Omega-3 fatty acids found to significantly reduce acne in new study

By Dr. Liji Thomas, MDReviewed by Benedette Cuffari, M.Sc.Jul 16 2024

Omega-3 fatty acids (ω-3 FA), like eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are essential fatty acids with anti-inflammatory activity. A recent study published in The Journal of Cosmetic Dermatology examines the efficacy of ω-3 FA in acne.

Study: Exploring the potential of omega-3 fatty acids in acne patients: A prospective intervention study. Image Credit: BLACKDAY / Shutterstock.com

How does nutrition affect acne?

Ultra-processed foods rich in refined sugars, dairy products, and saturated fats may cause sebum overproduction and excessive keratin accumulation within hair follicles in the dermis. The resulting inflammation and bacterial colonization of the follicles can trigger or worsen acne.

Dietary interventions to modulate the incidence and severity of acne have not been fully explored. However, the anti-inflammatory activity of ω-3 FA makes them promising dietary components for studying their therapeutic potential against acne.

Alpha-linolenic acid (ALA) is an essential fatty acid that cannot be endogenously produced in humans despite its importance in food digestion. EPA and DHA are synthesized in minute amounts from ALA; thus, ALA, EPA, and DHA must be consumed in adequate quantities to maintain healthy levels.

Modern Western diets often promote inflammation, as they contain up to 20 times as much pro-inflammatory ω-6 FA as anti-inflammatory ω-3 FA. Restoration of this balance is essential to reduce inflammation.

As a result, many enzymes are affected by ω-3 FA and are involved in different pathways that influence acne. With ω-3 FA supplementation, reduced sebum synthesis, inflammatory cytokine levels, and follicular acne-inducing bacterium Corynebacterium acnes, as well as improved skin integrity and increased antioxidant function, may be achieved.

About the study

The current study was motivated by the need to provide more direct evidence that ω-3 FA can mitigate acne. To this end, 60 patients with a mean age of 26 who were not on any prescription medication for acne were included in the study.

Thirty-seven study participants had papulopustular acne (AP), whereas 23 had comedonal acne (AC). About 64% of the study cohort were dissatisfied with their improvement after previous treatment or its side effects.

All study participants were advised to consume a Mediterranean diet, including ω-3 FA supplementation from algae. Each patient received oral supplements containing 600 mg DHA/300 mg EPA for the first eight weeks of the intervention, followed by 800 mg DHA/400 mg EPA for the next eight weeks.

The study participants attended four visits to monitor EPA, DHA, and ALA blood levels, as well as calculate the HS-omega-3 index. The HS omega-3 index reflects the percentage of EPA/DHA within red blood cells (RBCs).

The target index value was between eight and 11%, with values below 8% and 4% indicative of a deficit and severe deficit, respectively. These values were compared with the responses to standardized questionnaires and clinical findings.

What did the study show?

At baseline, over 98% of the patients were in EPA/DHA deficit, 40 and 18 of whom were in severe deficit and deficit, respectively.

At the baseline visit (V1), the average HS-omega 3 index was 5%. By the fourth visit (V4), it had significantly improved to 8%. Nevertheless, one in 18 participants remained in severe deficit and deficit, respectively.  

Both inflammatory and non-inflammatory lesions decreased throughout the study period. By the end of the study, 42 patients had AC, and 11 had AP, as compared to 23 and 37 at V1, respectively.

At baseline, 32 patients had intermediate severe acne, and 29 had mild acne. By V4, 45 had mild acne, and eight had intermediate severity, with two patients exhibiting no non-inflammatory lesions at V4. Additionally, 42 individuals reported less than ten non-inflammatory lesions compared to eight patients at baseline.

One patient reported 26-50 lesions by V4 compared to 20 patients at baseline. Between V1 and V4, 27 and eight patients reported 10-25 lesions at V1, respectively.

Complete clearance of inflammatory acne was observed in 13 patients at V4, while 33 had less than ten lesions as compared to 23 at V1. A significant reduction was observed from 28 individuals at V1, reporting 10-20 lesions to seven individuals at V4. No patient had over 20 lesions by the end of the study compared to nine at baseline.

While almost 80% of the study cohort reported improved acne, 8% of patients felt it had worsened. Overall, the patients reported a better quality of life despite the persistence of acne, with these improvements particularly evident in the AP group, which experienced the most significant change in HS-omega 3 index values.

Perceived food triggers had a greater impact on acne occurrence and flare-ups than foods like nuts, fruits, vegetables, and whole grains that were perceived as healthy. Certain foods like milk, fries, and chips were more frequently consumed in the AP group than those with AC. During the study period, most patients reduced their consumption of dairy products.

Conclusions

Although the current prospective study did not use a control group, most acne patients were in ω-3 FA deficit. These findings are similar to previous reports in which HS-omega 3 index values were below 5.5% and 8% in German and European studies, respectively.

These deficits can be corrected by consuming a Mediterranean diet coupled with algae-derived ω-3 FA. By recovering the ω-3 FA deficit through supplementation and dietary intervention, most patients in the current study experienced a significant improvement in the severity of their acne. The safety, acceptability, and quality of life improvements with this treatment approach support its potential role as an intervention alone or in combination with prescription medication.