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Oral nicotinamide for non-melanoma skin cancers: A review
Samantha Vicki Hunt1, Aaron Jamison2, Raman Malhotra2
1Corneoplastic unit, Queen Victoria Hospital, East Grinstead, England. samanthahunt2@nhs.net.
Abstract:
There has been much interest in the role of oral nicotinamide supplementation in reducing the incidence of non-melanoma skin cancers. This article reviews the hypothesised mechanisms of action of nicotinamide, and the available literature outlining its role for this purpose. There have been five randomised controlled trials (RCT), one histopathological study and two case series exploring the effect of oral nicotinamide supplementation on UV-induced immunosuppression of the skin, and incidence of actinic keratoses and non-melanoma skin cancers (NMSC). The largest RCT received criticism of the statistical analyses used, but the critics still acknowledged a likely benefit of treatment with oral nicotinamide in reducing the incidence of NMSC. Nicotinamide has a favourable safety profile. Current evidence is not definitive that oral nicotinamide supplementation reduces the incidence of NMSC, but it constitutes a low-risk management option that may be particularly relevant for high-risk individuals, and should be discussed as an option for these patients.
Insights
Oral nicotinamide may help reduce non-melanoma skin cancers. While not definitive, this vitamin B3 supplement is a low-risk option for those at high risk, warranting discussion with patients.
Area of Science:
- Dermatology
- Nutritional Science
- Oncology
Background:
- Non-melanoma skin cancers (NMSC) represent a significant public health concern.
- UV radiation is a primary risk factor for NMSC, inducing immunosuppression.
- Nicotinamide, a form of vitamin B3, has garnered interest for its potential chemopreventive properties.
Purpose of the Study:
- To review the hypothesized mechanisms of action for nicotinamide in skin cancer prevention.
- To evaluate the available literature on oral nicotinamide supplementation for reducing NMSC incidence.
Main Methods:
- Systematic review of randomized controlled trials (RCTs), histopathological studies, and case series.
- Analysis of studies investigating nicotinamide's effect on UV-induced immunosuppression, actinic keratoses, and NMSC incidence.
Main Results:
- Five RCTs, one histopathological study, and two case series were reviewed.
- The largest RCT, despite statistical criticisms, suggested a potential benefit of nicotinamide in NMSC reduction.
- Nicotinamide demonstrates a favorable safety profile.
Conclusions:
- Current evidence is not definitive for oral nicotinamide preventing NMSC.
- Nicotinamide represents a low-risk management option for NMSC prevention.
- Consideration of oral nicotinamide is recommended for high-risk individuals and should be discussed with patients.
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