Psoriasis is a life-long inflammatory skin disease affecting more than 21 million people across Europe and the USA.
There are five types of psoriasis, all of which trigger an overgrowth of skin cells, leading to a build up of red, flaky patches of skin covered with silvery scales. Psoriasis can be extremely painful, as the skin can crack and bleed, becoming itchy and inflamed. In severe cases, more than 10 per cent of the body can be affected.
Experts still aren’t sure about what causes psoriasis, but it’s thought to be mixture of genetics and environmental triggers like diet, stress and smoking1.
Psoriasis can be very isolating, causing distress, discomfort and low self-esteem2. In one survey, 75 per cent of people living with psoriasis believed their condition had a negative impact on their quality of life3.
In this study, we explored whether omega-3 supplements could impact quality of life in a group of people living with psoriasis.
What does quality of life mean?
Quality of Life is used to describe the level of wellbeing and happiness of an individual or group of people. We know that people living with psoriasis report a lower quality of life than healthy adults without psoriasis.
Lots of factors can contribute to this lower quality of life, including the pain and discomfort caused by skin lesions, a feeling of lack of control over symptoms, shame and embarrassment over the appearance of skin, and the effect of psoriasis on daily activities, work and relationships4.
How did we measure quality of life in the study?
In this study, we used a questionnaire called the Skindex-16 to help evaluate how psoriasis impacts daily life5. The Skindex-16 focuses on three areas – how bothered participants feel about their symptoms, how their disease affects their emotional state, and how it affects their daily activities and interaction with other people. Studies show the Skindex-16 can be used to measure how patients progress over time, or to measure the impact of different treatments on quality of life.
What is omega-3, and what has it got to do with quality of life?
Omega-3 is the name for a group of essential fats that we need in small amounts to stay healthy (you can read more about omega-3 and psoriasis here). Omega-3’s are mostly found in oily fish (like salmon and mackerel), and fish oil supplements.
Over the last 30 years, a number of studies have found that omega-3 supplements can have a positive effect on psoriasis severity, reducing symptoms, like redness, itching and scaling6. These positive effects are thought to be thanks to the anti-inflammatory properties of omega-37.
Based on these findings we decided to look at whether omega-3 supplements could have a positive effect on the quality of life in people living with psoriasis.
What type of omega-3 did you use?
Most studies looking at the relationship between omega-3 and psoriasis have used daily doses between 2 and 12 grams8, but most non-prescription supplements (that you can buy yourself) contain much less than this.
In this study, we wanted to test a non-prescription dose, to mimic a real life scenario. We partnered up with PurePharma who provided their O3 (Omega-3) capsules, which deliver a total of 1.75 grams of omega-3 per day. This is one of the highest levels of omega-3 available in a non-prescription supplement.
What did the study involve?
The study (which we called “The Omega-3 Study”) took place over three months during the second half of 2016. A group of 65 people from Canada living with psoriasis took part.
Participants were asked to take 3 capsules per day, and to continue with all their normal medications.
Who took part?
The people who took part in the study were all living in Canada, but in different parts of the country. People were invited to apply to join the study via adverts on social media and the CitizenResearch website. A total of 470 people applied to be part of the study. A simple screening tool was used help us select the 65 people who joined the study and received the omega-3 capsules.
The average age of the people who took part was 47 years. The group was 66 per cent female, and 34 per cent male. On average, the participants had lived with psoriasis for 19 years.
What did the participants have to do?
All participants in the study were asked to take 3 capsules of PurePharma omega-3 daily, providing a total dose of 1.75 grams of omega-3. During the study there was no face-to-face contact between any members of CitizenResearch and the participants, with communication made via emails and text messages.
At the start of the study, and after one, two and three months, all participants were asked to complete two online questionnaires. One questionnaire (the Skindex-16) was used to measure their quality of life, by asking questions around symptoms (itching, pain) emotions (how skin affects feelings) and how their skin affected daily activities. A total score was then calculated from all three areas, to estimate of the effect on their quality of life.
The other questionnaire (called the TSQM-9 – Treatment Satisfaction Questionnaire for Medication) was used to assess the participant’s experience of taking the omega-3 capsules.
Participants were also asked how many days they had successfully taken the Omega-3 each month.
The Skindex-16 Results
Over the three months, there was a significant improvement in Skindex-16 scores, which suggests that the quality of life of participants improved during the study. In particular, we found a significant improvement in the ‘emotions’ area of the Skindex-16 assessment.
In the other areas – symptoms and daily activities – there was an initial improvement from the start of the study to the end of month one, but from then on these scores remained unchanged.
The TSQM-9 Results
Positively, more than 94% of the participants reported that the omega-3 capsules were “somewhat convenient”, “convenient”, “very convenient” or “extremely convenient” to take.
More than 77% of the participants also said they were “somewhat confident”, “very confident” or “extremely confident” that taking the omega-3 was a positive thing for them.
What can we learn from this study?
Over the study period the participants generally reported that their skin disease impacted less on their quality of life. This seemed to be due to improvements in their emotional wellbeing.
It’s difficult to conclude why there was a positive change in the emotional state of the participants, but it could be a result of several factors. For example, they may have felt empowered by taking the omega-3, or by taking part in something that could positively affect their condition, and this contributed to a better sense of well being or self care.
Encouragingly, participants also found the omega-3 easy to take, and most of the participants felt it had a positive impact.
Although it’s too early to draw conclusions, this is a positive initial finding, and might contribute to the information we have around omega-3 and quality of life of people living with psoriasis.
Want to learn more about omega-3 and psoriasis? Click here.