Omega-3 Supplementation Improves Atopic Dermatitis Symptoms and QoL

by | Oct 8, 2024 | 2024, Infant and Children's Health, Omega - 3, Skin Health

Written by Chrystal Moulton, Science Writer. After 4 months treatment, researchers saw a significant decrease in SCORAD index within the intervention group (p<0.001).

fats and oils - omega 3An imbalance between omega-3 and omega-6 fatty acids has been implicated in the incidence of atopic dermatitis1. Omega-6 fatty acids trigger proinflammatory pathways within the body while omega-3 fatty acids trigger anti-inflammatory pathways1,2. Research suggests the ideal ratio between omega-6 and omega-3 to range from 1:1 to 6:1 [Omega-6 : Omega-3]1-4. Based on the Western diet, however, that ratio is 25:11. Since omega-3 and omega-6 fatty acids compete for the same enzymes during conversion to active compounds, higher levels of omega-6’s lead to more pro-inflammatory activity within the body therefore increasing the incidence of atopic dermatitis among individuals genetically predisposed to this skin disorder1,2. Furthermore, individuals with atopic dermatitis have lower delta-6-desaturase activity contributing to higher pro-inflammatory activity5,6. Although, research clearly outlines the positive effects of omega-3 fatty acids in treating atopic dermatitis, additional research is needed to determine standardized treatment utilizing omega-3 fatty acids in ameliorating symptoms of atopic dermatitis7. In the current trial, researchers investigated the effect of omega-3 fatty acid supplementation with GLA in children diagnosed with atopic dermatitis8.

This study was conducted from 2021 to 2023 during the spring, fall, and winter seasons. The study was designed as a prospective, triple-blind, randomized, placebo-controlled, parallel trial. Children aged 1-8 years old diagnosed with moderate to severe atopic dermatitis were recruited by their physicians for this trial. The Scoring Atopic Dermatitis Index (SCORAD) was used to determine severity of atopic dermatitis. The PO-SCORAD was used to capture subject score of atopic dermatitis severity by the parents during the treatment period. Children who met the inclusion criteria were randomly assigned to receive a 5ml dose of a citrus flavored liquid supplement containing 2g fish oil, 400mg DHA, 600mg EPA, 10mg GLA, 5mcg vitamin D3, and MCT oil [treatment] or MCT oil with other inactive ingredients [placebo]. The treatment period was 4 months. All children continued standard treatment while participating in this trial. The primary outcomes were a change in the use of topical corticosteroids and severity of atopic dermatitis. Secondary outcomes included changes in quality of life, sleep quality, and itchiness. Results were expressed as a median based on non-parametric U-tests [Mann-Whitney U test].

Of 53 patients enrolled, data from 52 subjects were included in this analysis [treatment= 26, placebo= 26]. Baseline data was similar across both groups with no significant differences observed. After 4months treatment, researchers saw a significant decrease in SCORAD index within the intervention group (p<0.001). Median SCORAD index in the intervention group was 42 at baseline and decreased to 25 after 4months. No change was observed in the placebo group. Also, researchers saw a significant decrease in topical corticosteroid use among the intervention group (p<0.001) and an increase in the placebo group (p=0.031). Subjective assessment of atopic dermatitis severity using the PO-SCORAD index [which was completed by the parents] showed a significant decrease in itchiness, sleep disturbance, and overall severity in the intervention group compared to placebo (p<0.001). Quality of life scores didn’t change in the placebo group, however, there was a significant improvement in QoL scores in the intervention group (p<0.001). Only 1 adverse event was reported. One child developed a mild rash. Since investigators could not determine whether or not the rash was a result of supplementation, data from that child was excluded from this analysis.

Results from this trial suggest that supplementation with omega-3 fatty acids improved itchiness, sleep quality, disease severity, and quality of life in children diagnosed with atopic dermatitis. Furthermore, researchers observed a decrease in the use of topical corticosteroids among those in the intervention group. Additional research will be needed to verify these results and standardize an effective dose for symptom treatment in atopic dermatitis.

Source: Niseteo, Tena, Iva Hojsak, Suzana Ožanić Bulić, and Nives Pustišek. “Effect of Omega-3 Polyunsaturated Fatty Acid Supplementation on Clinical Outcome of Atopic Dermatitis in Children.” Nutrients 16, no. 17 (2024): 2829.

© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

Click here to read the full text study.

Posted October 8, 2024.

Chrystal Moulton BA, PMP, is a 2008 graduate of the University of Illinois at Chicago. She graduated with a bachelor’s in psychology with a focus on premedical studies and is a licensed project manager. She currently resides in Indianapolis, IN.

References:

  1. Mirrahimi B, Moazemi M, Eslami N, et al. Evaluating the Effect of Eicosapentaenoic Acid in Children With Atopic Dermatitis: A Randomized Triple-Blind Clinical Trial. The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG. 2023;28(1):29-35. doi:10.5863/1551-6776-28.1.29
  2. Balić A, Vlašić D, Žužul K, Marinović B, Bukvić Mokos Z. Omega-3 Versus Omega-6 Polyunsaturated Fatty Acids in the Prevention and Treatment of Inflammatory Skin Diseases. Int J Mol Sci. Jan 23 2020;21(3)doi:10.3390/ijms21030741
  3. DiNicolantonio JJ, O’Keefe J. The Importance of Maintaining a Low Omega-6/Omega-3 Ratio for Reducing the Risk of Autoimmune Diseases, Asthma, and Allergies. Mo Med. Sep-Oct 2021;118(5):453-459.
  4. Liput KP, Lepczyński A, Ogłuszka M, et al. Effects of Dietary n-3 and n-6 Polyunsaturated Fatty Acids in Inflammation and Cancerogenesis. Int J Mol Sci. Jun 28 2021;22(13)doi:10.3390/ijms22136965
  5. Yen CH, Dai YS, Yang YH, Wang LC, Lee JH, Chiang BL. Linoleic acid metabolite levels and transepidermal water loss in children with atopic dermatitis. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology. Jan 2008;100(1):66-73. doi:10.1016/s1081-1206(10)60407-3
  6. Ziboh VA, Miller CC, Cho Y. Metabolism of polyunsaturated fatty acids by skin epidermal enzymes: generation of antiinflammatory and antiproliferative metabolites. Am J Clin Nutr. Jan 2000;71(1 Suppl):361s-6s. doi:10.1093/ajcn/71.1.361s
  7. Wollenberg A, Kinberger M, Arents B, et al. First update of the living European guideline (EuroGuiDerm) on atopic eczema. J Eur Acad Dermatol Venereol. Nov 2023;37(11):e1283-e1287. doi:10.1111/jdv.19269
  8. Niseteo T, Hojsak I, Ožanić Bulić S, Pustišek N. Effect of Omega-3 Polyunsaturated Fatty Acid Supplementation on Clinical Outcome of Atopic Dermatitis in Children. Nutrients. Aug 24 2024;16(17)doi:10.3390/nu16172829

 

×