oatmeal in dermatology

Full text

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
Indian Journal of Dermatology, Venereology, and Leprology | March-April 2012 | Vol 78 | Issue 2138
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 controlled 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, psoriasis, 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, 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
IJDVL_380_11R6
How to cite this article: Citation will be included before issue gets online***
Received: June, 2011. Accepted: August, 2011 Source of Support: Nil. Conict of Interest: None declared.
INTRODUCTION
Oat (Avena sativa) is distinct among the cereals due
to 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 that holds an excellent
safety record and a long history in the treatment
of disease, especially of a dermatologic nature.
Oatmeal possesses antioxidant and anti-inflammatory
properties. Colloidal oatmeal produced by finely
grinding the oat and boiling it to extract the colloidal
material became available in 1945. It is noteworthy
that many clinical properties of colloidal oatmeal
result from its chemical polymorphism.[2,4]
EQ1 BIOACTIVE CONSTITUENTS OF OATMEAL
Oatmeal possesses different types of phenols which
release the antioxidant and anti-inflammatory activity.
Avenanthramides are phenolic compounds present in
oats at approximately 300 parts per million (ppm) and
exhibit anti-oxidant 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]
Access this article online
Quick Response Code: Website:
www.ijdvl.com
DOI:
*****
PMID:
*****

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
Pazyar, et al. Oatmeal in dermatology
139Indian 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 kappaB 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-kappaB 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. An in vitro
study showed 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
proved that product contains liquid paraffin with 5%
colloidal oatmeal significantly decrease itching and
patients request 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 can
be used as an adjunct in the management of mild atopic
dermatitis in children under 2 years of age. There has
been no report of sensitivity to topical colloidal grains
in the patients so far.[8] 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 a psychosocial and medically debilitating
disorder.[13,14] It is hypothesized that colloidal oatmeal
is 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
eruption 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 is proved that avenanthramides exert 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

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
Pazyar, et al. Oatmeal in dermatology
Indian Journal of Dermatology, Venereology, and Leprology | March-April 2012 | Vol 78 | Issue 2140
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
in starches and beta-glucan is responsible for the
protective and water-holding functions of oats. Skin
hydration is one of the most important factors 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. In fact; 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, shaving gels, and
moisturizing creams.[2,21]
Sterilization
Anecdotal reports have demonstrated that colloidal
oatmeal can play a role as a dusting powder in the
sterilization of surgical gloves in comparison to talc
powder which contains an irritant[22] [Table 1].
GENERAL USES OF OATMEAL
Oatmeal plays a role in decreasing 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]
REFERENCES
1. Sadiq Butt M, Tahir-Nadeem M, Khan MK, Shabir R, Butt MS.
Oat: Unique among the cereals. Eur J Nutr 2008;47:68-79.
2. Kurtz ES, Wallo W. Colloidal oatmeal: History, chemistry and
clinical properties. J Drugs Dermatol 2007;6:167-70.
3. Panfili G, Fratianni A, Irano M. Normal phase high-performance
liquid chromatography method for the determination of
tocopherols and tocotrienols in cereals. J Agric Food Chem
2003;51:3940-4.
4. Cerio R, Dohil M, Jeanine D, Magina S, Mahé E, Stratigos AJ.
Mechanism of action and clinical benefits of colloidal oatmeal
for dermatologic practice. J Drugs Dermatol 2010;9:1116-20.
5. Scabies-killer. Available from: http://www.scabies-killer.com/
oatmeal-bath instructions.html. [accessed on 2011 Aug 8].
6. Alexandrescu DT, Vaillant JG, Dasanu CA. Effect of treatment
with a colloidal oatmeal lotion on the acneiform eruption
induced by epidermal growth factor receptor and multiple
tyrosine-kinase inhibitors. Clin Exp Dermatol 2007;32:71-4.
7. Sur R, Nigam A, Grote D, Liebel F, Southall MD. Avenanthramides,
polyphenols from oats, exhibit anti-inflammatory and anti-itch
activity. Arch Dermatol Res 2008;300:569-74.
8. Boisnic S, Branchet-Gumila MC, Coutanceau C. Inhibitory
effect of oatmeal extracts oligomer on vasoactive intestinl
peptide-induced inflammation in surviving human skin. Int J
Tissue React 2003;25:41-6.
9. Matheson JD, Clayton J, Muller MJ. The reduction of itch during
burn wound healing. J Burn Care Rehabil 2001;22:76-81.
10. Pigatto P, Bigardi A, Caputo R, Angelini G, Foti C, Grandolfo M,
et al. An evaluation of the allergic contact dermatitis potential of
colloidal grain suspensions. Am J Contact Dermat 1997;8:207-9.
11. Eichenfield LF, Fowler JF Jr, Rigel DS, Taylor SC. Natural
advances in eczema care. Cutis 2007;80:S2-16.
12. Boussault P, Léauté-Labrèze C, Saubusse E, Maurice-Tison S,
Perromat M, Roul S, et al. Oat sensitization in children with
atopic dermatitis: Prevalence, risks and associated factors.
Allergy 2007;62:1251-6;quiz 82-3.
13. Kurian A, Barankin B. Current effective topical therapies in the
management of psoriasis. Skin Ther Lett 2011;16:4-7.
14. Afifi T, de Gannes G, Huang C, Zhou Y. Topical therapies
for psoriasis: Evidence-based review. Can Fam Physician
2005;51:519-25.
15. Fowler JF Jr, Woolery-Lloyd H, Waldorf H, Saini R. Innovations
in natural ingredients and their use in skin care. J Drugs
Dermatol 2010;9:S72-81.
16. Alexandrescu DT, Vaillant JG, Dasanu CA. Effect of treatment
with a colloidal oatmeal lotion on the acneform eruption
induced by epidermal growth factor receptor and multiple
tyrosine-kinase inhibitors. Clin Exp Dermatol 2007;32:71-4.
17. Lee-Manion AM, Price RK, Strain JJ, Dimberg LH, Sunnerheim K,
Welch RW. In vitro antioxidant activity and antigenotoxic
effects of avenanthramides and related compounds. J Agric
Food Chem 2009;57:10619-24.
18. Aries MF, Vaissiere C, Pinelli E, Pipy B, Charveron M. Avena
Rhealba inhibits A23187-stimulated arachidonic acid
mobilization, eicosanoid release, and cPLA2 expression in
human keratinocytes: Potential in cutaneous inflammatory
disorders. Biol Pharm Bull 2005;28:601-6.
19. Safa G, Darrieux L. Successful treatment of molluscum
contagiosum with a zinc oxide cream containing colloidal
oatmeal extracts. Indian J Dermatol 2010;55:295-6.
20. Sørensen HP, Madsen LS, Petersen J, Andersen JT, Hansen AM,
Beck HC. Oat (Avena sativa) seed extract as an antifungal food

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
Pazyar, et al. Oatmeal in dermatology
141Indian Journal of Dermatology, Venereology, and Leprology | March-April 2012 | Vol 78 | Issue 2
preservative through the catalytic activity of a highly abundant
class I chitinase. Appl Biochem Biotechnol 2010;160:1573-84.
21. Baumann L, Rodriguez D, Taylor SC, Wu J. Natural
considerations for skin of color. Cutis 2006;78:S2-19.
22. White AM, Jeffrey LP. Sterilization of colloidal oatmeal for use
as dusting powder in surgical gloves. Am J Pharm Sci Support
Public Health 1958;130:82-5.
23. Whyte JL, McArthur R, Topping D, Nestel P. Oat bran lowers
plasma cholesterol levels in mildly hyper cholesterolemic men.
J Am Diet Assoc 1992;92:446-9.
24. Guo W, Wise ML, Collins FW, Meydani M. Avenanthramides,
polyphenols from oats, inhibit IL-1beta-induced NF-
kappaB activation in endothelial cells. Free Radic Biol Med
2008;44:415-29.
25. Lammert A, Kratzsch J, Selhorst J, Humpert PM, Bierhaus A,
Birck R, et al. Clinical benefit of a short term dietary oatmeal
intervention in patients with type 2 diabetes and severe
insulin resistance: A pilot study. Exp Clin Endocrinol Diabetes
2008;116:132-4.
26. Romier B, Van De Walle J, During A, Larondelle Y, Schneider YJ.
Modulation of signalling nuclear factor-kappaB activation
pathway by polyphenols in human intestinal Caco-2 cells. Br J
Nutr 2008;100:542-51.
27. Guo W, Kong E, Meydani M. Dietary polyphenols, inflammation,
and cancer. Nutr Cancer 2009;61:807-10.
Key
1. d, 2. c, 3. d, 4. b, 5. d, 6. c, 7. b, 8. d, 9. a, 10. b
Author Query???
EQ1: Please confirm all style applied for headings and
subheadings***
Multiple Choice Questions
1. Oat meal 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 oat meal?
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 is not bioactive constituent of oatmeal?
a. Fiber b. Lipid
c. Proteins 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