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Niacinamide (nicotinamide)

Vitamin B3 derivative with RCT support for non-melanoma skin cancer prevention (ONTRAC trial) and dermatological use in acne and rosacea.

Why

Niacinamide (nicotinamide) is the amide form of vitamin B3, without the flushing effect of niacin (nicotinic acid). The ONTRAC trial (Chen NEJM 2015, n=386) reported a 23% reduction in new non-melanoma skin cancers in high-risk patients on 500 mg twice daily over 12 months, one of the highest-quality results for any supplement in oncology prevention. Separate dermatology RCTs support topical niacinamide for acne, rosacea, and skin barrier improvement.

How it works

Precursor to NAD+ and NADP+, substrates for poly-ADP-ribose polymerase (PARP)-mediated DNA repair. Restores cellular ATP in UV-stressed keratinocytes. Topically reduces sebum production, calms inflammatory acne, and supports skin barrier (filaggrin and ceramide synthesis).

Expected onset · Skin-cancer prevention assessed over 12 months; topical acne effects over 4–8 weeks

How to take

Dosage

Skin-cancer prevention: 500 mg twice daily (ONTRAC dose). Topical acne/rosacea: 4% niacinamide cream or serum once or twice daily. Dietary: 14–16 mg/day (RDI).

Timing

Oral: with meals, divided. Topical: morning and/or evening on clean skin.

On the label

'Niacinamide' or 'nicotinamide' (not nicotinic acid / niacin). Topical: 4–5% concentration is the studied range for skin claims.

Ideal for

Adults with previous non-melanoma skin cancers or actinic keratoses (under dermatology guidance); people with mild-moderate inflammatory acne or rosacea; dietary supplementation alternative to flushing niacin.

Safety

Doses above 3 g/day can cause hepatotoxicity. Mild GI upset at higher doses. No flushing (distinguishes from nicotinic-acid niacin). Topical: occasional skin irritation in sensitive individuals. Pregnancy: dietary doses fine; pharmacological dose data limited.

Evidence

At a glance

Chen 2015 NEJM ONTRAC RCT (n=386 high-risk patients with ≥2 non-melanoma skin cancers): niacinamide 500 mg twice daily reduced new NMSC by 23% at 12 months, one of the strongest oncology-prevention signals for any supplement, in NEJM. Topical evidence for acne and rosacea is consistent across smaller RCTs.

Where to get it

Shop Niacinamide (nicotinamide) on Amazon

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