Niacin Rash vs Lamictal Rash: Why You Should Be Careful with Supplements

Disclaimer: this is not medical advice.  I am not a doctor.  If you take lamictal, and experience an unexplained rash, contact your doctor immediately.

Before I left for my trip, I had kind of a weird experience.

I was sitting at my studio table, typing away in front of my sun lamp, when I suddenly felt sunburned.  It came on very suddenly, almost in an instant.  Since lamictal can cause a deadly rash, I tend to freak out every time something weird happens to my skin.  The rash, officially called Stevens-Johnson, is so serious that a lot of pdocs will take you off lamictal if you have any kind of rash at all.  Now, it's pretty uncommon to experience the rash after the first two weeks on the med, and even rarer after the first eight weeks, but nonetheless I started to feel panicked.  I'd just been offered a job -- what if I have to go off my meds, at this time of year?  I wouldn't be able to work.  I wouldn't be able to do anything.

The rash was on my cheeks, nose, around my lips, on my chin, and even on my elbows ... but not on the rest of my arms.  It looked something like this: (I wanted to play with my drawing tablet, so I drew this.  Note the quivering lips and sad, shocked expression.)

(I wanted to play with my drawing tablet, so I drew this.  Note the quivering lips and sad, shocked expression.)

As always, I googled the question, and determined that the lamictal rash does not present as a feeling of sunburn.  I actually knew this but had forgotten it in my panic.  Then I googled "rashes that feel like sunburn."  I turned up a bunch of hits for something called a "niacin rash".  Niacin, or vitamin B3, is found in grains, and if you take too much of it, it can cause a sunburn-like rash, and if you keep taking too much of it, something called pellagra.

I had been eating one of my whole grain waffles as the rash appeared.  But I eat those every day, and I've never gotten a rash before.   So where was all of this niacin coming from?

I thought about it, and realized that the electrolyte mix I'd been taking to try and ease my lamictal constipation was also a vitamin supplement.  Maybe that contained niacin.  For the last few days, I'd been drinking 4 to 6 packets a day, just like the directions said ...

I double checked the box, and learned that, yes, it does contain niacin.  But I'm not supposed to take 4 to 6 packets a day.  I'm supposed to mix 1 or 2 packets into 4 to 6 oz. of water.  ADD strikes again.

Lesson learned.