Atopic Dermatitis / Eczema

Some unfortunate persons are not able to convert essential fatty acids (EFA’s) from their parent forms to their more active metabolites, such as converting linoleic acid, the primary omega-6, to gamma-linolenic acid (GLA). More than twenty years of research points to the inefficiency of this active conversion pathway as causative of inflammatory skin conditions. Wherever and whenever a metabolite cannot be made by the body on its own, administration of that substance may be in order.

At the start of the twenty-first century, research scientist David Horrobin described a positive relationship between evening primrose oil as a source of pre-formed GLA and the improvement in symptoms of atopic dermatitis, namely eczema.  He relates that, “In most but not all studies, administration of GLA has been found to improve the clinically assessed skin condition, the objectively assessed skin roughness, and the elevated blood catecholamine concentrations of patients with atopic eczema.”  Understandably, the condition may be ascribed a hereditary genesis.  (Horrobin. 2000)

When one of the crowd upsets the apple cart he becomes noticed because of the chaos he spawned.  David Horrobin is such a person.  He was responsible for opening the eyes of the research community to the potential of complementary and alternative medicine in the treatment of fatty acid deficiency conditions, including inflammatory skin conditions, schizophrenia, rheumatoid arthritis, and diabetes, to name but a few.  Horrobin—and others after him— discovered that metabolic inefficiency in the conversion of linoleic acid to gamma-linolenic acid (GLA) might be responsible for inflammatory skin responses that present as eczema, despite the presence of adequate linoleic acid in blood and adipose tissue.  (Dobryniewski. 2007. p. 100)

It is such that omega-6 and omega-3 fatty acids compete for the enzymes that transform them into super hero molecules known to control the inflammation activities that promote health. The omega-3 fatty acids prevail at the expense of the omega-6s, leading to a deficit of omega-6 metabolites and their benefits.  Therefore, it makes sense to overcome deficiencies by administering these metabolites directly, as in the oral and/or topical use of evening primrose oil (EPO), an omega-6 fatty acid accepted for its GLA content.  Horrobin’s desire to herald the attributes of GLA spread to the European continent, where scientists from Poland agreed that GLA is one of the most frequently deficient fatty acids, and that supplementation brings hopeful effects in the treatment of eczema and other conditions.  (Horrobin. 1993)  (Dobryniewski. 2007. p. 91)

There are predisposing factors in acute or chronic skin disease, including family history of allergic disorders and sensitivity to contact allergens or to certain foods.  Chronic disease is difficult to treat.  Itching causes scratching, which increases inflammation, which causes itching … The cycle is hard to break.  But evening primrose oil (EPO), with a history of efficacy that predates Dr. Horribin’s interest, has produced “…significant clinical improvement on atopic eczema.” (Ebden. 1989)  In meta analyses conducted in the late 1980’s, the British Journal of Dermatology recounted significant improvement in eczema symptoms using a commercial EPO product called Epogam (the name seemingly gleaned from EPO and GLA), after which use, “ The effects on itch were particularly striking.” (Morse.1989).

BodyBio evening Primrose Oil contains ten percent GLA and a sufficient amount of its precursor, linoleic acid, to help the body make the molecules that inhibit the pro-inflammatory series 2 prostaglandins and series 4 leukotrienes.  There is a distinct correlation between improvements in clinical scoring devices and an elevation of fatty acid levels.  Compared to placebo, children treated with EPO significantly improved the symptoms of atopic eczema.  (Bordoni. 1988)

Horrobin DF. Essential fatty acid metabolism and its modification in atopic eczema. Am J Clin Nutr. 2000 Jan;71(1 Suppl):367S-72S.

Dobryniewski J, Szajda SD, Waszkiewicz N, Zwierz K. The gamma-linolenic acid (GLA)--the therapeutic value. 

Horrobin DF. Fatty acid metabolism in health and disease: the role of delta-6-desaturase. Am J Clin Nutr. 1993 May;57(5 Suppl):732S-736S; discussion 736S-737S.

Dobryniewski J, Szajda SD, Waszkiewicz N, Zwierz K. Biology of essential fatty acids (EFA).

Ebden P, Bevan C, Banks J, Fennerty A, Walters EH. A study of evening primrose seed oil in atopic asthma. Prostaglandins Leukot Essent Fatty Acids. 1989 Feb;35(2):69-72.

P.F. MORSE, D.F. HORROBIN,, M.S. MANKU, J.C.M. STEWART, R. ALLEN, et al Meta-analysis of placebo-controlled studies of the efficacy of Epogam in the treatment of atopic eczema. Relationship between plasma essential fatty acid changes and clinical response British Journal of Dermatology. Volume 121, Issue 1, pages 75–90, July 1989

Bordoni A, Biagi PL, Masi M, Ricci G, Fanelli C, Patrizi A, Ceccolini E. Evening primrose oil (Efamol) in the treatment of children with atopic eczema. Drugs Exp Clin Res. 1988;14(4):291-7.