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Guertler, Anne; Neu, Katharina; Lill, Diana; Clanner‐Engelshofen, Benjamin; French, Lars E.; Reinholz, Markus (2024): Exploring the potential of omega‐3 fatty acids in acne patients: A prospective intervention study. Journal of Cosmetic Dermatology, 23 (10). pp. 3295-3304. ISSN 1473-2130

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Abstract

Background
Omega-3 fatty acids (ω-3 FA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA), are essential nutrients known for their anti-inflammatory properties, which involve reducing pro-inflammatory cytokines, eicosanoids, and insulin-like growth factor-1. This suggests their potential to alleviate acne severity, especially when deficits are present.

Aims
To elevate EPA/DHA levels in acne patients through dietary intervention and supplementation, observing subsequent clinical effects.

Methods
Over 16 weeks, 60 patients without prescription medication (n = 23 acne comedonica [AC], n = 37 acne papulopustulosa [AP]) adhered to a Mediterranean diet, incorporating oral algae-derived ω-3 FA supplementation (600 mg DHA/300 mg EPA week 1–8, 800 mg DHA/400 mg EPA week 8–16). At four visits (V1–V4), blood EPA/DHA levels were tracked using the HS-omega 3 index® (EPA/DHA (%) of total identified fatty acids in erythrocytes; target 8%–11%, deficit <8%, severe deficit <4%), alongside clinical assessments and standardized questionnaires.

Results
At baseline, 98.3% of patients had an EPA/DHA deficit, with the mean HS-omega 3 index® rising from 4.9% at V1 to 8.3% at V4 (p < 0.001). AC showed significantly higher indices than AP at V4 (p = 0.035). Objective improvements in both inflammatory and non-inflammatory lesions were observed (p < 0.001). While self-reported appearance worsened in four patients, overall quality of life improved (p < 0.001), particularly in AP. Dietary triggers were more clearly defined than beneficial foods. Intake of cow's milk and dairy products reduced (p < 0.001). Compliance was good; no adverse events were reported.

Conclusion
Many acne patients have a ω-3 FA deficit. The HS-omega 3 index® can be increased by a Mediterranean diet and oral supplementation with algae-derived ω-3 FA. Acne severity improved significantly in patients with target ω-3 FA levels.

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