assessing the safety and efficacy of colloidal oat compounds,
but on closer scrutiny that study had methodological problems.
A pair of the methodological flaws in the French study were
that the investigators used oat pollen and not proteins found
in colloidal oatmeal when conducting skin prick tests and IgE
testing. Oat pollen is unlikely to contain the same proteins that
are found in colloidal oatmeal, so an allergic reaction to oat
pollen would not be a predictor of an allergy to proteins found
in colloidal oatmeal.
Boussault and colleagues also used ATPs at three different
concentrations, but the investigators failed to report the
subjects’ reactions at the various concentrations, so clinical
correlation of allergic reactivity and ATPs is uncertain. The ATP
is neither routinely used, nor felt to be of clinical significance
in the US. The ROAT was also problematic, because they were
conducted in the subjects’ home in an unsupervised manner.
Moreover, only 25 of the original 302 subjects had a ROAT performed
with an oat-based emollient and only 7 of the subjects
had a “positive” test.
In conclusion, the FDA has acknowledged colloidal oatmeal to
be a safe and effective skin protectant, and it has been used
for decades to treat AD. In the treatment of AD, much of the
recognized benefit of oats is derived from its phenolic components,
especially avenanthramides, which have empirically
demonstrated robust antioxidant and anti-inflammatory effects.
Further, the majority of studies on oat-based products,
either in atopics or non-atopics, show no propensity toward
adverse events. And although rare cases of clinically relevant
oat allergy may exist, oat-based products are safe and effective
for the treatment of the vast majority of individuals,
including pediatric patients.
Joseph F. Fowler Jr. has served as a consultant for Johnson &
Johnson, Galderma, Innocutis, and Ranbaxy, and as a speaker
for Galderma, Innocutis, and Ranbaxy, and has received
research grants from Abbott, Allerderm, Allergan, Amgen,
Astellas, Galderma, Genentech, Johnson & Johnson, Lilly,
Medicis, Novartis, Qunnova, Taro, and Valeant.
Kurtz ES, Wallo W. Colloidal oatmeal: history, chemistry and clinical properties. J Drugs Dermatol. 2007;6(2):167-70.
Fowler JF, Nebus J, Wallo W, Eichenfield LF. Colloidal oatmeal formulations as adjunct treatments in AD. J Drugs Dermatol. 2012;11(7):804-7.
Camouse MM, Hanneman KK, Conrad EP, Baron ED. Protective effects of tea polyphenols and caffeine. Expert Rev Anticancer Ther. 2005;5(6):1061-8.
Saeed SA, Butt NM, McDonald-Gibson WJ, Collier HOJ. Inhibitor(s) of prostaglandin biosynthesis in extracts of oat (Avena sativa) seeds. Biochem Soc Trans. 1981;9:444.
Vie K, Cours-Darne S, Vienne MP, Boyer F, Fabre B, Dupuy P. Modulating effects of oatmeal extracts in the sodium laurel sulfate skin irritancy model. Skin Pharmacol Appl Skin Physiol. 2002;15(2):120-124.
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(10):569-74.
Chen CY, Milbury PE, Collins FW, Blumberg JB. Avenanthramides are bio available and have antioxidant activity in humans after acute consumption of an enriched mixture from oats. J Nutr. 2007;137(6):1375-82.
Schumaus G, Herrmann M, Joppe H, et al. Oat avenanthramides: new actives to reduce itch sensation in skin. Paper presented at: 23rd Congress of the International Federation of Societies of Cosmetic Chemists; October 24-27, 2004; Orlando, Fla.
Nebus J, Skillman NJ, Nystrand G. A daily oat-based skin care regimen for atopic skin. Poster presented at: 67th Annual Meeting of the American Academy of Dermatology, March 6-10, 2009; San Francisco, CA. P1301.
Goujon C, Jean-Decoster C, Dahel K, et al. Tolerance of oat-based topical products in cereal-sensitized adults with AD. Dermatology. 2009;218(4):327-33.
Pigatto P, Bigardi A, Caputo R, et al. An evaluation of the allergic contact dermatitis potential of colloidal grain suspensions. Am J Contact Dermat. 1997;8(4):207-9.
Grimalt R, Mengeaud V, Cambazard F. The steroid-sparing effect of an emollient therapy in infants with AD: a randomized controlled study. Dermatology. 2007;214(1):61-7.
Boussault P, Léauté-Labrèze C, Saubusse E, et al. Oat sensitization in children with AD: prevalence, risks and associated factors. Allergy. 2007;62(11):1251-6.
Joseph F. Fowler Jr. MD FAADFowlerjoe@msn.com