Q. You wrote about the use of niacin against basal cell and squamous cell skin cancers. I would like to try this, but I’m having trouble with the flushing. To avoid this, I have to take the pill after a full meal. Even then, I can manage only 125 milligrams. How can I build up a tolerance?
A. Niacin (vitamin B3) comes in different forms, and only niacinamide has been shown to reduce the risk of non-melanoma skin cancers (JAMA Dermatology, Sept. 17, 2025). Niacin, which may also be called nicotinic acid, can lower cholesterol, but it causes flushing that can be quite uncomfortable. Niacinamide, also known as nicotinamide, does not cause flushing.
You may want to consider trading in your bottle of niacin for nicotinamide instead. If you have skin cancer, you will want your dermatologist to monitor your progress.
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In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, FL 32803, or email them via their website: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”