Colloidal Oatmeal Formulations and the Treatment of Atopic Dermatitis

October 2014 | Volume 13 | Issue 10 | Original Article | 1180 | Copyright © October 2014

Joseph F. Fowler Jr. MD FAAD

Division of Dermatology, University of Louisville School of Medicine, Louisville, KY

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Atopic Dermatitis and hereditary eczema are characterized by erythema, pruritus, scaling, lichenification, and papulovesicles, and Schumaus and colleagues analyzed the efficacy of a proprietary formulation of standardized avenanthramide fraction isolated from oats in a topical suspension for ultraviolet (UV) radiation-induced erythema.8 The study included 9 subjects who were given an erythema-inducing dose of UV light. The test areas of the subjects skin were treated 24 hours after irradiation with the standardized avenanthramide fraction, and the subjects’ erythema was calculated relative to baseline. The 5ppm avenanthramides fraction produced a 75% reduction of histamine release in the irradiated areas of the skin, and a statistically significant (P<0.05) relief from erythema symptoms, such as itching, 30 minutes following its application. After one-hour, redness was reduced by more than 85% and after two hours the area of redness was reduced by 90%.
Oat colloidal suspensions have been used for decades as adjuncts in the treatment of AD, especially in the US, and Nebus and colleagues evaluated an oatmeal-based occlusive cream on subjects with AD.9 Fifty patients between 12 to 60 years of age with mild to moderate AD, as measured by Hanifin and Rajka criteria, were enrolled into this multicenter, double-blinded, randomized clinical study. For 8 weeks, the patients used a daily skin care regimen consisting of twice a day application of an oatmeal-based occlusive cream (with vitamins and ceramides) and an oatmeal glycerin cleanser for moisturizing and body cleansing. Patients were also allowed to use their normal topical medications for their AD.
Independent dermatologist evaluations were performed at multiple time points throughout the study. The investigators found that the subjects who used an oatmeal-based occlusive cream and an oatmeal glycerin cleanser had significant improvements (P<.05) in the Eczema Area Severity Index (EASI) and Investigator’s Global Assessment (IGA) scores after only 2 weeks of using the oat-based skin care regimen. Improvements in perceived itch (P<.05) were also noted at the 2-week time point. Patients provided positive feedback after using the regimen, and they perceived multiple skin benefits, including improved skin texture, decreased discomfort, and an overall improved look and feel. (Figure 2)
Goujon and colleagues assessed the risk of immediate and delayed allergic reactions to repeated and maximized applications of oat-containing cosmetics and oat extracts and their tolerance in cereal-sensitized adults with AD.10 The 45-day, open-label pilot study included 12 cereal-sensitized atopic adults. The subjects were given repeated and maximized applications of oat-containing cosmetics at day 0, day 10, and day 31, and patch and prick tests were performed at day 7 and day 42. Goujon and colleagues found that oat-based cosmetics in cereal-sensitized atopic adults did not produce immediate or delayed allergic reactions and were well tolerated, and cereal sensitization does not increase the risk of allergic reactions to oat-containing cosmetics.
Patients with AD are susceptible to allergens, and Italian investigators evaluated the allergic skin reactions of normal and