A new analysis of nearly 34,000 U.S. veterans suggests that taking nicotinamide, a widely available form of Vitamin B3, is linked to a meaningful reduction in non-melanoma skin cancers among people who have already had skin cancer. The biggest benefit was seen in those who started the supplement after their first cancer diagnosis. Participants who took 500 mg of nicotinamide twice daily for at least one month experienced about a 14% overall reduction in future skin cancers, with a striking 54% risk drop among those who began after their initial cancer. The cancers most affected were basal cell carcinoma and squamous cell carcinoma, the two most common non-melanoma forms. Importantly, the study did not assess melanoma.
Long before this large Veterans Affairs analysis, doctors had already begun recommending nicotinamide to patients with a history of skin cancer. A landmark Australian trial in 2015 showed a lowered risk of new skin cancers in high-risk individuals who took the vitamin B3 derivative regularly. Since then, many dermatologists have incorporated nicotinamide into secondary prevention strategies, noting its relative safety and over-the-counter availability. In the current study, researchers stressed that earlier initiation appears more protective, a point echoed by clinicians who say starting the supplement soon after a skin cancer diagnosis may yield stronger protection than waiting for a second or subsequent event.
For Thai readers, the news lands in a context familiar to many families and health professionals. Thailand sits in a sunny tropical belt, with outdoor work, sports, and temple fairs offering abundant sun exposure. Skin cancer, while less common than in heavily sun-drenched regions, remains a significant health issue, particularly among outdoor workers and aging populations who have cumulative sun damage. Public health campaigns in Thailand have long emphasized sun safety—slip, slop, slap, and shade—alongside regular skin checks. The new findings on nicotinamide add another layer to the conversation about practical, accessible prevention options that could reduce personal and national healthcare costs associated with skin cancers.
Equally important is what this study does not say. It does not address whether nicotinamide reduces the risk of melanoma, a more aggressive form of skin cancer. Nor does it establish benefits for people who have never had skin cancer. Its promise lies primarily with prevention of new non-melanoma cancers in people with a prior history of the disease. In interviews with experts, many stressed the need for Thai researchers to examine whether similar benefits occur in Thai populations, taking into account genetic factors, sun behavior, and local healthcare practices.
From a clinical perspective, the reported numbers are both encouraging and cautious. The magnitude of risk reduction varies by the timing of supplementation and cancer type. The most dramatic effect appeared in squamous cell cancers among those who started nicotinamide after their first diagnosis. The overall 14% reduction, while modest at first glance, translates into meaningful gains when applied to tens of thousands of patients over a lifetime, especially given the high cost of treating skin cancers in high-income health systems and the growing burden of cancer care in lower-resourced settings.
To translate these findings into practice in Thailand, dermatologists and primary care doctors might consider several steps. First, patient selection remains key. Nicotinamide should be discussed with a clinician, particularly for patients with a history of non-melanoma skin cancer, to weigh benefits against any potential risks and to ensure the licensing form is the “amide” version of Vitamin B3, not the other form that lacks the same protective effect. Second, public health messaging should maintain the emphasis on sun protection—sunscreen, protective clothing, and regular skin examinations—while offering nicotinamide as a supplementary strategy for eligible patients. Third, education campaigns could equip Thai healthcare workers with the latest evidence, helping them guide conversations in a culturally sensitive way that respects family decision-making patterns and Buddhist values around prevention and care. Finally, Thai researchers could pilot local studies to validate whether the same reductions are observed among Thai patients, adjusting for climate, lifestyle, and healthcare access.
Thailand’s family-centered culture often means that decisions around preventive health are made together with elders and medical advisors. This dynamic can be an opportunity: if trusted dermatologists and primary care providers frame nicotinamide as a secondary-prevention tool with clear dosing guidance and safety information, many Thai patients and families may adopt it as part of a broader sun-safety routine. The fiscal angle is worth noting too. Non-melanoma skin cancers incur substantial treatment costs, even when detected early. If further research confirms these protective effects in diverse populations, nicotinamide could become a cost-effective addition to public health programs, especially in regions where outdoor livelihoods are common and sunscreen access is variable.
Culturally, this topic intersects with Thailand’s long-standing respect for medical guidance and authority. It also connects with values around collective well-being and careful stewardship of health resources. The vitamin’s over-the-counter availability makes it accessible, but experts caution against self-prescribing without professional advice. Thai readers should engage with dermatology clinics or family physicians to discuss personal risk, the appropriate dosage (500 mg twice daily, for at least a month, as studied in the large trial), and how nicotinamide might fit with ongoing sun protection and cancer surveillance practices.
Looking ahead, the most immediate next steps include confirming results in diverse populations, clarifying effects for individuals without prior skin cancer history, and better understanding any long-term safety signals with prolonged use. If Thailand follows global progress, the government and medical societies may consider updating guidelines to include nicotinamide as a recommended adjunct for selected patients, not as a substitute for sun safety or routine skin checks. The science also invites a broader cultural conversation about prevention: how communities, families, and healthcare systems can integrate simple, accessible interventions into daily life without losing sight of traditional practices and local needs.
In sum, the latest large-scale study adds an important piece to the evolving puzzle of skin cancer prevention. Vitamin B3 in the form of nicotinamide shows potential to reduce non-melanoma skin cancers among people who have already had the disease, especially when started early after the first cancer diagnosis. For Thai readers, the takeaway is not to abandon sun protection or medical surveillance but to consider this supplement as a potential companion tool—decided in partnership with a healthcare professional and tailored to personal risk, lifestyle, and local realities. As always, prevention in health care is a mosaic: universal sun safety, regular skin checks, informed medical guidance, and now, potentially, Nicotinamide as part of a broader strategy to keep skin cancer at bay.