To get rid of your acne, you may have tried spot treatments, blackhead streaks, salicylic acid face washes, prescription retinoids, home scrubs, and more. You might even dab toothpaste on a pimple once. And if pimples continue to plague you, you’re still looking for the Acne Treatment X-Factor that finally does the job. And that’s why you may have Googled the option of using fish oil for acne.
When it comes to fish oil, there are two ways to get it: by consuming fish, especially oily fish like salmon and mackerel, or by taking a fish oil supplement. Both contain omega-3 fatty acids, which are polyunsaturated fatty acids. Fish oil supplements in particular contain two omega-3 fatty acids called eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), according to the National Center for Complementary and Integrative Health (NCCIH). (Fish contains DHA and EPA, as well as other omega-3 fatty acids such as docosapentaenoic acid.)
While many people take fish oil to get the reported heart and brain benefits, the NCCIH does not currently recommend taking fish oil or omega-3 supplements. Instead, the agency recommends eating at least 8 ounces (oz) of seafood per week.
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Whether fish oil is good for your face – and specifically fighting blemishes – requires an understanding of what causes acne. “We think acne usually has three main causes,” said S. Tyler Hollmig, MD, director of dermatological surgery and director of laser and cosmetic dermatology at the University of Texas at Austin. As he explains:
- The pores clog (often because the outer layer of skin cells isn’t falling off as quickly as it should).
- There is an overgrowth of bacteria from clogged pores and excess oil.
- Inflammation, a reaction to clogged pores and bacteria, leads to red, painful pimples.
“Inflammation is the body’s natural mechanism to deal with anything it doesn’t like, including bacterial overgrowth and the build-up of dead skin cells in a pore. This is what causes certain types of acne to turn red, raised, tender, and juicy, ”says Dr. Hollmig.
CONNECTED: What your breakouts are telling you about your acne
Omega-3 fatty acids have anti-inflammatory properties. “Omega-3s work primarily by blocking the arachidonic acid pathway that causes inflammation,” said Jason Miller, MD, a dermatologist with the Schweiger Dermatology Group in Freehold, New Jersey, who supports previous research. “There may also be evidence that omega-3s can regulate testosterone, a hormone that has been linked to acne flare-ups.”
People with acne may have lower levels of omega-3 EPA in their blood and higher levels of inflammatory markers compared to a control group, suggesting that people with acne can exist “in the presence of an inflammatory condition,” a small study published in the concluded January 2017 in Prostaglandins & Other Lipid Mediators. The researchers ultimately suggest that omega-3 fatty acids as supplements may be helpful in stopping acne before it starts, but more study is needed before dermatologists can recommend them as a means of preventing acne.
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For healthy skin, eating fish is better than taking nutritional supplements
Fish oil could theoretically help reduce inflammatory acne – that is, acne that is red, angry, and painful, says Hollmig. Even so, it is not guaranteed. “This has been studied, though probably not enough to make specific recommendations.”
Hollmig points to a small, earlier study that followed 13 people with inflammatory acne for three months. The severity of acne decreased in eight people but worsened in four. Interestingly, these four had mild acne, while the eight who improved from fish oil entered the study with moderate to severe acne. The researchers note that people who benefit from taking fish oil may be those who have more severe acne. However, this study was very small and of short duration. In addition, there was no placebo group, which is important in determining the effectiveness and outcome of a study group.
For a later randomized, double-blind, controlled study, the researchers had two groups take either an omega-3 fatty acid or a control oil for 10 weeks. The omega-3 group saw reductions in both inflammatory and non-inflammatory acne – but so did the control group.
That said, eating fish may be your best bet – provided you eat fish. Previous research on an Italian population found that eating fish at least once a week reduced the risk of developing moderate to severe acne by 32 percent compared to those who avoided seafood. Another study published in Acta Medica Marisiensis in January 2016 also found that people who ate fish were less likely to have acne. Specifically, more than 40 percent of people with acne never ate fish and three-quarters “rarely or never” ate fruits or vegetables, suggesting that a healthy seafood (and many products) diet is key here.
Overall, the quality of your diet can be more important than just adding a fish oil supplement to your existing habits. “Some studies show that a ‘Western diet’ [typically higher in ‘inflammatory’ processed foods, sugar, and red meat] leads to an increase in acne, while populations who eat a “non-western” diet of lean meat, seafood, vegetables and fruits have fewer outbreaks, ”says Dr. Miller. If you prefer not to eat fish or take a fish oil supplement, focus on eating more foods that contain alpha-linolenic acid (AHA), a plant-based omega-3 that according to flaxseed, soybean, Chia seeds and walnuts are found in the NCCIH.
CONNECTED: 7 of the best sources of omega-3 fatty acids
6 things you should know when treating acne
1. Identify your acne in order to find the right therapy
Are your pimples red and tender? Do you have a pustule in the middle? It can be hormonal acne. On the other hand, do you have mostly blackheads and whiteheads? Well, that’s comedone acne, says Hollmig. Both are treated differently.
2. Treat comedones with exfoliating acids
Glycolic acid and retinoids exfoliate the skin and normalize cell turnover. Products containing these ingredients are Hollmig’s first choice for this type of acne.
3. Treat hormonal acne with an Rx
If you are a woman between 20 and 40 and have acne around the jaw, it is likely that your acne is hormonal. In that case, a prescription drug used to treat hormones or one that reduces sebum (oil) production may be fine, Miller says. Talk to your doctor about whether your hormones might be fueling your breakouts.
4. Cut down on processed foods to reduce inflammation
There are many reasons to cut back on added sugar, including improving heart health, as Harvard University notes. But a diet high in whole plant-based foods can also be a boon to your skin health. “We know that a high-sugar diet makes acne worse, so it is beneficial for many acne sufferers to simply eat healthier,” says Hollmig. Eating a low glycemic diet of vegetables, fruits, beans, and especially oats can help improve acne, notes the American Academy of Dermatology (AAD).
Another good skin diet: Mediterranean, which contains fish, but also vegetables, whole grains, fruits and olive oil. A review published in the International Journal of Molecular Sciences in February 2020 recommends a Mediterranean diet for an ideal balance between omega-3 and omega-6 fatty acids that support optimal skin health. (Researchers note that in some cases, omega-3 supplementation may be beneficial, but this is determined on a case-by-case basis between the patient and the doctor.)
CONNECTED: A detailed guide to following an anti-inflammatory diet
5. Use fewer products
With how stubborn acne can be, it makes sense that you might want to toss all of the acne-fighting topicals and supplements on the problem to make it worse, but that can be too much. Even when it comes to acne, “it’s generally the way to go to simplify skin care and save money,” says Hollmig.
6. Look at your overall health
Your diet and the topical products you apply to your skin are only two pieces of the puzzle when it comes to acne. “There are several factors that can contribute to your outbreaks,” Miller says. “If what you’re doing doesn’t help, schedule a visit to your dermatologist to see if anything else – stress, the environment, hormones, medication – is causing your acne.”
Conclusion: does fish oil help with acne?
Taking a fish oil supplement may not be a cure for acne. “A healthy, balanced diet is usually sufficient for most people, so it is probably worth discussing the potential benefits of nutritional supplements with your doctor,” says Hollmig. If you end up taking one, even to try it, adjust your expectations, he adds, “Rarely is a single dietary supplement a panacea when it comes to skin health.”