Niacinamide and Skin Cancer
May 27, 2015
Oral niacinamide reduces incidence of common skin cancers in people prone to it.
About three years ago a report came to our attention that oral niacinamide reduced the size of actinic keratosis patches over a four-month period.
A second and even more promising study came out two weeks ago. In this new clinical trial participants who took niacinamide, a form of vitamin B-3, had a 23% lower risk of developing non-melanoma skin cancer than those who took placebo pills.
Diona Damian the lead investigator of the study is about to present her research at the annual meeting of the American Society of Clinical Oncology this coming weekend in Chicago.
The skin cancer prevention study focused on non-melanoma skin cancer, particularly basal cell carcinomas and squamous cell carcinomas. Together, these are the most common form of cancer in the United States, with the most recent study estimating that in 2006 there were 3.5 million cases in 2.2 million Americans. Most of these are curable through surgery or other techniques, though the surgery can leave scars and in some cases the cancers do become more serious.
The study involved 386 people in Australia who had had two or more such skin cancers in the prior five years. The average for the patients in the trial was eight cancers over the past five years; one patient had 52 cases.
Those who were randomly assigned to take the vitamin had an average of 1.77 new cancers in the year of the study compared with 2.42 cases for those in the placebo group, a risk reduction of 23%, after statistical adjustments. Those getting niacinamide also had fewer cases of actinic keratosis, thick patches of skin that may become cancerous.
Dr. Damian said the effect of the vitamin seemed to disappear once people stopped taking it. Two experts not involved in the study said the results were “interesting and potentially important,” in part because niacinamide had fewer side effects than the pharmaceutical alternatives for skin cancer prevention. 
Based on a 1995 paper, we have for what is now two decades, suggested topical niacinamide to treat facial acne.  There have been several clinical trials confirming this use. These include:
2013 “Topical 4% nicotinamide vs. 1% clindamycin in moderate inflammatory acne vulgaris” 
2012 “Inflammatory acne management with a novel prescription dietary supplement.” 
2011 “Topical clindamycin 1% vs. linoleic acid-rich phosphatidylcholine and nicotinamide 4% in the treatment of acne: a multicentre-randomized trial.” 
2006 “The effect of 2% niacinamide on facial sebum production.” 
Topical niacinamide has been suggested for other skin conditions including melasma, atopic dermatitis and rosacea. 
Niacinamide was also researched as a possible treatment for prevention of type-1 diabetes, what was once labeled juvenile diabetes.
The European Nicotinamide Diabetes Intervention Trial (ENDIT) was a prospective, placebo-controlled, double-blind trial that recruited first-degree relatives of individuals with type-1 diabetes. They had a 40% five-year risk of developing diabetes. 552 subjects were randomized to receive either niacinamide or placebo. After 4 years, 82 participants taking niacinamide and 77 taking placebo had developed diabetes. Obviously, the idea any idea that niacinamide would provide protection against diabetes was dropped for lack of significant benefit. 
8. European Nicotinamide Diabetes Intervention Trial (ENDIT) Group. European Nicotinamide Diabetes Intervention Trial (ENDIT): A randomized controlled trial of intervention before the onset of type 1 diabetes. Lancet. 2004;363:925–931.[PubMed] http://www.ncbi.nlm.nih.gov/pubmed/15043959