Oatmeal in dermatology: A brief review

Abstract

The purpose of this review is to gather and summarize in vitro, in vivo, and clinical trials on oatmeal preparations and their uses in dermatology. Literature searches have been carried out to collect in vivo and in vitro studies as well as clinical trials on this subject. The results suggest that oatmeal possesses antioxidant and anti-inflammatory properties and its administration is effective on a variety of dermatologic inflammatory diseases such as pruritus, atopic dermatitis, acneiform eruptions, and viral infections. Additionally, oatmeal plays a role in cosmetics preparations and skin protection against ultraviolet rays. Although some promising results citing the use of oatmeal to treat numerous dermatologic conditions have been found, the complete efficacy of oatmeal has not been sufficiently explored. This paper proposes accurate and useful information concerning the use of oatmeal in clinical practice to dermatologists.

Full text

Indian Journal of Dermatology, Venereology, and Leprology | March-April 2012 | Vol 78 | Issue 2142
Oatmeal in dermatology: A brief review
Nader Pazyar, Reza Yaghoobi, Afshin Kazerouni, Amir Feily
Review
Article
ABSTRACT
The purpose of this review is to gather and summarize in vitro, in vivo, and clinical trials on
oatmeal preparations and their uses in dermatology. Literature searches have been carried out
to collect in vivo and in vitro studies as well as clinical trials on this subject. The results suggest
that oatmeal possesses antioxidant and anti-inammatory properties and its administration is
effective on a variety of dermatologic inammatory diseases such as pruritus, atopic dermatitis,
acneiform eruptions, and viral infections. Additionally, oatmeal plays a role in cosmetics
preparations and skin protection against ultraviolet rays. Although some promising results
citing the use of oatmeal to treat numerous dermatologic conditions have been found, the
complete efcacy of oatmeal has not been sufciently explored. This paper proposes accurate
and useful information concerning the use of oatmeal in clinical practice to dermatologists.
Key words: Dermatology, oatmeal, colloidal oatmeal, review
Department of Dermatology,
Jundishapur University of
Medical Sciences, Ahvaz, Iran
Address for correspondence:
Dr. Amir Feily,
Skin and Stem Cell Research
Center, Tehran University of
Medical Sciences, Tehran, Iran.
E-mail: dr.feily@yahoo.com
How to cite this article: Pazyar N, Yaghoobi R, Kazerouni A, Feily A. Oatmeal in dermatology: A brief review. Indian J Dermatol Venereol
Leprol 2012;78:142-5.
Received: June, 2011. Accepted: August, 2011 Source of Support: Nil. Conict of Interest: None declared.
INTRODUCTION
Oat (Avena sativa) is unique among the cereals for its
multifunctional characteristics and nutritional profile.
Recent developments in food and nutrition have
shown the importance of its various components. Oat
bran especially, is a good source of B complex vitamins,
vitamin E, protein, fat, and minerals. Additionally, it
is rich in beta-glucan which is heart healthy soluble
fiber in particular.[1-3]
Oatmeal is a natural product which has an excellent
safety record and a long history in the treatment of
dermatologic disorders. Oatmeal possesses antioxidant
and anti-inflammatory properties. Colloidal oatmeal
produced by finely grinding the oat and boiling it to
extract the colloidal material and became available in
1945. It is noteworthy that many clinical properties
of colloidal oatmeal result from its chemical
polymorphism.[2,4]
BIOACTIVE CONSTITUENTS OF OATMEAL
Oatmeal possesses different types of phenols which
exert the antioxidant and anti-inflammatory activity.
Avenanthramides are phenolic compounds present in
oats at approximately 300 parts per million (ppm) and
exhibit antioxidant activity in various cell types. They
are responsible for the potent anti-inflammatory effect of
oatmeal that appears to mediate the anti-irritant effects
of oats.[2] The composition of colloidal oatmeal consists
mainly of starch (65%–85%), proteins (15%–20%), lipids
(3%–11%), fiber (5%), and beta-glucans (5%).[4]
FORMULATIONS
Today’s the formulations of colloidal oatmeal are
offered in various forms such as bath treatments,
cleansing bars, body washes, shampoos, lotions,
creams, and shaving gels.[2]
OATMEAL BATH DIRECTION
Oatmeal bath remedy is formulated with 100% natural
colloidal oatmeal. About 10 CC of oatmeal should be
sprinkle directly under the faucet into the running
water. The approximate time to soak in oatmeal bath is
15–20 min. The oatmeal bath gently cleans and soothes
sensitive skin and, therefore, soap is not necessary.[5]
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Pazyar, et al. Oatmeal in dermatology
143Indian Journal of Dermatology, Venereology, and Leprology | March-April 2012 | Vol 78 | Issue 2
MECHANISM OF ACTION
It has been demonstrated that oatmeal extract decrease
arachidonic acid, cytosolic phospholipase A2 and
tumor necrosis factor-alpha (TNF-alpha).[6] Additionally,
oatmeal extract can inhibit the activity of nuclear factor
kappa B (NF-kappa B) in keratinocytes and the release
of proinflammatory cytokines and histamine, which are
well known key mechanisms in the pathophysiology
of inflammatory dermatoses. Interestingly, it has been
shown that avenanthramides inhibit TNF-alpha induced
NF-kappa B luciferase activity and diminish secretion of
the proinflammatory cytokine interleukin-8 (IL-8).[7] Also
oatmeal extract oligomer, significantly mitigate the mean
surface of dilated vessels and edema in comparison with
vasoactive intestinal peptide (VIP) treated skin.[8]
DERMATOLOGIC APPLICATIONS OF OATMEAL [TABLE 1]
Anti-itch activity
Oatmeal has been used for centuries to decrease
itching in a variety of xerotic dermatoses.[7] It has been
illustrated that avenanthramides reduce oxazolone-
induced contact hypersensitivity, resiniferatoxin-
induced neurogenic inflammation, and compound
48/80-induced, histamine-mediated itch. Another
in vitro study has shown that avenanthramides caused
a considerable reduction in histamine release from
mast cells stimulated by substance P.[4] Matheson and
colleagues evaluated the efficacy of liquid paraffin
with 5% colloidal oatmeal in comparison with
other contained liquid paraffin in the management
of patients with burn injuries. They reported that
product contains liquid paraffin with 5% colloidal
oatmeal significantly decreased itching and patients
requested significantly less antihistamine.[9]
Atopic dermatitis
Colloidal grain suspensions of oatmeal are considered
as adjuncts in atopic dermatitis therapy, especially
in the United States. On the other hand, many
young children have been treated by colloidal grains
in Italy.[8] Studies have demonstrated that topical
formulation of natural colloidal oatmeal, particularly
avenanthramide, alleviates symptoms by restoring the
cutaneous barrier. Additionally, it may play a crucial
role in decreasing the use of corticosteroids and
calcineurin inhibitors in atopic dermatitis.[4,10,11]
In a double-blinded, randomized patch study, Pigatto
and colleagues showed that topical colloidal grains
could be used as an adjunct in the management of
mild atopic dermatitis in children under 2 years of age.
Furthermore, no sensitivity to topical colloidal grains
reported in the patients.[10] In contrary, another study
demonstrated that oat sensitization for allergy testing
is higher than expected in atopic dermatitis children.
It is possibly due to repeated applications of cosmetics
with oats on an impaired epidermal barrier.[12]
Psoriasis
Psoriasis is a chronic, recurring inflammatory disease
that affects 1%–3% of the population worldwide.
Psoriasis is considered a psychosocial and medically
debilitating disorder.[13,14] It is hypothesized that
colloidal oatmeal can be effective in the treatment of
psoriasis due to its anti-inflammatory properties.[1,15]
Acneiform eruptions
It has been illustrated that treatment with colloidal
oatmeal lotion is efficient in controlling the acneiform
eruptions associated with epidermal growth factor
receptor (EGFR) inhibitor drugs such as cetuximab,
erlotinib, panitumumab, sorafenib, and multiple
tyrosine-kinase inhibitors. As such, it increases
patients’ compliance with antineoplastic therapy.[16]
Antigenotoxicity
It has been found that avenanthramides show
antigenotoxic activities that are comparable to those
of ascorbic acid, which have the potential to exert
beneficial physiological effects.[17]
Antiviral activity
The dramatic antiviral properties of oatmeal extract
is likely due to inhibitory effects on eicosanoid
formation, expression of cytosolic phospholipase A2
(PLA2), and arachidonic acid mobilization in human
keratinocytes.[18] In an open trial study conducted
by, Safa et al, patients with molluscum contagiosum
were treated successfully with a zinc oxide cream
containing colloidal oatmeal.[19]
Table 1: Dermatologic applications of oatmeal
Anti-itchactivity
Atopicdermatitis
Psoriasis
Acneiformeruptions
Antiviralactivity
Antifungal activity
Skinprotection
Moisturizing
Cosmetics
Sterilization

Pazyar, et al. Oatmeal in dermatology
Indian Journal of Dermatology, Venereology, and Leprology | March-April 2012 | Vol 78 | Issue 2144
Antifungal activity
Oat seed extracts show a high degree of antifungal
activity and can be applied directly on rye bread to
prevent the formation of P. roqueforti colonies.[20]
Skin protection
Ultraviolet A (UVA) in the range of 320–370 nm is
absorbed by flavonoids in oats. The use of colloidal
oatmeal as a skin protectant is regulated by the U.S.
Food and Drug Administration (FDA) according to
the Over-The-Counter Final Monograph for Skin
Protectant Drug Products issued in June 2003.[2]
Moisturizing
Today, colloidal oatmeal is available in the form
of moisturizing creams. The high concentration of
starches and beta-glucans in oat are responsible for its
protective and water-holding functions. The hydration
of the skin is one of the most important agents involved
in preserving the integrity of the stratum corneum
barrier. Oatmeal is a good option for moisturizing of
dry or sensitive skin.[2]
Cosmetics
Avenacins are other phenolic esters in oat which
structurally belonging to saponins. A large lipophilic
region and a short chain of sugar residues, which
interact with nonlipid components is characteristic of
avenacins. Saponins have a soap-like action for this
structure. Accordingly; saponins are mostly responsible
for the cleansing activity of oat. A variety of functional
properties make colloidal oatmeal as a cleanser, buffer,
as well as a soothing agent. Additionally, colloidal
oatmeal can be used in shampoos and shaving gels.[2,21]
Sterilization
Anecdotal reports have demonstrated that colloidal
oatmeal can play a role as a dusting powder in the
sterilization of surgical gloves[22] [Table 1].
GENERAL USES OF OATMEAL
Oatmeal has been documented to decrease serum low-
density lipoprotein cholesterol (LDL) and coronary
heart disease as an anti-atherosclerotic agent.[23,24]
It is also considered a remedy for diabetes with
reduction of insulin dosage[25] as well as the treatment
of inflammatory bowel disease.[26] Nuclear factor-
kappa B (NF-kappa B), a key regulator of inflammation,
has been identified as an essential modulator in cases
where inflammation could develop into cancer. It has
been shown that avenanthramides are responsible for
anticancer activity, partially through the inhibition of
NF-kappa B activation.[27]
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Key
1. d, 2. c, 3. d, 4. b, 5. d, 6. c, 7. b, 8. d, 9. a, 10. b
Multiple Choice Questions
1. Oatmeal is a good source of the following components, except:
a. Beta-glucan b. Vitamin B complex
c. Vitamin E d. Vitamin C
2. Which of the following interleukins may interact in proinflamatory pharmacodynamic in oatmeal?
a. IL-1 b. IL-2
c. IL-8 d. IL-10
3. Oatmeal does treat all the following disorders documented by clinical trial except:
a. Itching b. Acneiform eruptions
c. Atopic dermatitis d. Lichen planus
4. UV light is absorbed by oatmeal, which of the following UV band is the rang of the protection?
a. 300-320 b. 320-370
c. 320-330 d. 340-380
5. Which ingredient in oatmeal has a valuable effect for moisturizing?
a. Vitamin E b. Vitamin C
c. Vitamin B d. Beta-glucan
6. In cosmetic point of view which of the following ingredients is more effective:
a. Vitamin E b. Beta –glucan
c. Phenolic ester d. Vitamin B
7. How does the oatmeal act on lipid profiles:
a. Decreased VLDL b. Decreased LDL
c. Increased TG d. Increased HDL
8 Which of the following components is not bioactive constituent of oatmeal?
a. Fiber b. Lipid
c. Protein d. Glucose
9. How long (minutes) the affected area should be soaked in the oatmeal?
a. 10 b. 30
c. 40 d. 60
10. Which of the antimicrobial effect of oatmeal is more prominent?
a. Antibacterial b. Antiviral
c. Antifungal d. Antiprotozae