I can’t take vitamin B3. How else can I reduce my risk?

If you can’t take nicotinamide due to side effects or potential medical risks, alternatives include topical therapies, fractional laser treatment and some medications.

Recent findings about vitamin B3 suggest that some of its metabolites might increase the risk of heart attack and stroke. The risk to healthy people wanting to reduce their skin cancer risk with vitamin B3 is uncertain, but in many cases, skin cancer doctors have advised patients to stop taking vitamin B3 until more information is available.

Fortunately, there are other ways to reduce the risk of solar keratoses, basal cell carcinoma and squamous cell carcinoma. These methods have different degrees of efficacy against various conditions, and there is a wide range of potential side effects and costs. These should be discussed with a skin cancer doctor, considering the patient’s medical history, risk factors, treatment preferences and budget.

Sunscreen

Sunscreen remains the single most effective way to reduce the risk of skin cancers.

Daily sunscreen use reduces the risk of squamous cell carcinoma by 60% and melanoma by almost 50%.

The protective benefits of sunscreen are still seen even when there is a history of skin cancer and significant sun damage. It’s the easiest, cheapest and most effective way to prevent skin cancer.

Medical treatments

Some of the treatments used to manage sun-damaged skin and aesthetic concerns have been shown to reduce the risk of future skin cancers in the treated area.

• After a single short course of topical treatment with fluorouracil/calcipotriol, the risk of squamous cell carcinoma in the treated area is reduced by about 75% for up to three years.
• In clinical trials, fractional laser treatments have been shown to reduce the risk by 50% (gentle treatment on the face) and up to 90% (aggressive treatment on the arms).
• The diabetes medication metformin has been shown to reduce the risk of basal cell carcinoma by 30%.

These are specialised treatments, and due to the risk of side effects, they should be discussed with an experienced skin cancer doctor.

Over-the-counter medication and supplements

Low-dose aspirin taken daily has been shown to reduce the incidence of squamous cell carcinoma by about 10%.

Trials have shown that fish oil, oral vitamin C, and astaxanthin have a protective effect against skin cancers, but other trials have shown no benefit, so no clear recommendation can be given.

More information

For more detailed information and references, see how to reduce your risk of skin cancer.