Borage Oil Capsules for Eczema: What the Trials Found

Oral borage oil has not demonstrated an eczema benefit beyond placebo in the Cochrane¹ review. The review concerns swallowed oil supplements. It does not establish whether a particular cream containing borage oil helps your skin.¹

The oral treatment tested

A 2003 English trial enrolled 151 people with atopic eczema. Eleven did not return for assessment, leaving 140 evaluable participants, including 69 children. The study was randomized, double-blind and placebo-controlled, with treatment lasting 12 weeks.²

Adults took four capsules twice daily, supplying 920 mg of gamma-linolenic acid, or GLA, per day; children received half that regimen. The figure is the GLA amount, not the weight of borage oil. Do not translate it into a capsule count for a different product.²

The clinical eczema score fell from 30 to 27 with borage oil and from 28 to 23 with placebo. The reported difference in mean improvement was 1.4 points favouring placebo, with a 95% confidence interval from −2.2 to 5.0. No significant advantage appeared in symptoms or topical steroid requirements. A capsule did not establish that patients could reduce their steroid treatment.²

What the larger review adds

Cochrane’s¹ 2013 review included 27 studies with 1,596 adults and children: eight tested borage oil and 19 tested evening primrose oil. Neither oil showed a statistically significant advantage over placebo for eczema improvement. Borage results could not be pooled because studies reported them differently.¹

Its literature search ran through August 2012. This is an older evidence base, not a review of every product currently sold. Reported adverse effects were mainly temporary gastrointestinal symptoms, and the short trials did not establish long-term safety.¹

If a label refers to GLA, starflower oil or an omega-6 ingredient, check the named oil and daily amount with a pharmacist. The ingredient description alone does not show that the finished product improved eczema in a clinical trial.

Safety depends on more than the fatty acid

Memorial Sloan Kettering’s borage monograph warns about unsaturated pyrrolizidine alkaloids, compounds that can damage the liver. It advises using only products certified free of these compounds and warns that liver risk increases with cumulative exposure. Certification addresses a safety concern; it does not supply evidence of eczema benefit.³

The monograph advises against borage use during pregnancy, breastfeeding or with liver disease. It also flags potential interactions with medicines that can harm the liver and with blood thinners such as warfarin. Bring the full label and your medicines list to a pharmacist before taking it.³

Keep a treatment plan for the eczema itself

The NHS⁴ lists emollients and topical corticosteroids as main eczema treatments. It recommends moisturizing at least twice daily, continuing when skin improves, and seeking a GP review when treatment is not helping. If you are buying capsules because a cream burns, feels too greasy or is difficult to use at work, describe that specific problem at the review.⁴

Ask for a written plan naming the product, where to apply it and how to handle a flare. Keep a list of what you have actually used, including prescriptions, moisturizers and supplements, so the clinician can assess the whole routine.

Painful, warm, swollen skin, pus, leaking fluid, sudden worsening or fever needs urgent assessment. In the UK, the NHS⁴ advises an urgent GP appointment or NHS 111 for these changes because infection or eczema herpeticum may need treatment. Waiting for a supplement to help should not delay that call.⁴

Skin, Head to Toe includes a Skin Log for product start dates, photographs and irritation notes. Those dated details can help explain what you have tried at an appointment. Its logging framework does not replace an eczema examination or an individual treatment plan.