With Vitamin E which helps protect cells from oxidative stress, which can be caused by sun light and natural processes including ageing.

The quantity of vitamin E must always be provided in terms of α-tocopherol (AT) (i.e. mg RRR-α-tocopherol), irrespective of the source material used. A meta‐analysis of results from seven EPO studies demonstrated that the difference in global eczema symptoms between the EPO and placebo groups was not statistically significant as assessed by the participants. A second meta‐analysis of results from eight studies also yielded no significant improvement of global eczema symptoms from EPO compared to placebo treatment, as measured by doctors. Over the years since the last study closed 10 years ago, there have been new developments in the use of systemic treatments for eczema: methotrexate for children, biologics, selective neuroepinephrine re‐uptake inhibitors, serotonin uptake inhibitors, μ‐ and κ‐opioid receptor agonists, and substance P antagonists, which are being evaluated ( Patel 2011). Duration: There was a 4‐week run‐in period during which all participants received olive oil. Participants then received treatment with either EPO or safflower oil (SAFF) for 8 weeks (period 1) Compliance undertaken by recording of mild topical cortisone, antihistamines, emollient, and blood assaysA minimum 4‐week wash‐out period was needed for participants who had received systemic steroids, psoralen plus ultraviolet A (PUVA), or other oral immunosuppressive treatment Symptoms and signs of eczema (erythema, scaling, excoriation, weeping, etc) and effect on daily living (level of discomfort, inability to sleep, etc) by participant (method = 0 to 10 scale, where 0 is none and 10 is most severe) They seem to have the same fairly common mild transient adverse effects, which are mainly gastrointestinal (ranging from 7% to 15% in‐house studies) ( France 1988). There is evidence that EPO may increase bleeding for people on Coumadin® (warfarin) medication. Recently, plant derivatives have been extensively studied to evaluate their ability to improve the therapy of many chronic diseases and cancer [ 17]. Therefore, we evaluated the effect of EPO, obtained from Evening Primrose seeds, which are rich in GLA and linoleic acid. While there are many studies about the anticancer effect of GLA [ 18, 19], data on the anticancer effect of EPO are few.

There is a lay perception that complementary treatments, such as EPO and BO, treat the skin 'from within' and are 'gentler'when compared to physician‐prescribed topicals. Farzaneh F, Fatehi S, Sohrabi MR, Alizadeh K. The effect of oral evening primrose oil on menopausal hot flashes: a randomized clinical trial. Arch Gynecol Obstet. 2013 Nov;288(5):1075-9. doi:10.1007/s00404-013-2852-6 the introduction of pseudo‐ceramide, immunomodulator and biologic agents which came to the market after all our included studies; Anyone under medical supervision or taking medication should consult their health care provider seek medical advice before taking any supplement, including those in the Efamol range. There are no known contraindications with other supplements so there should not be a problem taking Efamol products at the same time as other vitamin and mineral supplements. Total score (method: adding all 4 major parameter scores. The case was labelled as mild, moderate, or severe when the total score ranged from 1 to 4, 5 to 8, and 9 to 12, respectively)

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The short‐term studies included here do not examine possible adverse effects of long‐term use of EPO or BO. A case report warned that if EPO is taken for a prolonged period of time (more than one year), there is a potential risk of inflammation, thrombosis, and immunosuppression; another study found that EPO may increase bleeding for people on Coumadin® (warfarin) medication. The BO group was identified by letter A; the olive oil (placebo) group, by letter B. Investigators were unaware of this classification before and during the study. Comment: It is unclear if allocation was adequately concealed the term 'atopic eczema/dermatitis syndrome' (AEDS) to summarise all forms of eczema that have previously been called 'prurigo Besnier' or 'atopic dermatitis' (we did not find AEDS used in any included study); Majdinasab N, Namjoyan F, Taghizadeh M, Saki H. The effect of evening primrose oil on fatigue and quality of life in patients with multiple sclerosis. Neuropsychiatr Dis Treat. 2018;14:1505-1512. doi:10.2147/NDT.S149403