If you have eczema, wouldn’t you like to use a product derived from plant oils or fats, rather than a drug made in a lab, if this is as effective? I looked for relevant research to see which natural products work best (hint – Coconut oil is very good, and so is Shea butter and Argan oil). I found a great review article from the Journal of molecular science published in 2018. Various oils and butters have been studied for their beneficial effects on the skin, and this blog summarises these benefits, as shown in this review article.

In atopic dermatitis, the skin barrier function is compromised. What does this mean? Normally the skin acts as a barrier to germs, and is able to keep unwanted things out, and body fluids in. To do this, the outer layer of skin must be composed of both flattened dead skin cells, and glue that holds them together and waterproofed. We need fillagrin – a protein which pulls the skin cells together in a matrix, and ceramides (fats) in a kind of inter-cellular glue to form an envelope which encloses us. Dry skin is a component of atopic dermatitis, as the fillagrin or ceramides are defective, and the skin barrier function is not effective.

If there are good natural products that can be applied to the skin, how many of these actually work, and why? Which ones should we use, and which should we avoid? We should look for oils that are anti-inflammatory, have antibacterial properties, are anti-oxidant, repair the skin barrier, and stimulate wound healing. Generally the natural oils are pro-ceramides, in that the skin fatty acids are made from these oils.

Here is my list of oils and their properties, as proven by the research:

Plant oil Barrier repair Anti-bacterial Anti-inflammatory Anti-oxidant Wound healing
Soybean oil yes yes yes yes ?
Peanut oil yes ? ? ? ?
Sesame oil ? ? yes yes ?
Avocado oil ? ? ? ? Yes
Jojoba oil yes ? yes yes yes
Oat oil yes ? yes yes ?
Almond oil ? ? ? ? ?
Rose hip oil ? ? yes yes ?
Chamomile ? ? yes ? ?
Shea butter maybe ? yes yes ?
Argan oil yes ? yes ? yes
Coconut oil yes yes yes yes yes
Grapeseed ? yes ? yes Yes
Sunflowerseed no ? yes ? maybe
Olive oil no ? yes yes yes

 

This list is not comprehensive, but it is enough for me to draw some conclusions.

Coconut oil appears to be a clear winner, but I think Argan oil and Shea butter may be good candidates too. (The evidence for coconut oil comes from the following scientific studies: Evangelista et al 2014, Nevin et al 2010, Kim et al 2017, Korac et al 2011, Preuss et al 2005, Oyi et al 2010, Esquanazi et al 2002) Coconut oil is extracted from the kernel of mature coconuts and contains oils that are effective for moderately dry skin, atopic dermatitis, and protective against UVA and UVB radiation. It contains a fat which is specifically active against Staph aureus, and Staph epidermidis, and the germ that causes acne.

Argan oil has been shown to restore the skin barrier function by retaining water in the skin, improves skin elasticity, and improves healing after burns, and infections. Shea butter has been shown to have powerful anti-inflammatory and anti-oxidant properties, and is a ceramide precursor. Shea butter has slightly better sun protection than coconut oil but both have SPF around 6.

There is much that can be said about many of these different oils, some extremely good properties amongst many of them. In looking for a natural oil product to treat either very dry skin, or atopic eczema, it is very useful to have an oil that promotes the normal skin barrier function, reducing trans-epidermal water loss, reducing inflammation, promoting wound healing, or having anti-oxidant function, and particularly also having an antibacterial property. Since we know that Staph aureus is always associated with more severe eczema, and the toxins released by this germ powerfully stimulate inflammation, histamine and our immune responses, for me coconut oil is a clear winner.

However, it has long been traditional to mix some of these oils, into a blend that feels good on the skin, and reduces itch. In my experience patients also like creams with added oat oil, as this also has good evidence, and these oat oil creams have gained a reputation in the UK as Aveeno products for good reason.

Therefore, in making up my own blend of creams to use in eczema, it seems wise and appropriate to dilute known effective medicinal creams such as steroids into a cream containing argan oil, shea butter, and coconut oil. I generally add around 50g of these products to make up a total of 400g of cream, a 1/8 dilution. The addition of these natural products gives the cream a very pleasing feel, and the science shows us it aids healing through barrier repair (ceramides), anti-bacterial actions, anti-inflammatory actions, and anti-oxidant actions.

To find out more about my method of treating atopic eczema with a blend of prescribed drugs diluted in natural oils and creams, visit the page “book a free consultation”. There is a free trial of cream offer at present for those who have booked a consultation.

(Reference article: Anti-inflammatory and skin barrier repair effect of plant oils, Lin, Zhong, Santiago  Int J Mol Science 2018, 19,70)