Investigating Atopic Dermatitis Prevention With Omega-3 Supplementation in Different Ethnic Populations

J Clin Aesthet Dermatol. 2026;19(9):36–37.

Amjad El Othmani, BS; Hailey Olds, MD; Hussein Bazzi, BS; Lina Shalaby, BS; and Meena Moossavi, MD, MPH

Mr. El Othmani, Mr. Bazzi, and Ms. Shalaby are with the Wayne State University School of Medicine, Detroit, Michigan. Drs. Olds and Moossavi are with the Department of Dermatology at the Wayne State University School of Medicine, Detroit, Michigan.

FUNDING: No funding was provided for this article.

DISCLOSURES: The authors have no relevant conflicts of interest.

Abstract: Atopic dermatitis (AD) is a chronic inflammatory skin disease affecting approximately 5% of adults and 13% of children worldwide. Individuals with skin of color (SOC) are disproportionately affected and often experience more severe disease manifestations, including pigmentary changes and lichenification. Despite these disparities, SOC populations remain underrepresented in AD research, limiting the development of targeted prevention strategies. Emerging evidence suggests that omega-3 polyunsaturated fatty acids may play a protective role in AD through anti-inflammatory effects and support of the epidermal lipid barrier. However, the potential benefits of omega-3 supplementation in SOC populations have not been specifically examined. Global studies demonstrate significant geographic variation in omega-3 blood levels, with lower levels observed in many regions that include large SOC populations, suggesting that dietary differences may contribute to inflammatory disease risk. In addition, genetic variation in fatty acid desaturase genes influences endogenous omega-3 metabolism and may vary across ethnic groups, potentially affecting susceptibility to AD and responses to supplementation. Together, these dietary and genetic factors highlight the importance of evaluating omega-3 fatty acids as a potential preventive strategy in SOC populations. Further research examining omega-3 intake, fatty acid metabolism, and AD outcomes in diverse populations is needed to better understand their role in disease prevention and to address existing disparities in dermatologic care. Keywords: Atopic dermatitis, atopic dermatitis prevention, omega-3, skin of color

Introduction

Atopic dermatitis (AD) is a chronic inflammatory skin condition that affects about 5% of adults and 13% of children worldwide.¹ Despite the prevalence of the disease, the initial events responsible for its development remain unknown, which complicates prevention and symptom management.¹ However, it likely involves a complex interplay between various factors, including genetic predisposition and environmental triggers.² AD affects individuals of all ages and ethnicities, although it may disproportionately impact certain ethnic groups, particularly in skin of color (SOC).² The American Academy of Dermatology defines SOC as skin types of individuals more richly pigmented than White skin, including Black, Asian, Hispanic, Native American, Pacific Islander, and people of Middle Eastern descent.³ AD is characterized by chronic, pruritic, scaly papules and plaques.² There is currently no cure, and treatment is geared toward managing symptoms and minimizing flares. Due to the physical and psychosocial challenges posed by AD, it is crucial to investigate methods of prevention.²

Individuals with darker skin are disproportionately affected by AD and tend to have more severe manifestations of the disease, such as hyperpigmentation, hypopigmentation, and lichenification, compared to lighter-skinned individuals.² Despite these challenges, SOC populations remain underrepresented in the literature, making it difficult to address their specific needs and further perpetuating disparities in disease treatment. Emerging research has highlighted the benefits of omega-3 supplementation in the treatment and prevention of AD in the general population.^1,2 Although many studies address these benefits in the literature, there are none to our knowledge that specifically examine these effects in patients with SOC. This is particularly important because certain factors such as dietary omega-3 consumption and fatty acid metabolism may vary substantially across cultures, which could further perpetuate differences in AD prevenance. Herein, we aim to explore the potential benefits of omega-3 fatty acid supplementation as preventive measures for AD in patients with SOC.

Multiple studies have shown that omega-3 polyunsaturated fatty acid supplementation exhibits the potential to prevent AD.^1,2 This is likely secondary to effects on the intercellular lipid matrix, which plays a role in preventing water loss and penetration of allergens and irritants into the skin.¹ Given the positive impact of omega-3 in AD prevention, it is also important to explore how certain populations may have differences in omega-3 metabolism and dietary source, thus impacting treatment outcomes and overall effects. For instance, a global survey conducted by Stark et al⁴ evaluated blood levels of 2 key omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), across healthy adult populations. The highest blood levels of omega-3 (≥8%) were found in regions with traditionally seafood-rich diets such as Japan, South Korea, Norway, and Greenland and in indigenous populations. Low levels (≤4%) were common in North America, Central/South America, most of Europe, the Middle East, Southeast Asia, and Africa.⁴ Many of these regions have a high proportion of patients with SOC. As a result, the regions with very low omega-3 blood levels may have a higher baseline inflammatory state, potentially exacerbating conditions like AD. Another study found that countries with the lowest omega-3 index coincide with populations that are predominantly individuals with SOC.⁵ Overall, patients susceptible to AD in these regions may benefit from omega-3 supplementation or dietary modification to improve skin symptoms, reduce inflammation, and prevent AD.

Although omega-3 supplementation has been shown to confer protective effects against AD by modulating inflammation, it is important to note that it is unlikely to be the sole determinant of AD risk.⁶ Epidemiologic data indicate that AD prevalence remains relatively high in certain East Asian populations, such as in China, Japan, and Korea, despite traditionally seafood-rich diets and correspondingly higher omega-3 blood levels.⁶ In particular, Suaini et al⁶ emphasized the multifactorial nature of AD, noting that East Asian individuals may exhibit distinct skin barrier characteristics, immunologic profiles, and environmental influences, such as climate and air pollution, that contribute to high rates of AD pathogenesis, independent of dietary omega-3 intake.⁶

In addition to cultural differences in omega-3 consumption, multiple studies have noted that omega-3 metabolism varies between ethnic groups as well. A study conducted by Lin et al⁷ found that the protective effects of omega-3 fatty acids are mediated by the fatty acid desaturase (FADS) gene cluster. Single nucleotide polymorphisms (SNPs) within these genes were shown to influence the conversion of precursor fatty acids into bioactive omega-3, such as DHA.⁷ Furthermore, multivariable Mendelian randomization analyses indicated that the effects of omega-3 fatty acids on AD risk were independent of other fatty acids, highlighting the specific role of FADS genes, desaturase enzymes, and omega-3 metabolism in AD prevention.⁷ Although the study did not specifically examine participants with SOC, such findings illustrate the importance of understanding genetic variation in the FADS1 and FADS2 genes, as it may provide crucial insights on ethnic differences in AD prevalence and the variable effectiveness of omega-3 supplementation in preventing or managing this condition. In a study by Merino et al,⁸ SNPs in the FADS1 and FADS2 genes encoding desaturase enzymes were compared between 2 ethnic groups: Caucasian and Asian.⁸ Desaturase enzymes play an important role in converting shorter-chain fatty acids into long-chain omega-3 and omega-6 fatty acids. Through this comparative analysis, the researchers identified FADS1 SNP rs174547 as a dominant variant in both Caucasian and Asian patients and found it is strongly associated with reduced desaturase activity.⁸ However, FADS2 SNP rs498793 was strongly associated with higher conversion of long-chain acids to EPA in Asian patients only.⁸ This may be a protective factor in this population. Therefore, depending on the genetic variations of FADS genes, different desaturase activity may result in distinct omega-3 fatty acid production, anti-inflammatory effects, and protective effects against AD. Likewise, a study by Abdelmagid et al⁹ found that certain FADS2 SNPs, notably rs174576, were associated with an increased ability to convert EPA to DHA in Caucasian women, whereas this was not noted in East Asian participants, suggesting that FADS polymorphisms may have stronger effects on desaturase enzyme activity in the Caucasian population than in East Asian.⁹ Therefore, such genetic variations may also help explain the ethnic differences in disease prevalence and responses to omega-3 supplementation for AD prevention.

Future research is needed to investigate the exact impact of omega-3 supplementation on AD prevention in SOC populations. However, it is likely beneficial in these groups, especially due to cultural differences in diet and genetic variants in fatty acid metabolism. Some patients with SOC may have FADS gene variants that are protective in AD, but others may contain SNPs that predispose to this condition, and thus omega-3 fatty acid supplementation may be even more beneficial. More work is needed on variation in FADS gene expression as well as fatty acid metabolism in SOC populations. Overall, it is crucial to consider genetic, immunologic, and environmental variables in the prevention and management of AD.

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