Can Vitamin B₃ Reduce Recurrence of NMSC?

Amid the usual pre-summer media coverage for skin cancer prevention, a new study highlighting a potential new tool in the fight against skin cancer found its way into headlines for several popular media outlets. Presented at the American Society of Clinical Oncology Meeting in Chicago several weeks ago, the study suggests that a vitamin B₃ nutritional supplement may reduce the occurrence of skin cancers such as basal cell carcinoma and squamous cell carcinoma.

Australian researchers conducted a 12-month study in which 386 people who previously have been diagnosed with non-melanoma skin cancers (NMSC) received either nicotinamide (vitamin B₃) 500mg twice daily or placebo. Patients on placebo had 2.42 non-melanoma skin cancers, as compared to 1.77 for those in the nicotinamide group, a 23 percent difference.

Nicotinamide is available as an over-the-counter agent and is widely known as both an inexpensive and safe supplement. In an interview with The Washington Post, lead researcher Diona Damien noted that the vitamin intensifies skin repair by delivering a boost of energy to the skin.1 Another interesting finding the author pointed out was that when patients stopped taking the vitamin, the benefit was lost.

Patients treated with nicotinamide did not experience headaches, flushing, or low blood pressure, all of which have been associated with niacin, another form of B₃.

Discussion

While the implications of these findings may be significant, more research will be needed to confirm the potential of nicotinamide as a viable agent for skin cancer prevention. One important limitation of the study is that it only evaluated patients who have already been diagnosed with SCCs or BCCs. The study does not address whether nicotinamide offers similar potential benefits in individuals who have not had skin cancer. In general, however, the connection between vitamins and skin health, while intriguing, requires deeper inquiry before the findings of this study can definitively be confirmed.

Vitamin supplements have long been a popular subject in news media, but their medical value has not been confirmed. Some individuals believe that vitamins can help prevent or ward off a host of diseases, including cancer. Yet, very little scientific data support the use of vitamins. They don’t appear to be unsafe, and while they have been linked to some health benefits, these benefits cannot be isolated to the effect of vitamins.

The nicotinamide study, therefore, is significant for being one of the few articles suggesting some improvement. However, placed within context, we must approach these findings with caution until more work is done to verify the potential. Given the cost-effectiveness and safety of nicatinamide, it may be appropriate to recommend to certain high-risk individuals (those with family history, occupational sun exposure, etc.), provided that they are within the recommended daily doses.

The recent findings are compelling enough to explore further, and hopefully future studies will address the potential of vitamin B₃ in skin health and skin cancer prevention. In the meantime, for high-risk patients it is worth considering recommending the addition of nicotinamide to a broader sun protection regimen consisting of sun avoidance with the use of sunscreen and sun protective apparel.

Jonathan Wolfe, MD is an Associate Professor of Dermatology at the University of Pennsylvania and Division Director of Dermatology, Einstein Medical Center Montgomery.

1. Bernstein, L. “Common Vitamin Reduces Recurrence of Some Skin Cancers.” The Washington Post. May 13, 2015. http://www.washingtonpost.com/news/to-your-health/wp/2015/05/13/common-vitamin-helps-reduce-recurrence-of-some-skin-cancers/