Going back to the 1930s, some medical doctors who lived with the Canadian Inuits observed that the Inuits’ skin was unblemished and youthful. The first report was by Israel Rabinowitch, MD, DSc, of McGill University who spent months with the Inuit of Hudson Bay in 1935. Others, including Otto Schaefet, MD, who spent three decades treating the Inuit in Northwestern Canada, noted higher rates of acne and an assault to healthy skin as Western dietary influences encroached. Those dietary influences were the mountains of sugar, processed carbohydrates, and unhealthy fats we hauled into the Inuit pantries.
What Westerners removed from the Inuits was a traditional diet high in anti-inflammatory omega-3 fatty acids, as well as fiber and antioxidants. One skin-protecting component was far and away higher in the traditional diets of isolated communities — omega-3 fatty acids. As the research would later show, the anti-inflammatory properties of omega-3 fatty acids were the cornerstone of the skin-healthy, traditional Inuit diet. The story of cod-liver oil provides the link between the traditional Inuit diet and our modern-day knowledge of omega-3.
Cod-liver oil was introduced to the masses during the 1930s, when the scientific interest and commercial marketing surrounding the oil was based solely on its vitamin A and D content. The fact that cod-liver oil contained important omega-3 fatty acids was a non-issue for decades. In the late 1950s, researchers began reporting that oral cod-liver oil was working wonders for arthritis. Some European rheumatologists even reported anti-inflammatory benefit when they injected cod liver oil into the joints.
Around the same time, a small group of dermatologists were writing up cases of marked improvement in inflammatory skin conditions when specially prepared cod-liver oil ointments and lotions were applied to the skin. Despite the reported value, these lotions never really took off in the marketplace, likely because cod-liver oil has a distinct fishy smell (a delicate way of saying the liver oil reeks to the high heavens).
Still, these publications finally fueled researchers to think beyond vitamins A and D. As good as these vitamins are for skin, there had to be more to cod liver oil’s benefits. As scientists began to learn more about omega-3 fatty acids in the 1970s, researchers from the department of dermatology at Copenhagen’s famed Finsen Institute made an important observation. Niels Kiomann, MD, and colleagues reported that the Greenland Inuit had very low rates of psoriasis and other skin diseases. The Danish researchers also reported one major new finding: despite the same magnitude of UV exposure, the Greenland Inuit had rates of skin cancer that were far lower than would be expected for others in Northwest Europe. Could the omega-3 fatty acids be the UV-protecting factor? Investigations into the skin-specific anti-inflammatory and UV-protecting properties of omega-3 fatty acids would follow shortly thereafter.
The experimental and population studies started to show a cleat pattern— all polyunsaturated fatty acids could not be painted with the same brush. Fish oil, rich in eicosapentaenoic acid (EPA), an omega-3 fatty acid, was proving to be protective against UV-induced skin cancer. Chemical markers in the skin that ate known to be associated with high skin-cancer risk were ten times lower in animals fed fish oil versus those fed omega-6 corn oil. Supplementation with fish oil also proved to lower that age-inducing chemical feared by any living strand of collagen — yes, PGE2.
Even when animals were provided with just enough omega-6 linoleic acid to meet essential fatty acid requirements, researchers observed a threefold reduction in PGE2 levels when fish oil was added to the mix. Remember, the greater the omega-6 vegetable oil intake, the higher the PGE2 levels, unless they are held in check by fish oil. The epidemiological, or population studies, supported the initial observation of the Inuit—higher omega-3 intake and more fish and seafood in the diet go hand in hand with a significantly reduced risk of various skin cancers.
These experimental and population studies were interesting, yet we needed more. As the saying in science goes, correlation does not equal causation. In other words, associations are just that, associations. Until someone actually used fish oil in humans, the connection would remain speculative.
The folks from Baylor College of Medicine changed that with a publication in the Archives of Dermatological Research (1992). They reported that the oral administration of fish oil (2.8 grams of EPA daily) limited the influence of UV radiation in adults. The fish oil was estimated to provide an SPF of 1.15. While that might sound like a joke, an incredibly small number compared to that listed on your Coppertone bottle, a consistent daily SPF of 1.15 actually translates to a 30 percent reduction in the lifetime risk of skin cancer. For our purposes, since agents that reduce skin cancer are typically anti-aging for the skin, the finding showed the potential of fish oil for the maintenance of youthful skin.
Follow-up studies by other groups have also found that omega-3 fish-oil supplementation protects against UV-induced skin damage and keeps PGE2 in check. In addition, the more recent studies have answered a lingering question: do omega-3 fatty acids like EPA actually increase in skin tissue when orally supplemented? The answer is a clear yes; in fact, 4 grams of EPA taken orally for twelve weeks resulted in eightfold higher levels of EPA when human skin was subjected to biopsy.
New studies from the United Kingdom have shown that orally consumed fish oil may not only reduce the redness and skin cell damage that occurs with UV exposure, but also work to protect the delicate DNA within skin cells. There have been other equally exciting developments related to topically applied EPA in sun protection and collagen support; thankfully, new deodorization technology has succeeded in removing the fishy smell to allow for commercial use of topical EPA.