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ECZEMA IN ADULTS AND EVENING PRIMROSE OIL
More and more studies from around the world are confirming that evening primrose oil can help adults with atopic eczema. The first trial, at Bristol Royal Infirmary, showed that evening primrose oil worked best in higher doses, and when it had been taken for several months. The most effective dose was eight to 12 capsules of 500mg (4 to 6g) evening primrose oil taken for longer than 12 weeks.
Other trials on adults with eczema during the 1980s have tended to confirm that large oral doses (4 or 6g a day) of evening primrose oil produce the best results. They also confirm that the longer the patient takes evening primrose oil, the better the results.
In a multi-centre study involving 13 hospitals in England, Scotland, Denmark and Finland, the doctors found that evening primrose oil produced excellent results in a very difficult group of patients, who all had a prolonged history of eczema, mostly starting in infancy or early childhood. On average, the patients had suffered from eczema for 17 years without having found any effective treatment.
Nearly all the patients reported improvement from the evening primrose oil treatment in every symptom of eczema – redness, dryness, scaling, itch, and swelling. Fifty-three out of 54 patients suffering from moderately severe eczema and 58 out of 59 patients with severe eczema reported an improvement in their overall condition.
During the treatment with Efamol many patients were able to reduce or stop altogether their use of antihistamines, antibiotics, systemic steroids and the most potent grade of topical steroids. After treatment with evening primrose oil, some patients could halve their doses of potent and moderate topical steroids, and could cut down on their use of antihistamines by a quarter, and of antibiotics by about a sixth. Apart from the use of emollients, they could dramatically reduce all their usual medication.
Nearly all the 116 patients (71%) in this multi-centre study chose to keep on taking Efamol. For some, this has run into several years. The average time for taking it was 11 months. Fifteen patients who stopped taking Efamol noted a relapse of their eczema.
A double-blind trial in Finland in 1987 showed that evening primrose oil had a significant effect on patients with atopic eczema. The overall severity was reduced, there was less inflammation, there was a reduction in the percentage of the body surface covered by eczema, and the patients suffered from less dryness and less itching. The dose in this trial was eight capsules (four capsules twice a day) for 12 weeks.
In this trial, patients were allowed to use emollient creams at the same time if they wanted to. They were also allowed to use a mild topical corticosteroid cream or oral antihistamine, or both, during the trial if they had severe skin symptoms. Interestingly, three times as much topical steroid was used by patients in the placebo group than in the group taking evening primrose oil. This suggests that the evening primrose oil was working much better than the placebo.
The doctors conducting the trial came to the conclusion that evening primrose oil was an adjunct to the existing treatment for atopic eczema, and could be safely used alongside steroids and other creams.
Evening primrose oil as a treatment works best in cases of moderate or severe atopic eczema. It has not been found to work well in cases of very mild eczema, where there is no family history of atopic disorders, and where the essential fatty acid levels in the blood were normal to start with. Epogam, made by Scotia Pharmaceuticals, is available on prescription for atopic eczema.
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