Summary
Acne is an inflammatory condition that, most often on the facial skin, results in irritating and painful rashes, pimples or cysts. This negatively impacts affected individuals’ quality of life and can be very hard to treat in some cases. Observational and interventional studies have shown that the anti-inflammatory properties of Omega-3 fatty acids such as DHA and EPA can have a positive impact in the context of acne treatment.
 
Introduction
Acne is a prevalent skin condition that affects millions worldwide, characterized by the formation of comedones, pustules, and cysts. Our skin contains sebaceous glands that produce a fluid called sebum, which helps to protect and lubricate our skin. In acne, overactivity of sebaceous glands (that is often a result of hormonal fluctuations), as well as blockage of the glands, create the perfect conditions for bacterial colonization. This results in inflammatory reactions on the skin, leading to the formation of comedones (blackheads and whiteheads) papules, pustules and nodules.

Acne typically arises during puberty but can persist into adulthood, impacting physical appearance and psychological well-being. Most people have experienced these symptoms to varying degrees during adolescence, though acne can persist many decades into adulthood. Of the several acne sub-forms that exist, the most well-known form is perhaps acne vulgaris, a general description for acne with comedones, papules, pustules and sometimes cysts. Other common forms are acne comedonica (mildly inflammatory, mainly associated with presentation of comedones) and acne papulopustosa (a more inflammatory type of acne, associated with papules and pustules that are often red and painful).

The management of acne has evolved over the years, incorporating various treatment modalities including topical and systemic therapies. Recent research has also highlighted the potential benefits of dietary interventions, particularly the role of Omega-3 fatty acid docosahexaenoic acid. DHA is believed to exert its effects through its anti-inflammatory properties, which are crucial in addressing the inflammatory nature of acne lesions. Studies highlighted below indicate that a significant relationship is at play between acne and Omega-3 fatty acids, suggesting that DHA may play a positive role in the context of acne.
 
Research findings
In a mendelian randomization study, Kim and colleagues used a data from a biobank to investigate the relationship between genetic indicators of DHA levels and risk of acne (Kim et al. 2025). With a large enough sample size, data of presence of certain genetic variants in study participants can be bona fide indicators of specific Omega-3 and 6 levels in a population, which Kim and colleagues used to establish an interaction effect between DHA and acne. Using genetic and dermatological data from a total of almost half a million individuals, they found that people with genetic variants associated with higher total levels of DHA and its percentage to total fatty acid levels showed a decreased risk of acne. In contrast, people with genetically predicted higher levels of the Omega-6 fatty acid Linoleic acid showed an increased risk of acne. Further statistical analysis found that these causal links were independent of the body mass index. 

Jung and fellow scientists set up a double-blind randomized intervention study to investigate the effect of EPA & DHA, or gamma-linoleic acid on the symptoms of study participants with acne (Jung et al. 2014). Many Omega-6 acids such as linoleic acid are associated with pro-inflammatory reactions. Yet, the Omega-6 fatty acid gamma-linoleic acid specifically has anti-inflammatory properties. For a period of 10 weeks, participants received either no supplementation (the control group), or daily 1g of EPA and 1g of DHA, or daily 0.4g of gamma-linoleic acid. After this period, it was found that both the inflammatory and non-inflammatory acne lesions decreased in the intervention groups compared to the control group. This effect was confirmed by subjective assessments by the study participants themselves. Further analysis of the lesions showed that the acne lesions in the interventions groups had lower levels of interleukin-8, a pro-inflammatory factor. This study therefore showed the positive effects of certain Omega fatty acids, including DHA, in the context of acne.

In 2024, a research group led by Dr. Reinholz published a study on the deficit of Omega-3 fatty acids that is prevalent in acne patients (Guertler, Fiedler, et al. 2024). The same research group set up set up an interventionist study to research the effects of algae-derived DHA and EPA supplementation in 23 acne comedonica and 37 acne papulopustulosa patients (Guertler, Neu, et al. 2024). During the supplementation period of 16 weeks, study participants received 0.6g DHA & 0.3g EPA daily for the first 8 weeks and 0.8g DHA & 0.4g EPA daily for the last 8 weeks. In accordance with their previous study, 98% of study participants had a deficit of EPA and DHA at the start of the study. Of this 98%, 68% had a deficit and 30% had a severe deficit. At the 18 week timepoint, the percentage of participants with a severe deficit dropped from 30% to 2%, the percentage of participants with a deficit dropped from 68% to 34%. Accordingly, the percentage of participants with no EPA and DHA deficit increased from 2% at baseline to 62.3% at the end of the supplementation period. Most importantly, the authors reported that the number of inflammatory and non-inflammatory acne lesions decreased significantly after the supplementation period. In accordance with this, the quality of life was increased, as measured by the Dermatology Life Quality Index that assesses the impact of acne on quality of life and psychological stressors.
 
Conclusion
Acne is one of the most prevalent skin conditions that can negatively affect quality of life via altered aesthetics, as well as pain and irritation. In this condition, the sebum glands are often affected by inflammation in varying degrees, majorly contributing to the pathophysiology of many different kinds of acne. Studies have shown that low levels of DHA are associated with an increased risk of acne, which may come to no surprise due to the anti-inflammatory properties of DHA. Correspondingly, interventionist studies have shown that supplementation with DHA and EPA can decrease markers of inflammation associated with acne, reduce acne severity and improve quality of life. Persons with acne may therefore consider these Omega-3 fatty acids as adjunctive treatment options in their diet.
 
References
Guertler, Anne, Tobias Fiedler, Diana Lill, Anne-Charlotte Kuna, Arina Volsky, Jens Wallmichrath, Till Kämmerer, Lars E. French, and Markus Reinholz. 2024. ‘Deficit of Omega-3 Fatty Acids in Acne Patients—A Cross-Sectional Pilot Study in a German Cohort’. Life 14(4):519. doi: 10.3390/life14040519.

Guertler, Anne, Katharina Neu, Diana Lill, Benjamin Clanner-Engelshofen, Lars E. French, and Markus Reinholz. 2024. ‘Exploring the Potential of Omega-3 Fatty Acids in Acne Patients: A Prospective Intervention Study’. Journal of Cosmetic Dermatology. doi: 10.1111/jocd.16434.

Jung, Jae Yoon, Hyuck Hoon Kwon, Jong Soo Hong, Ji Young Yoon, Mi Sun Park, Mi Young Jang, and Dae Hun Suh. 2014. ‘Effect of Dietary Supplementation with Omega-3 Fatty Acid and Gamma-Linolenic Acid on Acne Vulgaris: A Randomised, Double-Blind, Controlled Trial’. Acta Dermato-Venereologica 94(5):521–25. doi: 10.2340/00015555-1802.

Kim, Bo Ri, Gahyun Kim, Seon-Pil Jin, Chong Won Choi, Jinho Kim, and Hyunsun Park. 2025. ‘The Causal Association between Polyunsaturated Fatty Acids and Acne: A Two-Sample Mendelian Randomization Study’. British Journal of Dermatology ljaf052. doi: 10.1093/bjd/ljaf052.