Eczema: Evening Primrose Oil, Borage Oil Not Helpful

Jennifer Garcia

April 29, 2013

Evening primrose oil (EPO) and borage oil (BO) provide little benefit for the relief of atopic eczema compared with placebo, according to a new review published in the April issue of the Cochrane Database of Systematic Reviews.

Joel Bamford, MD, from the University of Minnesota Medical School in Duluth, and colleagues identified 27 studies (19 EPO and 8 BO; 1596 adults and children overall) that evaluated the use of oral EPO or BO for treatment of eczema compared with placebo. The review authors searched the main scientific literature databases up to August 29, 2012.

A meta-analysis of 7 EPO studies showed no significant increase in symptom relief compared with placebo based on a visual analogue scale of 0 to 100 (mean difference [MD], −2.22 [95% confidence interval (CI), −10.48 to 6.04] among patients; MD, −3.26 [95% CI, −6.96 to 0.45] among physicians). Studies of BO also failed to show any significant symptom improvement; however, a meta-analysis of studies was not performed because of differences in study reporting.

Adverse effects were mild but similar for EPO and BO, were primarily gastrointestinal in nature, and ranged in frequency from 7% to 15%. One study reported that EPO may increase bleeding risk among patients receiving warfarin.

According to the researchers, 67% of the included studies were judged as having a low risk of bias for random sequence generation, 44% had a low risk of bias for allocation concealment, and 59% had a low risk of bias for blinding.

"[EPO and BO] do not seem to add any benefit to eczema as measured in this systematic review," Dr. Bamford and colleagues write.

"Noting that the confidence intervals between the active and placebo treatments are so narrow to exclude the possibility of any clinically useful difference, we conclude that further studies [of] EPO or BO for eczema would be hard to justify," they write.

In an email interview with Medscape Medical News, Hywel Williams, PhD, FRCP, from the Center of Evidence Based Dermatology, University of Nottingham, United Kingdom, wrote: "Although some of us always suspected that EPO was not especially useful in atopic eczema, this study provides robust evidence from the totality of evidence to suggest that it is of very little value, if any."

Dr. Williams agreed with the review authors that more research in this area is not needed and that "research monies should be spent elsewhere on eczema, such as finding out how best to prevent it."

The authors and Dr. Williams have disclosed no relevant financial relationships.

Cochrane Database Syst Rev. 2013;4:CD004416.

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