A simple vitamin cuts skin cancer recurrence risk by more than half, massive study confirms

• A simple vitamin B3 supplement significantly reduces recurring non-melanoma skin cancer risk.
• A massive study of nearly 34,000 patients provides the strongest real-world evidence for this effect.
• Taking nicotinamide after a first skin cancer diagnosis cuts the risk of a subsequent one by over half.
• The vitamin works by aiding cellular DNA repair from sun damage.
• It is a well-tolerated, over-the-counter strategy that complements sunscreen and skin checks.

For millions of Americans living with the fear of skin cancer returning, a powerful new defense is not a high-tech drug but a simple, affordable vitamin sitting on pharmacy shelves. A landmark study of nearly 34,000 patients has delivered robust, real-world confirmation that a specific form of vitamin B3 dramatically reduces the risk of common skin cancers coming back, offering a safe and accessible strategy to avoid the stress and scalpels of repeated surgeries.

This massive research, published in JAMA Dermatology and led by Dr. Lee Wheless of Vanderbilt University Medical Center and the VA Tennessee Valley Healthcare System, provides the strongest evidence to date for a practice many dermatologists have recommended for a decade. By analyzing decades of records from the Veterans Affairs health system, scientists tracked patients prescribed 500 milligrams of nicotinamide twice daily.

The results are clear and compelling. Overall, patients taking the supplement saw a 14 percent reduction in the risk of a new basal cell or squamous cell carcinoma. The most striking finding, however, was the timing. For patients who began taking nicotinamide after their very first skin cancer diagnosis, the risk of developing a subsequent cancer plummeted by an extraordinary 54 percent.

A natural defense against sun damage

So how does a simple vitamin achieve this? Researchers explain that nicotinamide works at a cellular level to help repair the DNA damage caused by ultraviolet radiation from the sun. “Our skin is constantly exposed to UV radiation, so our DNA repair machinery is working hard to keep up,” Wheless says. “Over time, small amounts of DNA mutations build up and can lead to skin cancer. By improving DNA repair, those mutations don’t accumulate as rapidly.”

This mechanism explains why starting the supplement early is so crucial. Patients with fewer prior skin cancers have less accumulated DNA damage, allowing the vitamin to effectively slow the progression toward new cancers. For those with many prior cancers, the background damage is already significant, making prevention more difficult.

Shifting medical practice earlier

The study’s scale and findings are poised to change standard patient care. “There are no guidelines for when to start treatment with nicotinamide for skin cancer prevention in the general population,” Wheless notes. “These results would really shift our practice from starting it once patients have developed numerous skin cancers to starting it earlier.”

Dermatologists not involved in the study agree. Dr. Anthony Rossi of Memorial Sloan Kettering Cancer Center calls the research “another high-level piece of evidence to show that nicotinamide does actually help reduce the risk of skin cancer.” He and others already recommend it to patients.

The appeal of nicotinamide extends beyond its efficacy. Unlike some pharmaceutical prevention options that require painful applications or carry risks of serious side effects requiring lab monitoring, nicotinamide is well-tolerated, inexpensive, and available over the counter. It represents a low-risk, high-reward addition to a patient’s defense plan.

Experts are quick to clarify that this is a supplemental strategy, not a replacement for proven protections. “It won’t replace sunscreen, hats, or skin checks, but it’s a smart supplement in the right context,” says dermatologist Dr. Brian Zelickson. “For high-risk patients, especially after a first skin cancer, B3 can make a meaningful difference.”

The study has limitations, including a focus on a VA population that was mostly white and male. Wheless acknowledges this, stating, “I would love to see this replicated in a broader population to confirm.” As an observational study, it also cannot account for every variable, prompting plans for a prospective clinical trial.

For anyone who has endured the biopsies and surgeries that come with skin cancer, the news offers a tangible sense of control. It turns a common vitamin into a legitimate shield, a daily pill that actively helps repair the past’s sun damage. In a world of complex and costly medical interventions, it is a refreshing reminder that powerful solutions can be simple, natural, and within reach.

Sources for this article include:

EverydayHealth.com

USNews.com

News.VUMC.org