Thought Archive

A Vitamin Pill Against Skin Cancer?

18 Sept 2025

A Vitamin Pill Against Skin Cancer?

Hook

Can a cheap vitamin pill really cut your risk of skin cancer?

Context

A new study in JAMA Dermatology looked at more than 33,000 veterans who took nicotinamide (a form of vitamin B3) and found something striking:

  • Overall skin cancer risk dropped by about 14%.
  • When started after a first skin cancer, risk dropped as much as 54%.
  • The biggest effect was on squamous cell carcinoma (SCC).
  • In transplant patients (who are at very high risk), the benefit was smaller, but still noticeable if treatment began early.

This is the largest population-scale look yet at nicotinamide and skin cancer prevention.

Your Take

The idea of a vitamin pill cutting cancer risk is both exciting and unsettling. Exciting, because prevention has always been the weak link in dermatology. Unsettling, because supplements are a notoriously messy space — full of hype, poor evidence, and wishful thinking.

But here’s the difference:

  • This isn’t a fringe study — it’s a massive VA cohort with real outcomes.
  • The effect isn’t magic — it’s significant, but not absolute.
  • And most importantly, it doesn’t replace sunscreen, shade, or regular skin checks.

Implications

If these findings hold, nicotinamide could become a low-cost, low-toxicity prevention tool — especially for people with a history of skin cancer. Dermatologists may start discussing it alongside SPF and annual skin checks.

But there are caveats:

  • The benefit is strongest if started early, after a first cancer.
  • Evidence in transplant patients is less convincing.
  • It’s still an observational study, not a randomized trial at this scale.

FAQ

Q: Should I start taking nicotinamide?
A: Not without talking to your doctor. It’s safe for most, but not a replacement for sunscreen or regular care.

Q: How much was used in the study?
A: 500 mg twice daily, for more than 30 days.

Q: Is this the same as niacin?
A: No. Niacin (another form of B3) has more side effects like flushing. Nicotinamide is the safer form used here.

Further Reading

Closing

A vitamin pill alone won’t save your skin — but paired with sunscreen and awareness, nicotinamide may become part of the prevention toolkit.