Fish Oils in the Treatment of Atopic Dermatitis

Atopic Dermatitis (AD), more commonly referred to as eczema, is a chronic relapsing inflammatory skin condition. Contributing factors include genetics, immunological reactions and environmental triggers.

Given that AD is an inflammatory condition, there are several anti-inflammatories, both topical and oral, have been indicated for the treatment of AD.

The prevalence of inflammation in today’s society has be linked to the modern diet promoting a state of chronic inflammation. Researchers have demonstrated that the progression of the human diet from hunter-gatherer to agricultural, to industrial and eventually fast food is directly linked to a decrease in the omega-6 to omega-3 fatty acid ratio. This in turn has decreased our ability to reduce oxidative stress and increased our glycemic index, leading to chronic inflammation and autoimmunity.

Omega-3 polyunsaturated fatty acids (PUFA) have also been widely studied for their anti-inflammatory properties. The mechanism underlying the anti-inflammatory actions of omega-3 fatty acids includes inhibiting the activation of the pro-inflammatory markers.

Omega-3 fatty acids are essential fatty acids, meaning they must be acquired from food sources as the body is unable to make them on its own. Omega-3 fatty acids include ALA (alpha-linoleic acid), EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). The main food source of EPA and DHA is fish such as anchovies, herring, mackerel, salmon and sardines. While sources of ALA mainly include flaxseed oil and soybeans.

Omega-3 fatty acids have been vastly used in conditions such as high cholesterol, heart disease, rheumatoid arthritis, osteoporosis and depression to name a few.

Given the anti-inflammatory indications of omega-3 fatty acids their clinical use in the treatment of Atopic Dermatitis has been shown to be beneficial in some cases.  Additionally, some studies have been done on the effects of fatty acids in breast milk demonstrating a protective role of omega-3 PUFAs in the development of atopic disease in infants.

References:

Calder PC. Omega-3 polyunsaturated fatty acids and inflammatory processes: nutrition or pharmacology. Br J Clin Pharmacol. 2013 Mar;75(3):645-62.

Thijs C, Muller A, Rist L, et al. Fatty acids in breast milk and development of atopic eczema and allergic sensitisation in infancy. Allergy. 2011 Jan;66(1):58-67.

Maes M, Christophe A, Bosmans E, Lin AH, Neels H. In humans, serum polyunsaturated fatty acid levels predict the response of proinflammatory cytokines to psychologic stress. Biol. Psychiatry. 2000;47:910–920.

Hallahan B, Garland MR. Essential fatty acids and mental health. Br. J. Psychiatry. 2005;186:275–277.