A 2026 randomized trial found fish oil 1 g/day plus isotretinoin 10 mg/day kept acne control in adults with persistent moderate-to-severe acne. Isotretinoin, a prescription vitamin-A-based drug for stubborn acne, worked as well with fish oil as without it for lesion reduction.
The trial enrolled 80 adults aged 18–25 with moderate-to-severe acne vulgaris, meaning lasting pimples, blackheads, and inflamed lesions. Half received fish oil and half received placebo for 3 months alongside low-dose isotretinoin, according to the U.S. National Library of Medicine PubMed record in the PubMed trial record.
Medical information disclaimer: This article is for general educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a physician or other qualified health professional about symptoms, medications, tests, or treatment decisions.
Table of Contents
- What Did the Trial Test?
- Did Acne Control Hold?
- How Did Skin and Triglycerides Respond?
- What Are the Limits and Safety Rules?
What Did the Trial Test?
Researchers enrolled adults 18–25 with moderate-to-severe acne vulgaris and an IGA score of at least 3. IGA means Investigator's Global Assessment, a clinician rating of acne severity. One group took isotretinoin 10 mg daily plus fish oil 1 g daily, while the other took the same isotretinoin dose plus placebo.
Treatment lasted 3 months under double-masked conditions, so neither patients nor assessors knew the assignments. The team tracked acne counts, IGA scores, and skin moisture as planned outcomes. It also tracked mouth and skin side effects, triglycerides, and liver enzymes, as described in the Journal of the American Academy of Dermatology abstract.
Did Acne Control Hold?
The fish-oil group proved noninferior to placebo for total lesion-count reduction. Noninferior means it did not perform worse by a meaningful margin. The between-group mean difference was minus 6.0 lesions, with a 95% interval from minus 16.5 to 4.5.
MIMS reported this result from the JAAD trial in the MIMS trial summary. For adults 18–25 with moderate-to-severe acne, low dose meant 10 mg of isotretinoin daily in this trial. Adding 1 g of fish oil daily did not weaken that acne control.
How Did Skin and Triglycerides Respond?
Fish-oil recipients lost less skin moisture during treatment than placebo recipients. A corneometer, a small probe that measures skin hydration, showed smaller declines in the fish-oil group. The JAAD/PubMed abstract links that pattern to better-preserved moisture during isotretinoin therapy.
Fish-oil recipients also had smaller rises in serum triglycerides than placebo recipients. Triglycerides are blood fats that often rise on isotretinoin. Practical Dermatology, reporting on Sungkhasunya et al. JAAD 2026, reads this as attenuated drug-related rises in the Practical Dermatology report.
What Are the Limits and Safety Rules?
The authors flagged IGA-based enrollment as a factor that may have shaped the noninferiority result. The 3-month duration also limits conclusions about long-term clearance or relapse. Both points come from the JAAD/PubMed abstract.
Isotretinoin remains prescription-only with serious risks. It can harm fetal development, so treatment requires iPLEDGE enrollment and repeated pregnancy testing. Common effects include cheilitis, xerosis, dry eyes and nose, plus lipid and liver-enzyme changes, according to the NLM DailyMed label in the DailyMed isotretinoin label.
- Use isotretinoin only by prescription with scheduled lipid, liver, and pregnancy checks
- Tell your prescriber about dry lips, dry skin, and dry eyes or nose during treatment
- Do not replace prescribed acne care with fish oil alone
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