In the video above, online, Dr. Dermatologist Dr. Andrea Suarez, known as Dray, shares some interesting insights about niacinamide, a water-soluble vitamin B3 (niacin), and its benefits for skin health.1
Niacinamide, also known as nicotinamide, is a precursor to NAD+, which is not only involved in converting food into energy, but is also important in the process of repairing damaged DNA. This is important because the skin faces constant environmental stressors, including ultraviolet (UV) radiation, which can damage the DNA of skin cells and suppress the immune system.
Niacinamide shows promise in preventing skin cancer due to its ability to enhance DNA repair and reduce UV-induced immunosuppression in skin cells. These mechanisms are useful in preventing the development of non-melanoma skin cancers (NMSCs), including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).
Niacinamide’s promise to prevent skin cancer
Clinical trials have shown that taking 500 mg of niacinamide twice daily significantly reduces the incidence of NMSC in high-risk groups.2 This news is especially encouraging for people with a history of skin cancer. However, many studies on skin cancer prevention use the 500mg dose, but caution is advised.
Niacinamide 50 mg three times daily is a better dosage and will provide fuel for NAD+, the rate-limiting enzyme, NAMPT. The lowest dose available in most supplements is 500 mg, and it is recommended to take niacinamide in powdered form because it reduces NAD+ due to negative feedback on NAMPT. This is the opposite of what you want.
Other studies have specifically shown a beneficial role for niacinamide intake in reducing the risk of SCC. In one large study involving the Nurses’ Health Study and the Health Professionals Follow-up Study, researchers found that total niacin intake was inversely associated with SCC risk. The pooled risk ratio was 0.84, meaning that people with higher niacin intake had a 16% lower risk of SCC.3
Niacinamide: Your Skin’s New Best Friend
A study conducted in Australia and published in The New England Journal of Medicine found that this simple supplement significantly reduced the risk of developing non-melanoma skin cancer.4 This study of 386 high-risk patients found that taking niacinamide 500 mg twice daily for 12 months reduced the risk of developing new non-melanoma skin cancers by 23 percent compared to patients taking a placebo.
This effect was seen in both basal cell carcinoma and squamous cell carcinoma, the two most common types of skin cancer. Again, the benefits of niacinamide were most pronounced in patients with a history of numerous skin cancers, suggesting that it may be particularly helpful for those at high risk. The best part? Niacinamide is inexpensive and readily available as an over-the-counter supplement, and has minimal side effects.
In addition to reducing the risk of skin cancer, niacinamide has shown impressive results in reducing actinic keratosis (precancerous skin lesions that can develop into squamous cell carcinoma). Participants taking niacinamide had an 11% reduction in actinic keratosis at 3 months and a 20% reduction at 9 months compared to the placebo group. This translates into an average reduction of 3 to 5 actinic keratoses.
The mechanism behind niacinamide’s protective effects lies in its ability to prevent adenosine triphosphate (ATP) depletion and enhance cellular energy to enhance DNA repair. Cells need ATP for life, repair, and regeneration. Niacinamide also reduces UV-induced immunosuppression without altering baseline immunity, providing a two-pronged approach to skin protection.
Many conventional chemopreventive agents, such as oral retinoids, cause serious side effects such as skin dryness, increased lipid levels, and even liver toxicity. However, niacinamide did not produce clinically significant side effects in studies. Studies have used doses of 500 mg twice daily, but the minimum effective dose for preventing skin cancer is not known.
Niacinamide reduces skin cancer in high-risk individuals
Niacinamide may be especially beneficial if you have had multiple skin cancers in the past. Systematic reviews and meta-analyses have shown that the skin cancer prevention effect of niacinamide tends to be increased in individuals with a high previous risk of skin cancer.5
Niacinamide was effective in reducing both BCC and SCC, with a 54% reduction in BCC and a 52% reduction in SCC compared to controls. Consistency is important to reap the full benefits of niacinamide for skin cancer prevention.
Again, studies showing significant reductions in skin cancer took 500 mg orally twice daily for at least 12 months. This therapy appears to be effective both in healthy people and in organ transplant recipients who are at high risk of developing skin cancer due to immunosuppression.
Niacinamide: Your Secret Weapon to Prevent Skin Cancer
Unlike sunscreens that block UV rays, niacinamide serves to repair DNA damage that has already occurred in skin cells. This means it can help reverse past sun damage and reduce your risk of developing skin cancer, especially BCC and SCC. As noted in the journal Cureus:6
“By providing a precursor molecule for the key building blocks that produce adenosine triphosphate (ATP), nicotinamide replenishes cellular energy after UV damage, enhancing DNA repair. Current research also suggests that nicotinamide acts as a blocker of inflammatory cell activation. and has been shown to affect cell lifespan and cancer progression.”
Niacinamide’s skin-protective benefits come from its ability to strengthen the body’s natural defense mechanisms. Taking niacinamide supplements provides your cells with the building blocks they need to produce ATP, the cell’s energy currency. This additional energy allows skin cells to more efficiently repair DNA damage after UV exposure.
But that’s not all. Niacinamide blocks inflammatory cell activation and affects cell lifespan and survival. This multifaceted approach makes it a powerful ally in any skin cancer prevention strategy. Simply adding it to your daily routine can provide significant benefits to your skin health.
This is especially important if you have a history of skin cancer, as studies show that many people with non-melanoma skin cancer have vitamin deficiencies.7 By addressing these deficiencies, you give your skin the tools it needs to protect itself.
Interestingly, a 2023 study found that patients who believed more strongly in niacinamide’s ability to reduce skin cancer risk were more likely to continue using it.8 On average, patients perceived that niacinamide could reduce their risk of basal cell carcinoma by 31.2% and their risk of squamous cell carcinoma by 30.2%.
In fact, people who took niacinamide had a significantly higher perception of its effectiveness and believed it could reduce their risk of BCC by 41.2% and SCC by 38.3%. “Our results should encourage providers to educate patients and their families about nicotinamide and its association with skin cancer prevention,” the researchers said.9
Taking too much niacinamide can have adverse effects
Keep in mind that the niacinamide doses used in studies vary widely and may be on the high side. Typically, I recommend taking small doses of niacinamide, 50 mg three times a day.
This dosage has been shown to increase NAD+ levels, which optimizes energy metabolism and is the foundation for optimal health. You can take it 4 times a day at intervals. Take it immediately after waking up and before going to bed, twice at equal intervals in between.
The problem is that taking too much vitamin B3, whether niacin or niacinamide, can be counterproductive and cause cardiovascular disease.10,11 And other side effects. Dray emphasized the importance of proper dosage and warned of the potential risks of excessive consumption.12
“If you take very large doses, it can cause dangerous side effects. If you take too much, you can get into the toxic range. If you take 3.5 grams a day, you’ll reach a toxic level that can cause liver damage.”
Other potential side effects of high doses include nausea, vomiting, headache, dizziness, and fatigue. There is also a risk of drug interactions, especially with carbamazepine. It is recommended that you take niacinamide in powder form so that you can control your dosage. If you buy niacinamide as a powder, it will cost about 25 cents per month. Typically, 1/64 teaspoon of niacinamide powder is approximately 50 mg.
Niacinamide: Versatile Skincare Ingredient and Overall Health Remedy
While the focus of much of the research is on oral supplements, Dray also notes the benefits of topical niacinamide in skincare products, saying, “It’s an anti-inflammatory and an antioxidant, so when applied topically, it’s actually very beneficial for a variety of skin issues.” said. “13 She explains that topically applied niacinamide is useful for:14
1. Acne Treatment — “4% niacinamide is as effective as 1% clindamycin for moderate acne.”
2. Reduce sebum — “The 2% niacinamide gel… reduces sebum production, reducing oiliness and shine.”
3. Anti-aging benefits — “Applications of 2% to 4% have been shown to help improve the appearance of fine lines and red spots. It may also help improve the appearance and fade of sunspots.”
4. Managing Rosacea — “Niacinamide may improve barrier function and improve symptoms of rosacea.”
However, Dray notes that some individuals may find topical niacinamide irritating, especially in high concentrations. In addition to benefiting your skin, oral niacinamide may also help with other aspects of your health, including:
- Brain health, including Alzheimer’s disease15
- chronic pain16
- reduce stress17
- Vision health, including glaucoma18
- Improving damage caused by linoleic acid (LA) intake
The last one is especially important. That’s because one of LA’s most toxic metabolic byproducts is 4HNE, a toxic aldehyde that appears to be a cause of heart failure.19 Fortunately, there is an enzyme system called aldehyde dehydrogenase that deactivates 4HNE.
The best way to increase the activity of this enzyme system is to ensure sufficient NAD+, and the most efficient way to optimize NAD+ levels is to take 50 mg of niacinamide three times a day.
Additionally, as niacinamide has emerged as a promising and versatile compound for skin health and cancer prevention, its ability to enhance DNA repair, reduce UV-induced immunosuppression, and reduce the incidence of non-melanoma skin cancer makes it a valuable tool in dermatological practice. It goes.
Clinical trials have shown significant benefits at higher doses, but excessive intake can lead to side effects, so it is important to approach supplementation cautiously. The recommended dosage of 50 mg three times daily in powder form strikes a balance between efficacy and safety.
In addition to skin health, niacinamide provides benefits for the entire body, highlighting its importance as a multifaceted supplement. As research continues to progress, niacinamide is emerging as a simple, cost-effective, and generally safe addition to a health regimen, especially for those concerned about their skin cancer risk and overall skin health.
