oct 22;373(17):1618-26.
Chen AC, Martin AJ, Damian DL.Nicotinamide for Skin-Cancer Chemoprevention. N Engl J Med. 2016 Feb 25;374(8):790.