Nicotinamide: An Update and Review of Safety & Differences From Niacin

Reed Huber, BSc; Aaron Wong, MD, FRCPC


Skin Therapy Letter. 2020;25(5):7-11. 

In This Article

Real World Experience

Despite nicotinamide's potential benefit to a large cohort of patients as a safe and inexpensive over-the-counter vitamin supplement for NMSC prevention, its translation into clinic practice has been hindered, mainly due to difficulties of finding it in stores, confusion over labeling, and relation to niacin. Notably, both products may be labeled vitamin B3, with niacin being the acid form and nicotinamide the amide form. Also, the labeling of North American products is predominantly niacinamide rather than nicotinamide, but both are the same thing.

In our own experience, drug store chains and other retailers are more likely to sell niacin and vitamin B-50 and B-100 complexes, the latter two only contain 50 mg and 100 mg of nicotinamide (or niacinamide), respectively. However, most large naturel health product stores we've encountered sell nicotinamide/niacinamide 500 mg products in the vitamin aisle along with other B vitamins. In addition, nicotinamide/niacinamide is easily accessible online (Table 2) and from specialty vitamin stores. The authors have had some success writing this as a prescription and having the pharmacist order in or locate the niacinamide/nicotinamide for patients (Figures 3 and 4).

Figure 3.

Sample prescribing sheet for practitioners for actinic keratosis and nonmelanoma-skin cancer.

Figure 4.

Sample prescribing sheet for practitioners for bullous pemphigoid.