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By Dr. Derrick Adams
Here is a quick primer on things you can do to protect your skin from the sun, in addition to wearing sunscreen:
500mg twice daily of nicotinamide reduced skin cancer by 23% and reduced precancers by 13% in a very well done study that was published in 2015 (New England Journal of Medicine 2015 Oct 22;373(17):1618-26). Nicotinamide is not niacin and will not cause headache and flushing like niacin will. Be sure to avoid niacinamide and double check that you have nicotinamide. Niacinamide may cause flushing like niacin does. Nicotinamide is very cheap and should cost about a nickel a day.
This is an herbal product from tropical regions that can be taken in pill form. It is sold under the brand name Heliocare in the US. Each capsule contains 240mg of standardized extract. To date, there has been no evidence it can prevent skin cancer but it has been proven to reduce sun burns. There are no known side effects. Shopping around for Helicare is worthwhile as prices can range for $17 to $30 a month. It should be taken once a day during the sunny months or as travel dictates.
Dermatologists at UC Davis have reported milk thistle seed extract has been effective in helping treat medical conditions that are exacerbated by sun exposure. There is no evidence it reduces skin cancer or sunburn in humans. The active ingredient in milk thistle is silymarin.
A study from 2008 demonstrated that oral beta carotene offered a mild benefit from sunburn. Participants had to take it for 10 weeks though before any benefit was seen. No evidence exists that it prevents skin cancer. The optimal dose is not known. A Finnish study of 29,000 smokers found that beta carotene increased incidence of lung cancer by 28% and all causes of death by 18%. I do not recommend beta carotene supplementation for sun protection.
The Women’s Health Initiative Study data was analyzed by Stanford dermatologists and they concluded that daily 325mg aspirin reduced the risk of melanoma by 21% in women over a 12 year period. While that data is limited to older women, a more inclusive review of 11 published studies in 2015 suggests that “low dose aspirin” (less than 150mg per day) reduced all types of skin cancers in men and women. Aspirin does have well known side effects and you should consult your doctor to find out if aspirin is safe for you.