Effect of high-dose oral therapy with evening primrose oil on the main lipid fractions in severe atopic dermatitis

In atopic dermatitis a deficiency of γ-linoleic acid is supposed. Therefore a treatment with evening primrose oil is recommended. In an open uncontrolled study, 10 patients (8 men and 2 women) were treated for 12 weeks with daily 5,6-6,4 g evening primrose oil, which is equivalent to 480 mg γ-linolenic acid. Every four weeks clinical and serological parameters, transepidermal water loss (TEWL), surface lipids from the elbows and stratum corneum lipids were examined. The main lipid fractions including phospholipids, cholesterol sulfate, glucosyl ceramides, ceramides, free sterols, free fatty acids, triglycerides, sterol and wax esters, and n-alkanes were separated and quantified by densitometry. The percent extension of the eczema was significantly reduced from 56.6 ± 26.9% to 21.5 ± 18.6% (p < 0.001). The general eczematous state compared to the state before therapy (scored with Abrams' scale) showed an increasing improvement (p = 0.002). Lipid analysis and serological parameters including total IgE-levels and RAST-classification of the main immediate-type allergens demonstrated no noticeable changes. In both locations forearm and subscapula area there was a significant decrease of the TEWL (p < 0.001). A therapy with evening primrose oil seems to improve efficient the epidermal barrier function in atopic dermatitis.