Abstract Title:

Borage oil, an effective new treatment for infantile seborrhoeic dermatitis.

Abstract Source:

Diabetologia. 1999 Mar;42(3):292-6. PMID: 8396411

Abstract Author(s):

A Tollesson, A Frithz

Abstract:

Infantile seborrhoeic dermatitis (ISD) was described as a separate entity as early as 1887, by Unna.1 ISD usually develops within the first 3-4 weeks of life, and spontaneous  recovery normally occurs at about 6-7 months of age, although some cases recover 2 or 3 months earlier.  The a etiology of ISD is poorly understood. Many theories have been suggested, amongst which have been nutritional factors, including biotin deficiency and the influence of maternal hormones.  In a recent study of fatty acids in the serum of infants suffering from ISD, we demonstrated evidence of impaired function of the enzyme delta-6-desaturase (D-6-D), which desaturates linoleic acid (LA) to gamma linolenic acid (GLA).2 The most important finding was an increased level of the fatty acid 20:2w6, which indicates activation of an alternative pathway in the metabolism of 18 : 2w6. This pathway is of no, or low, importance unless the function of D-6-D is impaired.  The function of this enzyme appears to normalize at the age of about 6-7 months, the age at which spontaneous recovery from ISD usually occurs. Our findings would be consistent with an immature function of the enzyme, which normalizes with increasing age.  LA is an essential fatty acid, and its importance in mammals has been intensively investigated. LA is metabolized by desaturating and elongating enzymes, to GLA. dihomogammalinolernc acid (DGLA) and arachidonic acid (AA). LA, GLA and AA are of great importance in the maintenance of a normal epidermal barrier, probably as membrane stabilizing factors. AA is, in addition, the substrate for potent inflammatory mediators such as prostaglandins and leucotrienes.  To investigate the possibility of correcting the abnormal metabolism of LA by topical application of GLA in children with ISD, a pilot study was conducted in which 48 children with this condition were treated with topical GLA in the form of borage oil. Borage oil contains approximately 24% GLA. and is obtained from seeds of the plant Borago officinalis (borage).  All 48 children fulfilled the clinical criteria for ISD according to Atherton.3 None showed any signs of atopic dermatitis, and pruritus was absent. Before referral to us, all the children had been treated with hydrocortisone, antimycotics and moisturizing preparations, with either minimal or no effect. All but two of the children were breast-fed, and tests of the mothers' milk showed a normal pattern of essential fatty acids.  Borage oil (0-5 mI) was applied to the nappy region twice daily. Within 10-12 days all the children were free from skin lesions, even in areas not treated with the oil. When treatment was discontinued, the lesions recurred within 1 week. With intermittent therapy 2-3 times/week, there were no recurrences. Treatment was stopped at about 6-7 months of age, and there were no relapses thereafter. There were no side effects of treatment in any of the children.  The results support our hypothesis of an immature function of the enzyme D-6-D. The finding that the dermatitis also cleared from areas not treated with the oil suggests that it was absorbed. Good percutaneous absorption of essential fatty acids has previously been reported in the treatment of essential fatty acid deficiency with sunflower-seed oil.4  In our experience, topical treatment with preparations rich in GLA appears to be an effective remedy for ISD.  

Study Type : Human Study
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