Exploring the potential of omega-3 fatty acids in acne patients: A prospective intervention study.
Mediterranean diet
exposome factors
nutraceuticals
nutrition
supplementation
Journal
Journal of cosmetic dermatology
ISSN: 1473-2165
Titre abrégé: J Cosmet Dermatol
Pays: England
ID NLM: 101130964
Informations de publication
Date de publication:
10 Jul 2024
10 Jul 2024
Historique:
revised:
31
05
2024
received:
26
03
2024
accepted:
11
06
2024
medline:
10
7
2024
pubmed:
10
7
2024
entrez:
10
7
2024
Statut:
aheadofprint
Résumé
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. To elevate EPA/DHA levels in acne patients through dietary intervention and supplementation, observing subsequent clinical effects. 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. 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. 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.
Sections du résumé
BACKGROUND
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
OBJECTIVE
To elevate EPA/DHA levels in acne patients through dietary intervention and supplementation, observing subsequent clinical effects.
METHODS
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
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
CONCLUSIONS
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.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024 The Author(s). Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.
Références
Dessinioti C, Dreno B. Acne treatments: future trajectories. Clin Exp Dermatol. 2020;45:955‐961.
Khan A, Chang MW. The role of nutrition in acne vulgaris and hidradenitis suppurativa. Clin Dermatol. 2022;40:114‐121.
Auffret N, Claudel JP, Leccia MT, Ballanger F, Dreno B. Novel and emerging treatment options for acne vulgaris. Eur J Dermatol. 2022;32:451‐458.
Passeron T, Krutmann J, Andersen ML, Katta R, Zouboulis CC. Clinical and biological impact of the exposome on the skin. J Eur Acad Dermatol Venereol. 2020;34(Suppl 4):4‐25.
Dreno B, Bettoli V, Araviiskaia E, Sanchez Viera M, Bouloc A. The influence of exposome on acne. J Eur Acad Dermatol Venereol. 2018;32:812‐819.
Mavranezouli I, Daly CH, Welton NJ, et al. A systematic review and network meta‐analysis of topical pharmacological, oral pharmacological, physical and combined treatments for acne vulgaris. Br J Dermatol. 2022;187:639‐649.
Piquero‐Casals J, Morgado‐Carrasco D, Rozas‐Muñoz E, et al. Sun exposure, a relevant exposome factor in acne patients and how photoprotection can improve outcomes. J Cosmet Dermatol. 2023;22:1919‐1928.
Baldwin H, Tan J. Effects of diet on acne and its response to treatment. Am J Clin Dermatol. 2020;22:55‐65.
Melnik BC. Western diet‐induced imbalances of FoxO1 and mTORC1 signalling promote the sebofollicular inflammasomopathy acne vulgaris. Exp Dermatol. 2016;25:103‐104.
Melnik BC. Linking diet to acne metabolomics, inflammation, and comedogenesis: an update. Clin Cosmet Investig Dermatol. 2015;8:371‐388.
Conforti C, Agozzino M, Emendato G, et al. Acne and diet: a review. Int J Dermatol. 2022;61:930‐934.
Jung JY, Kwon HH, Hong JS, et al. Effect of dietary supplementation with omega‐3 fatty acid and gamma‐linolenic acid on acne vulgaris: a randomised, double‐blind, controlled trial. Acta Derm Venereol. 2014;94:521‐525.
Guertler A, Neu K, Fiedler T, et al. Clinical effects of omega‐3 fatty acids on acne vulgaris. J Dtsch Dermatol Ges. 2022;20:1023‐1027.
von Schacky C. Omega‐3 fatty acids in pregnancy‐the case for a target Omega‐3 index. Nutrients. 2020;12(4):898. doi: 10.3390/nu12040898
Krupa K, Fritz K, Parmar M. Omega‐3 fatty acids. StatPearls; 2023.
Simopoulos AP. An increase in the Omega‐6/Omega‐3 fatty acid ratio increases the risk for obesity. Nutrients. 2016;8:128.
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. 2021;22:6965.
Simopoulos AP, DiNicolantonio JJ. The importance of a balanced omega‐6 to omega‐3 ratio in the prevention and management of obesity. Open Heart. 2016;3:e000385.
Torres‐Castillo N, Silva‐Gómez JA, Campos‐Perez W, et al. High dietary omega‐6:omega‐3 PUFA ratio is positively associated with excessive adiposity and waist circumference. Obes Facts. 2018;11:344‐353.
Gurtler A, Laurenz S. The impact of clinical nutrition on inflammatory skin diseases. J Dtsch Dermatol Ges. 2022;20:185‐202.
Cholewski M, Tomczykowa M, Tomczyk M. A comprehensive review of chemistry, sources and bioavailability of Omega‐3 fatty acids. Nutrients. 2018;10(11):1662. doi: 10.3390/nu10111662
Kim H, Moon SY, Sohn MY, Lee WJ. Insulin‐like growth Factor‐1 increases the expression of inflammatory biomarkers and sebum production in cultured Sebocytes. Ann Dermatol. 2017;29:20‐25.
Li Y, Seifert MF, Ney DM, 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.
Snodgrass RG, Huang S, Choi IW, Rutledge JC, Hwang DH. Inflammasome‐mediated secretion of IL‐1beta in human monocytes through TLR2 activation; modulation by dietary fatty acids. J Immunol. 2013;191:4337‐4347.
Balic A, Vlasic D, Zuzul K, Marinovic B, Bukvic Mokos Z. Omega‐3 versus Omega‐6 polyunsaturated fatty acids in the prevention and treatment of inflammatory skin diseases. Int J Mol Sci. 2020;21:741.
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.
Contassot E, French LE. New insights into acne pathogenesis: propionibacterium acnes activates the inflammasome. J Invest Dermatol. 2014;134:310‐313.
Yan Y, Jiang W, Spinetti T, et al. Omega‐3 fatty acids prevent inflammation and metabolic disorder through inhibition of NLRP3 inflammasome activation. Immunity. 2013;38:1154‐1163.
Dreno B. What is new in the pathophysiology of acne, an overview. J Eur Acad Dermatol Venereol. 2017;31(Suppl 5):8‐12.
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.
Khayef G, Young J, Burns‐Whitmore B, Spalding T. Effects of fish oil supplementation on inflammatory acne. Lipids Health Dis. 2012;11:165.
von Schacky C. Confusion about the effects of omega‐3 fatty acids: contemplation of study data taking the omega‐3 index into consideration. Internist (Berl). 2019;60:1319‐1327.
Zainab Z, Malik NA, Obaid S, et al. Effectiveness of oral omega 3 in reducing mucocutaneous side effects of oral isotretinoin in patients with acne vulgaris. J Ayub Med Coll Abbottabad. 2021;33:60‐63.
Davis C, Bryan J, Hodgson J, Murphy K. Definition of the Mediterranean diet; a literature review. Nutrients. 2015;7:9139‐9153.
EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA), Turck D, Castenmiller J, et al. Safety of oil from Schizochytrium limacinum (strain FCC‐3204) for use in infant and follow‐on formula as a novel food pursuant to regulation (EU) 2015/2283. EFSA J. 2021;19:e06344.
Harris WS, Von Schacky C. The Omega‐3 index: a new risk factor for death from coronary heart disease? Prev Med. 2004;39:212‐220.
von Schacky C. Omega‐3 index in 2018/19. Proc Nutr Soc. 2020;1‐7:381‐387.
Nast A, Bayerl C, Borelli C, et al. S2k‐guideline for therapy of acne. J Dtsch Dermatol Ges. 2010;8(Suppl 2):s1‐s59.
Crowther JM. Method for quantification of oils and sebum levels on skin using the Sebumeter(®). Int J Cosmet Sci. 2016;38:210‐216.
Haftenberger M, Heuer T, Heidemann C, Kube F, Krems C, Mensink GBM. Relative validation of a food frequency questionnaire for national health and nutrition monitoring. Nutr J. 2010;9:36.
Gose M, Krems C, Heuer T, Hoffmann I. Trends in food consumption and nutrient intake in Germany between 2006 and 2012: results of the German National Nutrition Monitoring (NEMONIT). Br J Nutr. 2016;115:1498‐1507.
Finlay AY, Khan GK. Dermatology Life Quality Index (DLQI)–a simple practical measure for routine clinical use. Clin Exp Dermatol. 1994;19:210‐216.
Thuppal SV, von Schacky C, Harris WS, et al. Discrepancy between knowledge and perceptions of dietary Omega‐3 fatty acid intake compared with the Omega‐3 index. Nutrients. 2017;9:930.
Nast A, Dréno B, Bettoli V, et al. European evidence‐based (S3) guideline for the treatment of acne – update 2016 – short version. J Eur Acad Dermatol Venereol. 2016;30:1261‐1268.
Svoboda SA, Christopher M, Shields BE. Reexamining the role of diet in dermatology. Cutis. 2021;107:308‐314.
Molina‐Garcia M, Granger C, Trullas C, Puig S. Exposome and skin: Part 1. Bibliometric analysis and review of the impact of exposome approaches on dermatology. Dermatol Ther (Heidelb). 2022;12:345‐359.
Fontes JD, Rahman F, Lacey S, et al. Red blood cell fatty acids and biomarkers of inflammation: a cross‐sectional study in a community‐based cohort. Atherosclerosis. 2015;240:431‐436.
Block RC, Dier U, Artero PC, et al. The effects of EPA+DHA and aspirin on inflammatory cytokines and angiogenesis factors. World J Cardiovasc Dis. 2012;2:14‐19.
Al‐Shahed FAN, Shoeb HH, El‐Shawwa MM. Effect of isotretinoin (Netlook) on the testis of adult male albino rats and the role of omega 3 supplementation: a histological and biochemical study. J Cell Mol Med. 2022;26:5213‐5221.
Gellert S, Schuchardt JP, Hahn A. Low long chain omega‐3 fatty acid status in middle‐aged women. Prostaglandins Leukot Essent Fatty Acids. 2017;117:54‐59.
Wolkenstein P, Machovcová A, Szepietowski JC, Tennstedt D, Veraldi S, Delarue A. Acne prevalence and associations with lifestyle: a cross‐sectional online survey of adolescents/young adults in 7 European countries. J Eur Acad Dermatol Venereol. 2018;32:298‐306.
Nguyen QG, Markus R, Katta R. Diet and acne: an exploratory survey study of patient beliefs. Dermatol Pract Concept. 2016;6:21‐27.
Kostecka M, Kostecka J, Szwed‐Gulaga O, Jackowska I, Kostecka‐Jarecka J. The impact of common acne on the well‐being of young people aged 15‐35 years and the influence of nutrition knowledge and diet on acne development. Nutrients. 2022;14:5293.