Niacin causes redness and warmth on the skin due to blood vessel dilation. It is a B vitamin essential for maintaining health and reducing cholesterol levels. Side effects include flushing, tingling, pain or itching. Slow-release niacin formulations and aspirin can reduce flushing.
Niacin flush refers to the redness and warmth that appears on the skin of the face and upper body shortly after a person has taken the vitamin niacin. The reaction is a result of niacin binding to receptors on cells near the skin’s surface. These cells then release compounds that cause blood vessels beneath the surface to dilate. The dilation of these blood vessels causes redness of the skin.
Niacin, also known as nicotinic acid, is one of the B vitamins and is essential for maintaining health. It helps in the metabolism of carbohydrates and fats. Eating a healthy diet of proteins, fruits and vegetables is usually sufficient to maintain acceptable niacin levels. Niacin has been shown to reduce blood cholesterol levels. Heart patients who are at risk of heart attack due to high cholesterol levels may benefit from taking niacin supplements.
Supplementing your diet with 1,000-2,000 mg of niacin per day can lead to a reduction in low-density lipoprotein (LDL), or bad cholesterol, levels and a reduction in blood triglyceride levels. Niacin also increases levels of high-density lipoproteins (HDL), which serve to protect the heart by carrying bad cholesterol from the arteries to the liver. Doctors may prescribe niacin in combination with a cholesterol-lowering statin.
Many patients experience side effects after taking a niacin supplement. Niacin flushing, which can lead to uncomfortable redness and warmth in the upper body, can last up to an hour after ingesting niacin. Other side effects may include tingling, pain or itching. Many patients stop taking niacin due to these side effects.
Once ingested, niacin works by binding to a receptor on cells under the skin. This receptor is known as G protein-coupled receptor 109A (GPR109A). It is present on the surface of spindle cells called Langerhans cells. Once activated, Langerhans cells begin to release two types of prostaglandin molecules, PGD2 and PGE2.
These prostaglandins are hormone-like and are derived from lipids. Prostaglandin molecules interact with smooth muscle cells and cause blood vessels to dilate. The dilation of these vessels on the skin surface causes the niacin flush.
Most patients taking niacin experience a decrease in niacin flow over time. As blood niacin levels stabilize, patients develop a tolerance to niacin and the flushing response must be reduced. Slow-release niacin formulations can also help reduce the flow of niacin. Aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce hot flashes by stopping the production of prostaglandins by Langerhans cells. The elimination of annoying flushing may make niacin more attractive as a therapy for heart patients.
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