Quick Answer: Nicotinamide and niacinamide are the same molecule, the amide form of vitamin B3; the names are used interchangeably. The difference that matters is how it is used. In the ONTRAC trial, people with at least two prior nonmelanoma skin cancers who took oral nicotinamide 500 mg twice daily for 12 months had 23% fewer new nonmelanoma skin cancers than placebo, with no evidence of benefit after stopping. Topical niacinamide in serums is a cosmetic ingredient and has not been shown to provide that protection. Unlike niacin (nicotinic acid), nicotinamide does not cause flushing, according to the NIH Office of Dietary Supplements.
Nicotinamide vs Niacinamide at a Glance
| Feature | Nicotinamide | Niacinamide |
|---|---|---|
| What it is | Amide form of vitamin B3 | Same compound, alternate name |
| Where you see the name | Research papers, supplement labels | Skincare labels, some supplements |
| Studied oral dose for skin cancer | 500 mg twice daily (ONTRAC) | Same compound |
| Causes flushing? | No, per NIH ODS | No |
| Compared with niacin (nicotinic acid) | Different form; niacin can cause flushing | Same as nicotinamide |
| Topical use | Not the form studied in ONTRAC | Common cosmetic ingredient |
Doses above are from the current U.S. Drug Facts or prescribing labels listed in Sources. Always follow the label on the package you buy, because store brands and formulations differ.
Same Compound, Two Names
Vitamin B3 comes in several forms. Niacin usually refers to nicotinic acid, while nicotinamide (also called niacinamide) is its amide. Both are almost completely absorbed, according to the NIH Office of Dietary Supplements (ODS). Supplement makers and researchers tend to say nicotinamide, while skincare brands usually say niacinamide, but the chemical in the bottle is the same. Related compounds such as nicotinamide riboside and nicotinamide mononucleotide (NMN) are different molecules.
The Skin Cancer Evidence
The ONTRAC phase 3 trial (Chen and colleagues, New England Journal of Medicine 2015) randomized 386 people in Australia who had had at least two nonmelanoma skin cancers in the previous 5 years to nicotinamide 500 mg twice daily or placebo for 12 months. New nonmelanoma skin cancers were 23% lower with nicotinamide. Rates of new squamous cell carcinomas were 30% lower and basal cell carcinomas 20% lower, though the basal cell difference was not statistically significant. Actinic keratoses, a precancerous lesion, were 11% to 20% lower at each 3-month check. Adverse events were similar between groups, and there was no evidence of benefit after nicotinamide was stopped.
These results apply to people at high risk who had already had skin cancers. The trial did not test people without prior skin cancer, and it did not test topical niacinamide. Oral nicotinamide does not replace sunscreen, protective clothing or skin checks.
Nicotinamide vs Niacin
ODS explains that nicotinic acid in supplemental doses can cause skin flushing, which is why some niacin products are sustained-release, while nicotinamide does not cause flushing because of its slightly different structure. The Food and Nutrition Board’s upper limits for supplemental niacin are based on flushing, and ODS notes that excess nicotinamide does not cause flushing. ODS also reports that the most common adverse effects of 500 to 1,500 mg per day of nicotinamide for several months were diarrhea and low platelet count. If you are buying for the ONTRAC use, make sure the label says nicotinamide or niacinamide, not niacin.
What Supplement Labels Show
Many nicotinamide supplements in the NIH Dietary Supplement Label Database contain 500 mg per capsule. Some combine nicotinamide with other ingredients. For example, one NusaPure label lists nicotinamide 500 mg plus Polygonum cuspidatum extract 100 mg, directs one capsule daily, and cautions against use in pregnancy, liver problems, stomach ulcers or diabetes unless recommended by a practitioner. That directed amount is half the ONTRAC daily dose, so check labels carefully and discuss dosing with your dermatologist.
Putting It Together: Common Situations
The scenarios below summarize what the labels and guidelines cited on this page say. They are general information, not a personal treatment plan. Your pharmacist can check the choice against your other medicines, and your clinician can tailor it to your health history.
- History of two or more nonmelanoma skin cancers: ask your dermatologist about the ONTRAC regimen of 500 mg twice daily.
- Want a skincare ingredient for tone or texture: topical niacinamide is a cosmetic ingredient, not the oral regimen studied for skin cancer.
- Buying a B3 supplement: check that it says nicotinamide or niacinamide, not niacin, if you want to avoid flushing.
How to Read the Label Before You Buy
- Find the active ingredient first. Brand names are often reused across products with different ingredients. The active ingredient and its strength appear at the top of the Drug Facts or Supplement Facts panel.
- Check the “Uses” or labeled indication. A product is tested and labeled for specific uses. Using it for something else may not help.
- Read the “Do not use” and “Ask a doctor before use” sections. They list conditions and medicines where the product may be unsafe.
- Follow the directions for dose and duration. Note the maximum daily amount and how many days you can use it before checking with a clinician.
- Check for duplicate ingredients. Combination products can contain the same ingredient as something else you take, which raises the risk of taking too much.
- Note the “Stop use and ask a doctor” signs. These are the label’s own warning signs that a product is not working or is causing harm.
Common Mistakes to Avoid
- Taking niacin instead of nicotinamide because the names look similar.
- Stopping sun protection because you take a supplement.
- Assuming two products with similar names are interchangeable. Compare the active ingredients and strengths instead of the packaging.
- Forgetting to tell your clinician. Keep a current list of every prescription, OTC medicine and supplement you take, and bring it to appointments and the pharmacy.
FormulaCompare does not recommend one brand over another. Use the sources below to check the details for the exact product in front of you, since formulas and labels can change.
Who Was in the Trial
ONTRAC participants were adults at high risk who had had at least two nonmelanoma skin cancers in the 5 years before enrolling, and they were checked by dermatologists every 3 months for 18 months. The benefit was seen during the 12 months of treatment. People in sunny climates with fair skin and many prior skin cancers are most like the trial population. Results may not apply to people with no history of skin cancer.
Sun Protection Still Comes First
Broad spectrum sunscreen of SPF 15 or higher, shade, protective clothing and regular skin checks remain the foundation of skin cancer prevention. Report any new, changing or non-healing spot. Nicotinamide is best viewed as an add-on that a dermatologist may suggest for selected high-risk patients, not a replacement for these measures. If you start it, ask how long to continue, because ONTRAC found no lasting benefit after stopping.
Side Effects and Who Should Be Careful
In ONTRAC, adverse events were similar with nicotinamide and placebo over 12 months. The NIH Office of Dietary Supplements reports that the most common adverse effects of 500 to 1,500 mg a day for several months in other studies were diarrhea and thrombocytopenia (a low platelet count). Supplement labels add their own cautions: the aSquared Nutrition label says it is not intended for pregnant or nursing mothers or for anyone under 18, and advises consulting a doctor if you take medicines, have a medical condition or are planning a procedure. The NusaPure label cautions people with liver problems, stomach ulcers or diabetes to use it only on a practitioner’s recommendation. Both of those products also add resveratrol or Polygonum cuspidatum extract, which the trial did not use, so a plain nicotinamide product is the closer match to the studied regimen.
When to Talk to Your Doctor or Pharmacist
Talk to a dermatologist before starting high-dose nicotinamide, especially if you have had skin cancer, liver disease, low platelets, diabetes or kidney disease, are pregnant, or take other supplements. See a clinician promptly for any new, changing, bleeding or non-healing skin spot.
Frequently Asked Questions
Are nicotinamide and niacinamide the same thing?
Yes. They are two names for the same amide form of vitamin B3.
Does nicotinamide prevent skin cancer?
In the ONTRAC trial, 500 mg twice daily reduced new nonmelanoma skin cancers by 23% in people with at least two prior skin cancers. Benefit did not persist after stopping.
Does niacinamide serum prevent skin cancer?
The ONTRAC trial used oral nicotinamide. It did not test topical niacinamide.
Will nicotinamide make me flush like niacin?
No. NIH ODS says nicotinamide does not cause flushing.
Is niacin the same as nicotinamide?
No. Niacin usually means nicotinic acid, which can cause flushing at supplemental doses.
Can I take nicotinamide with sunscreen?
Yes. Supplements are not a substitute for sunscreen, clothing and skin checks.
Are nicotinamide riboside and NMN the same as nicotinamide?
No. ODS describes them as related but different niacin-like compounds.
Sources
- PubMed: Chen et al., phase 3 randomized trial of nicotinamide for skin-cancer chemoprevention (N Engl J Med, 2015)
- NIH Office of Dietary Supplements: Niacin fact sheet for health professionals
- NIH DSLD: NusaPure Nicotinamide 500 mg label
- NIH DSLD: aSquared Nutrition Nicotinamide 500 mg label
Medical disclaimer: This article is for educational purposes and does not replace medical advice. Consult a licensed healthcare provider before starting any supplement, medication, or treatment — particularly if you are pregnant, breastfeeding, taking other medications, or have a diagnosed medical condition.