Borage oil comes from the seeds of Borago officinalis, a Mediterranean plant with distinctive blue star-shaped flowers. What makes borage oil interesting is its unusually high concentration of gamma-linolenic acid (GLA), an omega-6 fatty acid that the body converts into anti-inflammatory compounds.

If you’re researching natural supplements for inflammatory conditions, borage oil deserves a careful look. But as with any supplement, the reality is more nuanced than the marketing suggests. Let me walk you through what the research actually shows.

What is borage oil?

Borage (Borago officinalis) is a flowering herb native to the Mediterranean region, though it now grows throughout Europe and North America. The plant produces small blue flowers arranged in a star pattern, which is why it’s sometimes called “starflower.” Traditional herbalists used borage leaves and flowers for various purposes, but modern interest focuses almost entirely on the oil extracted from its seeds.

The key compound in borage oil is gamma-linolenic acid (GLA), an 18-carbon omega-6 polyunsaturated fatty acid. Borage seed oil contains roughly 20-26% GLA by weight, making it the richest natural source of this fatty acid. By comparison, evening primrose oil contains only about 8-10% GLA, and blackcurrant seed oil falls somewhere in between.

How GLA works in the body

When you consume GLA, your body converts it through a series of enzymatic reactions into dihomo-gamma-linolenic acid (DGLA), which then serves as a precursor for certain prostaglandins and leukotrienes. These are signalling molecules that help regulate inflammation.

Specifically, DGLA can be converted into prostaglandin E1 (PGE1), which has anti-inflammatory and vasodilatory effects. It can also compete with arachidonic acid for the same enzymes, potentially reducing the production of pro-inflammatory compounds like prostaglandin E2 and leukotriene B4.

This biochemical pathway explains why researchers have been interested in GLA supplementation for inflammatory conditions. However, the body’s actual response to GLA supplements varies considerably between individuals, depending on factors like existing fatty acid status, enzyme activity, and overall diet.

Forms and dosing

Borage oil is available in several forms:

Softgel capsules - The most common form for oral supplementation. Typical doses in studies range from 1-3 grams daily, providing roughly 200-600mg of GLA.
Liquid oil - Can be taken by spoon or added to foods. Some people find this more economical than capsules.
Topical preparations - Creams and lotions containing borage oil for direct skin application.

For oral supplementation, most clinical studies have used doses providing 240-920mg of GLA per day. There’s no established optimal dose, and individual responses vary.

Research on borage oil benefits

Let me be clear upfront: the research on borage oil is limited. Most studies have small sample sizes, and results have been mixed. That said, here’s what the evidence suggests for various conditions.

Eczema and atopic dermatitis

Atopic dermatitis (eczema) is a chronic inflammatory skin condition characterised by dry, itchy, red patches that can significantly impact quality of life. It affects roughly 15-20% of children and 1-3% of adults worldwide, often persisting from childhood into adulthood.

The theory behind using GLA for eczema centres on a specific metabolic defect. Some research suggests that people with atopic dermatitis may have impaired delta-6-desaturase activity, the enzyme needed to convert dietary linoleic acid into GLA. This could lead to GLA deficiency and contribute to skin barrier dysfunction.

The evidence is, frankly, disappointing. A 2013 Cochrane systematic review examined multiple trials of evening primrose oil and borage oil for eczema. The review concluded that neither supplement provided meaningful benefits over placebo for symptom improvement 1.

One of the larger studies included in this review gave 141 patients with atopic dermatitis either 920mg of GLA from borage oil or placebo for 12 weeks. There was no significant difference between groups in clinical symptom scores.

That doesn’t mean GLA is useless for everyone with eczema. Some individuals may respond better than others, particularly those with confirmed GLA deficiency. But on a population level, the evidence doesn’t support borage oil as an effective eczema treatment.

If you’re dealing with eczema, you might find our article on healthy foods beneficial for eczema useful for a broader perspective on dietary approaches.

Rheumatoid arthritis

Rheumatoid arthritis (RA) is an autoimmune condition where the immune system attacks joint tissue, causing inflammation, pain, and progressive joint damage. Unlike osteoarthritis, which results from mechanical wear, RA is fundamentally an inflammatory disease.

The research here is somewhat more promising than for eczema. An early study from 1993 gave 37 patients with active RA either borage seed oil (providing 1.4g GLA daily) or placebo for 24 weeks. The GLA group showed significant reductions in tender and swollen joint counts, with improvements of 36% and 28% respectively compared to baseline 2.

A more recent 2014 trial compared borage oil to fish oil in 150 patients with RA. Both groups showed similar improvements in disease activity scores over 18 months. Interestingly, both supplement groups also reduced their use of disease-modifying anti-rheumatic drugs (DMARDs) and biological agents compared to patients not taking supplements 3.

For those interested in nutritional approaches to joint health, our article on health foods beneficial to osteoarthritis covers related ground, though RA and osteoarthritis are quite different conditions.

What this means in practice: GLA supplementation may provide modest benefits for RA symptoms, potentially allowing some patients to reduce other medications. However, it’s not a substitute for conventional RA treatment, and any changes to medication should be discussed with a rheumatologist.

Acne

Acne vulgaris is an inflammatory skin condition involving hair follicles and sebaceous glands. It affects approximately 85% of teenagers and can persist well into adulthood. The condition involves multiple factors including excess sebum production, abnormal follicular keratinisation, bacterial colonisation (particularly Cutibacterium acnes), and inflammation.

A 2014 randomised controlled trial examined omega-3 fatty acids and GLA supplementation in 45 participants with mild to moderate acne over 10 weeks. Both supplements significantly reduced inflammatory and non-inflammatory acne lesions compared to baseline 4.

This is a single small study, so I wouldn’t overstate the findings. But the mechanism makes theoretical sense: if acne is partly driven by inflammation, and GLA has anti-inflammatory properties, some benefit is plausible. More research with larger sample sizes would help clarify whether this approach is genuinely useful.

Diabetic peripheral neuropathy

Diabetic neuropathy is nerve damage caused by prolonged high blood sugar levels. It affects up to 50% of people with diabetes and typically manifests as numbness, tingling, pain, or weakness in the hands and feet. The condition significantly impacts quality of life and can lead to serious complications including foot ulcers.

A 1990 study examined GLA supplementation in 22 patients with diabetic polyneuropathy. After six months, the GLA group showed statistically significant improvements in neuropathy symptom scores and various nerve conduction measurements compared to placebo 5.

The proposed mechanism involves GLA’s effects on nerve blood flow and nerve membrane composition. However, this remains a single small study from over 30 years ago. The lack of follow-up research makes it difficult to draw firm conclusions.

For those managing diabetes-related complications, understanding diabetic bladder dysfunction may also be relevant, as diabetes can affect multiple organ systems.

Weight management after dieting

This one is interesting. A 2007 study followed 50 people who had recently lost weight through dieting. Half were given borage oil supplements, and half received a control oil. After one year, the borage oil group regained significantly less weight than the control group 6.

The researchers proposed that GLA helps rebalance fatty acid metabolism after weight loss, potentially influencing fat storage and energy expenditure. It’s a single study with a relatively small sample, but the results are intriguing enough to warrant further investigation.

Side effects and safety concerns

At typical supplemental doses (1-3 grams of borage oil daily), side effects are generally mild and uncommon. Reported adverse effects include:

Nausea
Bloating and indigestion
Soft stools or diarrhoea
Burping
Headache

These gastrointestinal symptoms usually resolve with continued use or dose reduction.

Pyrrolizidine alkaloids: A real concern

Here’s something genuinely important to know: the borage plant naturally contains pyrrolizidine alkaloids (PAs), which are toxic compounds that can cause liver damage with chronic exposure. Some PAs are also considered potentially carcinogenic.

Quality supplement manufacturers remove these compounds during oil extraction, producing “PA-free” or “certified hepatotoxic alkaloid-free” products. If you’re considering borage oil supplements, look for products that explicitly state they are PA-free or have been tested for pyrrolizidine alkaloid content.

Don’t assume all products are equally safe. Cheaper or poorly regulated products may contain harmful levels of these compounds. This is one supplement where quality really matters.

Who should avoid borage oil

Pregnancy and breastfeeding: Safety data is insufficient. Given the potential for PA contamination and lack of safety studies, avoidance is prudent.

Liver disease: People with existing liver problems should be particularly cautious due to the PA risk.

Bleeding disorders or anticoagulant use: GLA may have mild antiplatelet effects 7. While clinically significant interactions are uncertain, people taking warfarin, aspirin, or other blood thinners should consult their doctor before supplementing.

Epilepsy or seizure disorders: There’s some theoretical concern that high-dose GLA could lower the seizure threshold. People with epilepsy should discuss this with their neurologist before use.

Before surgery: Stop borage oil at least two weeks before scheduled surgery due to potential bleeding effects.

Comparison with evening primrose oil

Both borage oil and evening primrose oil provide GLA, so which should you choose?

Borage oil contains roughly twice the GLA concentration of evening primrose oil (20-26% vs 8-10%). This means you need smaller doses of borage oil to achieve the same GLA intake, which can be more convenient and cost-effective.

However, evening primrose oil has been studied more extensively and has a longer safety track record in supplement use. Some practitioners prefer it for this reason.

In terms of efficacy, head-to-head studies are lacking. Both appear to work through the same mechanism, so theoretical benefits should be similar at equivalent GLA doses.

Practical recommendations

If you’re considering trying borage oil, here are some practical points:

Choose PA-free products from reputable manufacturers. Look for third-party testing certifications.
Start with lower doses (1 gram daily) and increase gradually if well tolerated.
Give it time. Anti-inflammatory effects from GLA supplementation may take 8-12 weeks to become apparent.
Don’t expect miracles. The evidence supports modest benefits at best, primarily for inflammatory conditions.
Keep your doctor informed about all supplements you take, especially if you have chronic health conditions or take medications.
Consider food sources too. GLA is found in spirulina and some seeds, though in lower concentrations than supplemental oils.

Summary

Borage oil is the richest natural source of gamma-linolenic acid (GLA), an omega-6 fatty acid with anti-inflammatory properties. Research suggests possible benefits for rheumatoid arthritis, acne, and diabetic neuropathy, though evidence quality is generally limited by small study sizes.

For eczema, despite theoretical promise, clinical trials have failed to show meaningful benefits. The evidence doesn’t support borage oil as an effective eczema treatment for most people.

Safety-wise, borage oil appears well-tolerated at normal doses, but the risk of pyrrolizidine alkaloid contamination means product quality matters. Choose PA-free supplements from established manufacturers, and discuss use with your healthcare provider if you have existing health conditions or take medications.

5 Benefits and Side Effects of Borage Oil [Updated Dec/2022]