Topical fish oil in psoriasis-a controlled and blind study

Abstract

Omega-3 polyunsaturated fatty acids compete with arachidonic acid as substrates for lipoperoxidases, which transform them into leukotrienes with low biological activity. As this process, in skin, may benefit psoriatic patients, a randomized controlled single blind-study was carried out on a sample of 25 patients. In the study fish oil (FO) was compared with liquid paraffin (LP); both were topically applied and administered daily for 6 h under an occlusive dressing over a 4-week period. Evaluations were performed weekly assessing erythema, scaling, plaque thickness (induration) and itching. The results showed statistically significant improvement in erythema and scaling for both treatments compared to basal values; significant differences between treatments were achieved in scaling but not in erythema. Compared to baseline, FO significantly improved plaque thickness while LP did not. After 4 weeks, FO proved to be significantly better than LP. All patients accepted the treatment despite its unpleasant smell. Irritation and a burning sensation were reported in the FO treated plaque of one patient. This adverse effect reverted after completing the treatment. These findings demonstrate that topical FO shows a better performance than LP under an occlusive dressing.

Clinical evaluation of omega-3 fatty acids in psoriasis

“…Jedno z takich badań, z podwójnie ślepą próbą i grupą kontrolną placebo, przeprowadzili Escobar i wsp. [12], jednak nie uzyskali poprawy w stosunku do placebo [34]. Bezpieczeństwo stosowania kwasów omega-3 jest powszechnie uznane i w żadnym z badań nie stwierdzono ciężkich działań niepożądanych.…”

“…Intravenous infusions of fish oils have been shown to decrease erythema, scaling and induration in patients in a few studies [14,15]. Topical fish oil application has been found to be efficacious in a few trials, such as that conducted by Escobar et al [12], but no improvement over placebo was seen in a double-blind placebo-controlled study [34]. The safety of omega-3 fatty acids is well established and no serious side effects have been found in any studies.…”

Enhanced topical delivery and ex vivo anti-inflammatory activity from a betamethasone dipropionate formulation containing fish oil

“…Topical application of EPA can result in its incorporation into cell membranes, where it subsequently competes with AA in the inflammation cascade [13]. Trials using fish oil [14] and EPA [15,16] have shown that EPA could be beneficial in alleviating symptoms related to psoriasis, although no direct evidence was provided to prove its successful delivery to the viable epidermis [17]. In addition to its anti-inflammatory activity, EPA has also been established to act as a permeation enhancer in formulations containing fish oil and NSAIDs, where the amount of NSAID and EPA from the fish oil delivered to the skin was increased compared to fish oil or NSAIDs alone [18,19].…”

n-3 polyunsaturated fatty acids supplementation in psoriasis: a review

“…Escobar et al [25] treated 25 patients with plaque psoriasis, applying topical fish oil (containing 15.8% EPA and 10.1% DHA) or liquid paraffin under an occlusive dressing daily for 4 weeks. Significant decreases in scale score and thickness were found in the fish oil treated group compared with control.…”