Why essential fatty acids are vital for skin health

Essential fatty acids first became exposed for their role in achieving optimal skin health almost 100 years ago in 19291. The experimental scientists, Burr and Burr followed the effects of a diet devoid in fats and found that in this instance, skin became dry and scaly. When diet was subsequently corrected with essential fatty acids, skin symptoms lessened and in some cases completely reversed.
The past 3 decades of fat-free diets and fat reduced foods have proven a great trial for the quest towards healthy, youthful skin.
…but not all fats are equal. Not all fats have the same healthy skin effects and simply increasing your consumption of one essential fatty acid does not guarantee an individuals improved skin health. Balance is key.
What is an essential fatty acid?
Essential fatty acids are a type of fatty acid the body cannot create itself. The human body contains many enzymes which allow it to manufacture fatty acids and antioxidants from food sources that do not contain them i.e. rather than these nutrients having to be consumed directly, in times of scarcity, the body can manufacture them from alternate building blocks. However in the case of essential nutrients or essential fatty acids, the body lacks the needed enzymes to manufacture these ingredients from alternative food sources, therefore needing to be supplied a consistent and steady dietary stream. There are two families of essential fatty acids;- Omega 3 fatty acids (eaten as alpha-linolenic acid)
- Omega 6 fatty acids (eaten as linoleic acid)
The role of fatty acids in skin
When skin has an adequate supply and balance of essential fatty acids, it’s able to perform optimally in several ways; Essential fatty acids maintain the stratum corneum permeability barrier The top layers of skin are designed to form a barrier which locks in hydration and locks out irritants, allergens and bacteria. Essential fatty acids play a crucial role in this process3. Skin’s permeability barrier is formed by a brick wall structure of dead skin cells locked together with lipid glue – a natural mixture of fatty acids, ceramides and cholesterol. Fatty acids make up a 15% portion of this mixture4. Essential fatty acids serve as building blocks for the synthesis of complex lipids5 Ceramides are crucial to the maintenance of the skin’s barrier function, accounting for over 50% concentration in the lipid glue maintaining it. Linoleic acid and its breakdown products are required for the synthesis of stratum corneum ceramides6. Essential fatty acids help to maintain epidermal homeostasis The epidermis, the first of 3 layers of skin (followed by the dermis and hypodermis) is in a constant state of renewal – a cycle lasting on average 30 days. Skin, similarly to hair and nails, is consistently being grown, matured and shed. Essential fatty acids help to regulate this 30 day cycle. When skin cells mature they evolve from cells called keretinocytes into corneocytes – the technically dead skin cells responsible for forming an effective skin barrier. This differentiation process is one of many regulated in part by essential fatty acids7. Essential fatty acids contribute towards maintenance of skins acid mantle Upon the top layer of the epidermis rests a thin film referred to as skins acid mantle. The acid mantle describes a biological mixture of sweat and sebum with a pH between 4.2-5.68. This acidification assures skin is shielded against bacterial proliferation and therefore infection. At pH levels in excess of 5.6 pathogenic strains of bacteria are able to colonize skin. Essential fatty acids can be processed into free fatty acids which help maintain the acidification of skins acid mantle9.Omega 3 vs. Omega 6
Although originally thought of as having similar effects, omega 3 and 6 essential fatty acids are now known to have very different benefits. Omega 3 essential fatty acids consumed in the diet as linolenic fatty acids act as immune modulators. They may exert anti-inflammatory effects helping to treat inflammatory skin conditions such as acne and eczema. Omega 3 fatty acids are most prolific in the western diet through foods such as;- Fatty fish e.g. salmon, tuna and mackerel
- Nuts e.g. walnuts
- Chia, hemp and flaxseeds>
- Egg yolks
- Vegetable oils e.g. sunflower
- Poultry e.g. pork and chicken
- Nuts e.g. almonds and brazil nuts
- Dairy e.g. cheese and butter
The effect of EFA deficiency or imbalance on skin health
With improper essential fatty acid balance or essential fatty acid deficiency, skin experiences noticeably different metabolism cumulating in 3 marked changes;- Dryness/water loss
- Inflammation
- Hyperkeratosis
Essential fatty acid supplementation: Does it work?
If an individual is suffering from acne, atopic dermatitis, chronic dryness, psoriasis or a similar inflammatory skin condition, will supplementation with essential fatty acids help to alleviate the condition? Studies have previously shown that essential fatty acid deficiency causes dry, scaly skin, however large scale clinical trials are still required to substantiate the role of supplementation in cases of acne, atopic dermatitis and dry, dehydrated skin. What however has been shown is that;- Evening primrose oil supplementation can help relieve specific cases of atopic dermatitis
- Daily consumption of 4g evening primrose oil increases sunburn threshold17
- High doses of fish oil may help improve the symptoms of psoriasis
- Fish oil supplementation during pregnancy associated with decreased severity of atopic dermatitis
- Omega 3 supplementation may help improve inflammatory skin conditions such as acne23
- Burr GO, Burr MM. A new deficiency disease produced by the rigid exclusion of fat from the diet. J Biol Chem 1929;82:345-67.
- D. Khnykin, J.H.Miner, F. Jahnsen, Role of fatty acid transporters in epidermis: implications for health and disease, Dermatoendocrinology 3 (2011) 53–61.
- W.M. Holleran, Y. Takagi, Y. Uchida, Epidermal sphingolipids: metabolism, function, and roles in skin disorders, FEBS Lett. 580 (2006) 5456–5466.
- Wertz PW. Biochemistry of human stratum corneum lipids. In: Elias PM, Feingold KR, editors. Skin barrier. New York: Taylor & Francis; 2006. p. 33-42.
- M.E. Stewart, D.T. Downing, Chemistry and function ofmammalian sebaceous lipids, Adv. Lipid Res. 24 (1991) 263–301.
- Healing fats of the skin: the structural and immunologic roles of the omega-6 and omega-3 fatty acids. McCusker MM, Grant-Kels JM. Clin Dermatol. 2010 Jul-Aug;28(4):440-51. doi: 10.1016/j.clindermatol.2010.03.020.
- M. Schmuth, Y.J. Jiang, S. Dubrac, P.M. Elias, K.R. Feingold, Thematic review series: skin lipids. Peroxisome proliferator-activated receptors and liver X receptors in epidermal biology, J. Lipid Res. 49 (2008) 499–509.
- Blank HI, Measurement of pH of the skin surface. J lnvrsl Dermatol 1939;2:67-79.
- J.W. Fluhr, J. Kao, M. Jain, S.K. Ahn, K.R. Feingold, P.M. Elias, Generation of free fatty acids from phospholipids regulates stratum corneum acidification and integrity, J. Invest. Dermatol. 117 (2001) 44–51.
- Das UNA. Perinatal strategy for preventing adult diseases: the role of long-chain polyunsaturated fatty aids. Boston: Kluwer; 2002.
- Ollis TE, Meyer BJ, Howe PR. Australian food sources and intakes of omega-6 and omega-3 polyunsaturated fatty acids. Ann Nutr Metab 1999;43:346-55.
- Hansen HS, Jensen B. Essential function of linoleic acid esterified in acylglycosylceramide and acylceramide in maintaining the epidermal water permeability barrier. Evidence from feeding studies with oleate, linoleate, arachidonate, columbinate and alpha-linoleate. Biochim Biophys Acta 1985;834:357-63.
- Healing fats of the skin: the structural and immunologic roles of the omega-6 and omega-3 fatty acids. McCusker MM, Grant-Kels JM. Clin Dermatol. 2010 Jul-Aug;28(4):440-51. doi: 10.1016/j.clindermatol.2010.03.020.
- Picardo M, Ottaviani M, Camera E, Mastrofrancesco A. Sebaceous gland lipids. Dermato-endocrinology. 2009;1(2):68-71.
- Stewart MK, Stars JK. Strauss JS. Downing DT. Increased proportions of linoleale in human sebaceous lipids during treatment with 1 3 cis retinoic acid. Clin Res 1986: 34: 783s.
- Morse NL, Clough PM. A meta-analysis of randomized, placebocontrolled clinical trials of efamol evening primrose oil in atopic eczema. Where do we go from here in light of more recent discoveries. Curr Pharma Biotech 2006;7:503-24.
- Rhodes LE, Shahbakhti H, Azurdia RM, et al. Effect of eicosapentanoic acid an omega-3 polyunsaturated fatty acid, on UVR-related skin cancer risk in humans: An assessment of early genotoxic markers. Carcinogenesis 2003;24:919-25.
- Miller AB, Gaudette LA. Cancers of skin, bone, connective tissue, brain, eye, thyroid and other specified and unspecified sites in Inuit. Acta Oncol 1996;35:607-16.
- Mayser P, Mrowietz U, Arenberger P, et al. Omega-3 fatty acid-bsed lipid infusion in patients with chronic plaque psoriasis: Results of a double-blind, randomized, placebo-controlled, multicenter trial. J Am Acad Dermatol 1998;38:539-47.
- Balbás GM, Regaña MS, Millet PU. Study on the use of omega-3 fatty acids as a therapeutic supplement in treatment of psoriasis. Clinical, Cosmetic and Investigational Dermatology. 2011;4:73-77. doi:10.2147/CCID.S17220.
- Denburg J, Hatfield H, Cyr M, et al. Fish oil supplementation in pregnancy modifies neonatal progenitors at birth in infants at risk of atopy. Pediatr Res 2005;57:276-81.
- Elias SL, Innis SM. Infant plasma trans, n-6, and n-3 fatty acids and conjugated linoleic acids are related to maternal plasma fatty acids, length of gestation, and birth weight and length. Am J Clin Nutr, 2001;73:807-14.
- James M, Gibson RA, Cleland LG. Dietary polyunsaturated fatty acids and inflammatory mediator production. Am J Clin Nutr 2000; 71 (Suppl.): 343S –348S
- Khayef G, Young J, Burns-Whitmore B, Spalding T. Effects of fish oil supplementation on inflammatory acne. Lipids in Health and Disease. 2012;11:165. doi:10.1186/1476-511X-11-165.