What Works Skin — Independent · Evidence-First · Ad-FreeIssue 014 · 20 April 2026 · Next: 04 Maywhatworksskin.com
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Supplement · Barrier & inflammation · Omega-3

P. 17 · BRIEF

Omega-3.

Inflammation baseline. Real and slow.

The most-evidenced anti-inflammatory supplement in dermatology. Useful adjunct in inflammatory acne, atopic dermatitis, and rosacea — and a defensible foundational supplement for the same broader-health reasons. Slow timelines; modest individual effect; cumulative payoff.

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— § 02

What the literature shows.

Inflammatory acne adjunct
Multiple RCTs, 2 g EPA+DHA/d

Modest reduction in inflammatory lesion count over 10–12 weeks. Useful alongside topicals.

65%
Atopic dermatitis severity
Mixed RCTs

Symptomatic improvement in itch and flare frequency. The fish-oil literature here is older; the algae-oil work is newer.

55%
Photoprotection (acute UV)
Small mechanistic studies

Reduces UV-induced inflammation and erythema. Adjunct, not sunscreen replacement.

50%
General inflammation markers (CRP)
Replicated

Strong, replicated effect on systemic inflammation biomarkers. Indirect skin benefit.

75%
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— § 03

Forms and bioavailability.

Fish oil 1000 mg (300 mg EPA+DHA)

Absorption · Good

Standard. Take 2–3 capsules daily with food to reach 1–2 g EPA+DHA target.

Concentrated EPA+DHA 1000 mg

Absorption · Good

60–80% EPA+DHA per capsule. Premium pricing; fewer capsules per day.

Algae-derived omega-3

Absorption · Good

Vegetarian / vegan source. EPA+DHA equivalent; sustainable; no fishy aftertaste.

Krill oil

Absorption · Better

Phospholipid-bound omega-3; absorbs slightly better at lower doses. Premium pricing.

Flaxseed / chia (ALA)

Absorption · Poor

ALA conversion to EPA/DHA is <10% in humans. Not a substitute.

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Bottom line

A defensible foundational supplement for inflammatory skin presentations. Slow, modest, cumulative — exactly the unsexy profile the marketing dislikes and the literature supports.

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— § 04

Frequently asked.

How much EPA+DHA do I need?

1–2 g/d combined for skin and inflammation endpoints. The American Heart Association cardioprotective dose (1 g/d) is in the same range. Most over-the-counter fish oil capsules contain 300 mg combined per 1000 mg total — read the label carefully.

How long until effect?

10–12 weeks at minimum for inflammatory skin endpoints. CRP shifts can be measured by week 6. Patients who quit at week 4 because 'nothing has changed' are quitting before the published timelines.

Will it interact with anticoagulants?

At doses ≥3 g/d combined EPA+DHA, mild antiplatelet effect is real. Discuss with your clinician if you take warfarin, DOACs, or daily aspirin. Most skin-dose protocols (1–2 g/d) sit safely below the threshold.

Why fish oil over flaxseed?

ALA (the omega-3 in flax and chia) converts to EPA and DHA at <10% efficiency. To reach 1 g of EPA+DHA via flax, you would need to consume an unrealistic dietary volume. Fish oil or algae-derived oil are the practical routes.