Exploring the potential of omega-3 fatty acids in acne patients: A prospective intervention study

Background: Omega-3 fatty acids (omega-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 omega-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 (R) (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 (R) 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 omega-3 FA deficit. The HS-omega 3 index (R) can be increased by a Mediterranean diet and oral supplementation with algae-derived omega-3 FA. Acne severity improved significantly in patients with target omega-3 FA levels.