Study: Nicotinamide Linked with Reduced Skin Cancer Risk Following First Diagnosis

Key Takeaways

• Nicotinamide use was associated with a 14% overall reduction in skin cancer risk.

• Starting supplementation after the first skin cancer led to a 54% risk reduction.

• Solid organ transplant recipients did not see a significant overall benefit, although early use was linked with cSCC incidence.

A large Veterans Affairs (VA) cohort study has found that nicotinamide supplementation is associated with a reduced risk of subsequent skin cancers, particularly when initiated after a patient’s first diagnosis.

Researchers on the retrospective analysis examined EHRs from 33,822 patients treated between 1999 and 2024. Among them, 12,287 individuals who received nicotinamide, 500 mg twice daily for at least 30 days, were matched to 21,479 unexposed patients based on demographics, comorbidities, and prior skin cancer history. Patients had a mean age of 77 years (95% White).

Overall, nicotinamide use was associated with a 14% lower risk of developing additional skin cancers vs. controls. Initial benefit when supplementation began after the first skin cancer (which rose to 54%) declined if treatment was started after subsequent cancers. Reductions were reported for both basal cell carcinoma and cutaneous squamous cell carcinoma (cSCC). Among solid organ transplant recipients (3.9% of the cohort), no significant risk reduction was detected. Early use was associated with a lower incidence of cSCC.

“The results of this cohort study suggest that there is a decreased risk of skin cancer among patients treated with nicotinamide, with the greatest effect seen when initiated after the first skin cancer,” the authors concluded.

Source: Breglio KF, et al. JAMA Dermatol. 2025. doi:10.1001/jamadermatol.2025.3238