Actinic Keratosis improves with oral niacinamide

Jacob Schor ND, FABNO



Reference: Suriana D, et al. Oral nicotinamide reduces actinic keratoses in phase II double-blinded randomized controlled trials. J Invest Dermatol 2012;132:1497-1500.



Actinic Keratosis is the medical term for sundamaged skin.  People here in Colorado all recognize the term but for our long distance readers, these things are “ … a small, rough, raised area found on skin that has been in the sun for a long period of time.”  We pay attention to them because some may develop into a skin cancer. Actinic keratosis is caused by being in sunlight and you are more likely to develop this if you have fair skin, blue or green eyes, or blond or red hair, spend lots of time in the sun, have a history of severe sunburns early in life and are getting older  (which would include most of us).


This new study is interesting as it offers a possibly simple means to reduce these things.  Suriana and colleagues set up a randomized double-blind, placebo-controlled trial in which  76 healthy people (aged 48 to 90 years) with sun-damaged skin and at least 4 actinic keratosis on the face, scalp, or arms, too 500 mg of niacinamide once or twice a day or placebo for 4 months.


After only 4 months of taking niacinamide, the niacinamide reduced the number of actinic keratoses by one-third. This beneficial effect was statistically significant after only 2 months. Compared with placebo, niacinamide decreased the incidence of new skin cancers (basal cell or squamous cell carcinoma) by 76% (p = 0.01) and decreased the number of patients who developed at least 1 skin cancer by 86%. The higher dosage of niacinamide appeared to be slightly more effective than the lower dosage.


This is important news for those of us living in Colorado. Basal cell and squamous cell carcinomas are among the most common types of cancer.  Niacinamide has already been shown to be useful in mice preventing progression to skin cancer.   This study advances our understanding and strongly suggests niacinamide may play a similar role in people.


Oral niacinamide has long been used, both orally and topically, to treat teen age acne.  We avoid high doses of 3,000 mg/day or more as it occasionally raises liver enzymes, something we hope to avoid.  Doses though of 500 to 1,500 mg are generally well tolerated.  This study again, used doses of either 5,00 or 1,000 mg per day. 


[Thanks to Alan Gaby, MD and Emerson Ecologics for bringing this study to my attention]


A face that could stand a bit of niacinamide!