Fish oil plus low-dose isotretinoin shows promise as acne vulgaris therapy

The combination of fish oil supplementation and low-dose isotretinoin demonstrates noninferiority to isotretinoin monotherapy and keeps the skin hydrated in patients with moderate-to-severe acne vulgaris, reports a study. The combined treatment also helps control triglyceride levels.

This randomized, double-masked, controlled, noninferiority trial compared the efficacy and safety of low-dose isotretinoin plus fish oil with low-dose isotretinoin monotherapy in moderate-to-severe acne. Eighty participants aged 18 to 25 years with an acne Investigator's Global Assessment (IGA) score ≥3 received either isotretinoin 10 mg with fish oil 1 g (n=40) or placebo (n=40) once daily for 3 months.

The authors then assessed the following outcomes: acne counts, IGA scores, skin biophysics, mucocutaneous adverse effects, serum triglyceride, and liver transaminases.

Fish oil plus low-dose isotretinoin was noninferior to placebo in reducing total acne counts from baseline (between-group mean difference, ‒6.0, 95 percent confidence interval, ‒16.5 to 4.5). Likewise, fish oil use led to smaller decreases in corneometer values and smaller increases in triglyceride levels.

The study was limited by the use of IGA-based inclusion criteria, which may have influenced the noninferiority analyses, and the 3- month duration, which limits long-term interpretation.

“Isotretinoin is a treatment for moderate-to-severe acne, but it is limited by side effects,” the authors said. “Fish oil may reduce these side effects, [but] its impact on the clinical efficacy and safety of low-dose isotretinoin in the treatment of acne vulgaris has not been [previously] evaluated.”