Content

List volumes - List articles in this issue

Investigative Report

Effect of Dietary Supplementation with Omega-3 Fatty Acid and Gamma-linolenic Acid on Acne Vulgaris: A Randomised, Double-blind, Controlled Trial

doi: 10.2340/00015555-1802

Abstract:

This study was undertaken to evaluate the clinical efficacy, safety, and histological changes induced by dietary omega-3 fatty acid and γ-linoleic acid in acne vulgaris. A 10-week, randomised, controlled parallel dietary intervention study was performed in 45 participants with mild to moderate acne, which were allocated to either an omega-3 fatty acid group (2,000 mg of eicosapentaenoic acid and docosahexaenoic acid), a γ-linoleic acid group (borage oil containing 400 mg γ-linoleic acid), or a control group. After 10 weeks of omega-3 fatty acid or γ-linoleic acid supplementation, inflammatory and non-inflammatory acne lesions decreased significantly. Patient subjective assessment of improvement showed a similar result. Heamatoxylin & eosin staining of acne lesions demonstrated reductions in inflammation and immunohistochemical staining intensity for interleukin-8. No severe adverse effect was reported. This study shows for the first time that omega-3 fatty acid and γ-linoleic acid could be used as adjuvant treatments for acne patients.

Authors:

Jae Yoon Jung, Hyuck Hoon Kwon, Jong Soo Hong, Ji Young Yoon, Mi Sun Park, Mi Young Jang, Dae Hun Suh
Department of Dermatology, Seoul National University Hospital, Seoul, Korea

References

1. Cordain L, Lindeberg S, Hurtado M, Hill K, Eaton SB, Brand-Miller J. Acne vulgaris: a disease of western civilization. Arch Dermatol 2002; 138: 1584–1590.

2. Cordain L. Implications for the role of diet in acne. Semin Cutan Med Surg 2005; 24: 84–91.

3. Steiner PE. Necropsies on Okinawans; anatomic and pathologic observations. Arch Pathol 1946; 42: 359–380.

4. Jung JY, Yoon MY, Min SU, Hong JS, Choi YS, Suh DH. The influence of dietary patterns on acne vulgaris in Koreans. Eur J Dermatol 2010; 20: 768–772.

5. Smith RN, Braue A, Varigos GA, Mann NJ. The effect of a low glycemic load diet on acne vulgaris and the fatty acid composition of skin surface triglycerides. J Dermatol Sci 2008; 50: 41–52.

6. Smith RN, Mann NJ, Braue A, Makelainen H, Varigos GA. The effect of a high-protein, low glycemic-load diet versus a conventional, high glycemic-load diet on biochemical parameters associated with acne vulgaris: a randomized, investigator-masked, controlled trial. J Am Acad Dermatol 2007; 57: 247–256.

7. Kwon HH, Yoon JY, Hong JS, Jung JY, Park MS, Suh DH. Clinical and histological effect of a low glycaemic load diet in treatment of acne vulgaris in Korean patients: a randomized, controlled trial. Acta Derm Venereol 2012; 92: 241–246.

8. Danby FW. Acne and milk, the diet myth, and beyond. J Am Acad Dermatol 2005; 52: 360–362.

9. Adebamowo CA, Spiegelman D, Berkey CS, Danby FW, Rockett HH, Colditz GA, et al. Milk consumption and acne in adolescent girls. Dermatol Online J 2006; 12: 1.

10. Adebamowo CA, Spiegelman D, Berkey CS, Danby FW, Rockett HH, Colditz GA, et al. Milk consumption and acne in teenaged boys. J Am Acad Dermatol 2008; 58: 787–793.

11. Adebamowo CA, Spiegelman D, Danby FW, Frazier AL, Willett WC, Holmes MD. High school dietary dairy intake and teenage acne. J Am Acad Dermatol 2005; 52: 207–214.

12. Rubin MG, Kim K, Logan AC. Acne vulgaris, mental health and omega-3 fatty acids: a report of cases. Lipids Health Dis 2008; 7: 36.

13. Koch C, Dolle S, Metzger M, Rasche C, Jungclas H, Ruhl R, et al. Docosahexaenoic acid (DHA) supplementation in atopic eczema: a randomized, double-blind, controlled trial. Br J Dermatol 2008; 158: 786–792.

14. Bjorneboe A, Smith AK, Bjorneboe GE, Thune PO, Drevon CA. Effect of dietary supplementation with n-3 fatty acids on clinical manifestations of psoriasis. Br J Dermatol 1988; 118: 77–83.

15. Soyland E, Funk J, Rajka G, Sandberg M, Thune P, Rustad L, et al. Effect of dietary supplementation with very-long-chain n-3 fatty acids in patients with psoriasis. N Engl J Med 1993; 328: 1812–1816.

16. Mayser P, Grimm H, Grimminger F. n-3 fatty acids in psoriasis. Br J Nutr 2002; 87 Suppl 1: S77–82.

17. Kragballe K. Dietary supplementation with a combination of n-3 and n-6 fatty acids (super gamma-oil marine) improves psoriasis. Acta Derm Venereol 1989; 69: 265–268.

18. Din JN, Newby DE, Flapan AD. Omega 3 fatty acids and cardiovascular disease – fishing for a natural treatment. BMJ 2004; 328: 30–35.

19. Laganiere S, Yu BP, Fernandes G. Studies on membrane lipid peroxidation in omega-3 fatty acid-fed autoimmune mice: effect of vitamin E supplementation. Adv Exp Med Biol 1990; 262: 95–102.

20. Menendez JA, Lupu R, Colomer R. Exogenous supplementation with omega-3 polyunsaturated fatty acid docosahexaenoic acid (DHA; 22: 6n-3) synergistically enhances taxane cytotoxicity and downregulates Her-2/neu (c-erbB-2) oncogene expression in human breast cancer cells. Eur J Cancer Prev 2005; 14: 263–270.

21. Manda K, Kriesen S, Hildebrandt G, Fietkau R, Klautke G. Omega-3 fatty acid supplementation in cancer therapy: does eicosapentanoic acid influence the radiosensitivity of tumor cells? Strahlenther Onkol 2011; 187: 127–134.

22. Andreeva VA, Touvier M, Kesse-Guyot E, Julia C, Galan P, Hercberg S. B vitamin and/or omega-3 fatty acid supplementation and cancer: ancillary findings from the supplementation with folate, vitamins B6 and B12, and/or omega-3 fatty acids (SU.FOL.OM3) randomized trial. Arch Intern Med 2012; 172: 540–547.

23. Macsai MS. The role of omega-3 dietary supplementation in blepharitis and meibomian gland dysfunction (an AOS thesis). Trans Am Ophthalmol Soc 2008; 106: 336–356.

24. Thies F, Nebe-von-Caron G, Powell JR, Yaqoob P, Newsholme EA, Calder PC. Dietary supplementation with gamma-linolenic acid or fish oil decreases T lymphocyte proliferation in healthy older humans. J Nutr 2001; 131: 1918–1927.

25. Mayser P, Mayer K, Mahloudjian M, Benzing S, Kramer HJ, Schill WB, et al. A double-blind, randomized, placebo-controlled trial of n-3 versus n-6 fatty acid-based lipid infusion in atopic dermatitis. J Parenter Enteral Nutr 2002; 26: 151–158.

26. Van Gool CJ, Thijs C, Henquet CJ, van Houwelingen AC, Dagnelie PC, Schrander J, et al. Gamma-linolenic acid supplementation for prophylaxis of atopic dermatitis – a randomized controlled trial in infants at high familial risk. Am J Clin Nutr 2003; 77: 943–951.

27. Foster RH, Hardy G, Alany RG. Borage oil in the treatment of atopic dermatitis. Nutrition 2010; 26: 708–718.

28. Andreassi M, Forleo P, Di Lorio A, Masci S, Abate G, Amerio P. Efficacy of gamma-linolenic acid in the treatment of patients with atopic dermatitis. J Int Med Res 1997; 25: 266–274.

29. Balbas GM, Regana MS, Millet PU. Study on the use of omega-3 fatty acids as a therapeutic supplement in treatment of psoriasis. Clin Cosmet Investig Dermatol 2011; 4: 73–77.

30. Rhodes LE, O’Farrell S, Jackson MJ, Friedmann PS. Dietary fish-oil supplementation in humans reduces UVB-erythemal sensitivity but increases epidermal lipid peroxidation. J Invest Dermatol 1994; 103: 151–154.

31. Frati C, Bevilacqua L, Apostolico V. Association of etretinate and fish oil in psoriasis therapy. Inhibition of hypertriglyceridemia resulting from retinoid therapy after fish oil supplementation. Acta Derm Venereol 1994; 186: 151–153.

32. Kim HH, Lee Y, Eun HC, Chung JH. Eicosapentaenoic acid inhibits TNF-alpha-induced matrix metalloproteinase-9 expression in human keratinocytes, HaCaT cells. Biochem Biophys Res Commun 2008; 368: 343–349.

33. Logan AC. Omega-3 fatty acids and acne. Arch Dermatol 2003; 139: 941–942; author reply 942–943.

34. Eriksen BB, Kare DL. Open trial of supplements of omega 3 and 6 fatty acids, vitamins and minerals in atopic dermatitis. J Dermatolog Treat 2006; 17: 82–85.

35. Pinna A, Piccinini P, Carta F. Effect of oral linoleic and gamma-linolenic acid on meibomian gland dysfunction. Cornea 2007; 26: 260–264.

36. Ziboh VA, Cho Y, Mani I, Xi S. Biological significance of essential fatty acids/prostanoids/lipoxygenase-derived monohydroxy fatty acids in the skin. Arch Pharm Res 2002; 25: 747–758.

37. O’Brien SC, Lewis JB, Cunliffe WJ. The Leeds revised acne grading system. J Dermatol Treat 1998; 9: 215–220.

38. Hitch JM, Greenburg BG. Adolescent acne and dietary iodine. Arch Dermatol 1961; 84: 898–911.

39. Simopoulos AP. Omega-3 fatty acids in inflammation and autoimmune diseases. J Am Coll Nutr 2002; 21: 495–505.

40. Alestas T, Ganceviciene R, Fimmel S, Müller-Decker K, Zouboulis C. Enzymes involved in the biosynthesis of leukotriene B4 and prostaglandin E2 are active in sebaceous glands. J Mol Med 2006; 84: 75–87.

41. Zhang Q, Seltmann H, Zouboulis CC, Travers JB. Activation of platelet-activating factor receptor in SZ95 sebocytes results in inflammatory cytokine and prostaglandin E2 production. Exp Dermatol 2006; 15: 769–774.

42. Zouboulis CC. Leukotrien-Antagonisten bei atopischen Erkrankungen und Akne. Akt Dermatol 2003; 29: 419–425.

43. Oeff MK, Seltmann H, Hiroi N, Nastos A, Makrantonaki E, Bornstein SR, et al. Differential regulation of Toll-like receptor and CD14 pathways by retinoids and corticosteroids in human sebocytes. Dermatology 2006; 213: 266.

44. McCusker MM, Grant-Kels JM. Healing fats of the skin: the structural and immunologic roles of the omega-6 and omega-3 fatty acids. Clin Dermatol 2010; 28: 440–451.

45. Lee JY, Zhao L, Youn HS, Weatherill AR, Tapping R, Feng L, et al. Saturated fatty acid activates but polyunsaturated fatty acid inhibits Toll-like receptor 2 dimerized with Toll-like receptor 6 or 1. J Biol Chem 2004; 279: 16971–16979.

46. Zouboulis CC. Is acne vulgaris a genuine inflammatory disease? Dermatology 2001; 203: 277–279.

47. Zouboulis CC, Eady A, Philpott M, Goldsmith LA, Orfanos C, Cunliffe WJ, Rosenfield R. What is the pathogenesis of acne? Exp Dermatol 2005; 14: 143–152.

48. Li Y, Seifert MF, Ney DM, Grahn M, Grant AL, Allen KG, et al. Dietary conjugated linoleic acids alter serum IGF-I and IGF binding protein concentrations and reduce bone formation in rats fed (n-6) or (n-3) fatty acids. J Bone Miner Res 1999; 14: 1153–1162.

49. Bhathena SJ, Berlin E, Judd JT, Kim YC, Law JS, Bhagavan HN, et al. Effects of omega 3 fatty acids and vitamin E on hormones involved in carbohydrate and lipid metabolism in men. Am J Clin Nutr 1991; 54: 684–688.

50. Zouboulis CC, Nestoris S, Adler YD, Picardo M, Camera E, Orth M, Orfanos CE, Cunliffe WJ. A new concept for acne therapy: a pilot study with zileuton, an oral 5-lipoxygenase inhibitor. Arch Dermatol 2003; 139: 668–670.

51. Zouboulis CC, Saborowski A, Boschnakow A. Zileuton, an oral 5-lipoxygenase inhibitor, directly reduces sebum production. Dermatology 2005; 210: 36–38.

52. Zouboulis CC. Zileuton, a new efficient and safe systemic antiacne drug. Dermatoendocrinol 2009; 1: 188–192.

53. Zouboulis CC, Seltmann H, Alestas T. Zileuton prevents the activation of the leukotriene pathway and reduces sebaceous lipogenesis. Exp Dermatol 2010; 19: 148–150.

54. Jung JY, Choi YS, Yoon MY, Min SU, Suh DH. Comparison of a pulsed dye laser and a combined 585/1,064-nm laser in the treatment of acne vulgaris. Dermatol Surg 2009; 35: 1181–1187.

55. Abd El All HS, Shoukry NS, El Maged RA, Ayada MM. Immunohistochemical expression of interleukin 8 in skin biopsies from patients with inflammatory acne vulgaris. Diagn Pathol 2007; 2: 4.

56. Jung JY, Hong JS, Ahn CH, Yoon JY, Kwon HH, Suh DH. Prospective randomized controlled clinical and histopa­thological study of acne vulgaris treated with dual mode of quasi-long pulse and Q-switched 1064-nm Nd: YAG laser assisted with a topically applied carbon suspension. J Am Acad Dermatol 2012; 66: 626–633.

57. Jung JY, Kwon HH, Yeom KB, Yoon MY, Suh DH. Clinical and histological evaluation of 1% nadifloxacin cream in the treatment of acne vulgaris in Korean patients. Int J Dermatol 2011; 50: 350–357.

58. Lee DH, Choi YS, Min SU, Yoon MY, Suh DH. Comparison of a 585-nm pulsed dye laser and a 1064-nm Nd: YAG laser for the treatment of acne scars: A randomized split-face clinical study. J Am Acad Dermatol 2009; 60: 801–807.

59. Manolis EN, Kaklamanos IG, Spanakis N, Filippou DK, Panagiotaropoulos T, Tsakris A, et al. Tissue concentration of transforming growth factor beta1 and basic fibroblast growth factor in skin wounds created with a CO2 laser and scalpel: a comparative experimental study, using an animal model of skin resurfacing. Wound Repair Regen 2007; 15: 252–257.



Related articles



From the Melanoma Incidence in Australia to the Role of Essential Fatty Acids in Acne



Share with your friends





Actions


Abstract

Full text

PDF

Supplementary


Figure S1
Figure S2
Figure S3
Figure S4

Print information


Volume 94, Issue 5

DOI: 10.2340/00015555-1802

Pages: 521-525

View at PubMed