COLLOIDAL OATMEAL CHEAT SHEET

Oatmeal has been used as a skin care ingredient since 2000 BC in ancient Egypt, where whole oats were used in soothing baths. Colloidal oat has been the subject of dedicated skin care research starting in the 1950s. After > 30 clinical studies comprised of over 3000 patients including conditions associated with a compromised skin barrier, colloidal oat is now recognized as a skin protectant by Health Canada and the US FDA, which acknowledged it as the only natural ingredient that can claim to protect and relieve symptoms of eczema.

COLLOIDAL OATMEAL CHEAT SHEET

INGREDIENT NAME 

Colloidal oatmeal, 0.007 percent minimum; 0.003 percent minimum in combination with mineral oil.

COMPOSITION AND BENEFITS

• • The main components of colloidal oatmeal are 65-85% polysaccharides (including beta glucans), 15-20% proteins, 3-11% lipids, saponins, vitamins (including vitamin E), minerals, antioxidants (including avenanthramides), and other protective compounds.¹

• • Beta Glucans: Polysaccharide constituents with potent hygroscopic (water holding) qualities.

• • Avenanthramides & other Polyphenols: Avenanthramides, the main polyphenolic antioxidants in colloidal oatmeal, demonstrate greater antioxidant activity than that of other oat phenolic compounds such as vanillin or caffeic acid^2,3

• • Oat Lipids: Fractionated oat oil is ~80% unsaturated fatty acids (42-52% linoleic acid, 27-32% oleic acid, and 17-21% palmitic acid), helps restore the skin moisture barrier and has shown pro-ceramide activity in-vitro.⁴

• • Proteins: Skin pH buffering, water-binding and barrier enhancing hydrophilic amino acids

• • Vitamin E: Naturally occurring antioxidant that helps protect against oxidative stress, inflammation and photo-induced aging.⁵

MECHANISM OF ACTION

• • Colloidal oatmeal has various mechanisms of action including direct anti-inflammatory, anti-pruritic, antioxidant, pre-biotic and moisture barrier repair properties, and beneficial effects on skin pH.

• • Moisture Barrier

In vitro data showed oat extracts increase transcription of skin barrier and differentiation genes which may aid in the treatment of inflammatory skin conditions.⁵ The occlusive and water-binding colloidal oatmeal film holds moisture in the stratum corneum, helping to replenish the barrier.^2,3 In vitro data showed oat lipids induce ceramide formation in skin cells.^2,3

• • pH Modulation

Colloidal oatmeal has been shown to have immediate and sustained pH buffering action to counteract elevated skin pH^6,7

• • Anti-pruritic

Avenanthramides, in colloidal oatmeal, have been shown in vitro to inhibit neurogenic inflammation, helping to break the itch-scratch cycle.⁸

• • Anti-inflammatory

Colloidal oatmeal extracts reduce the release of cytokines from human keratinocytes.^9,10 Avenanthramides inhibit IL-1ß induced NF-kB activation in endothelial cells; suppress IL-1ß secretion of pro-inflammatory cytokines such as IL-6, IL-8 and MCP-1.¹¹

• • Antioxidant

Avenanthramides, in colloidal oatmeal, function as antioxidants inhibiting lipoxygenase-activated fatty acid oxidation and nonenzymatic oxidation.^3,12

• • Pre-biotic

Oat flour supports the growth of commensal microorganisms, such as S. epidermidis to help balance the skin’s microbiome.¹³

FDA MONOGRAPH Skin Protectant Product:

• • A drug product that temporarily protects injured or exposed skin or mucous membrane surfaces from harmful or annoying stimuli, and may help provide relief to such surfaces.
  • Colloidal Oatmeal, that meets the strict quality requirements as determined by US pharmacopeia and National Formulary, is an active ingredient in the US OTC skin protectant monograph.¹⁵
  • Colloidal oatmeal is the only single skin protectant OTC active ingredient that can claim to temporarily protect and help relieve symptoms of eczema as recognized by the US FDA & Health Canada OTC Monographs.^14-16

INDICATIONS

• • Temporarily protects and helps relieve minor skin irritation and itching due to:
    • Rashes
    • Eczema
    • Poison ivy, oak, or sumac
    • Insect bites

CLINICAL OUTCOMES:

Oat is one of the most studied natural ingredients in skincare, with extensive in vitro and in vivo data across diverse adult and pediatric patient populations and clinical applications.

• • Colloidal oatmeal containing formulas have been proven to reduce itch severity and improve quality of life in eczema patients, delivering significant improvements in sleep quality, social activity and daily functioning.^17-19
  • Colloidal oatmeal containing formulas have been shown to improve symptoms of eczema as early as 1 day with increasing improvements over time.¹⁷
  • A 1% colloidal oatmeal containing emollient has been shown to be as effective at improving the signs and symptoms of eczema as a prescription barrier cream^20,21
  • In a 2-year retrospective study of over 54,000 patients with chronic dry skin and eczema, use of a colloidal oatmeal containing emollient showed a significant reduction in prescriptions written for steroids and antimicrobials²²
  • A colloidal oatmeal containing lotion has been shown to deliver significantly greater improvements versus its own vehicle in relieving the intensity, duration and frequency of itchy, dry skin.²³
  • A colloidal oatmeal containing lotion delivered significant and sustained improvements in dryness and roughness in diabetic dry skin patients.²⁴
  • A colloidal oatmeal containing lotion significantly improved dryness roughness, desquamation, discomfort, itching and the appearance of redness associated with mild psoriasis.²⁵
  • Colloidal Oatmeal containing formulas have been shown to significantly improve dermatologic side effects of oncology treatments in patients on systemic therapies.²⁶
  • A colloidal oatmeal containing lotion effectively controlled rash associated with epidermal growth factor receptor EGFRIs and multiple tyrosine kinase inhibitors in 100% of participants allowing for the continuation of antineoplastic therapy.²⁷
  • A colloidal oatmeal containing emollient shown to be an effective skincare approach in radiotherapy.²⁸

HOW TO USE

• • Apply as needed.

STORAGE

• • Store at room temperature.

WARNINGS

• • For external use only. See labeling for product specific warnings. 

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REFERENCES

1. 1. Health Benefits of Oat Phytochemicals. In: Oats Nutrition and Technology. Chichester, UK: John Wiley & Sons Ltd; 2013:171-194.
   2. Chu, Y.F.; Wise, M.L.; Gulvady, A.A.; Chang, T.; Kendra, D.F.; Jan-Willem van Klinken, B.; Shi, Y.; O’Shea, M. In vitro antioxidant capacity and anti-inflammatory activity of seven common oats. Food Chem.2013, 139, 426–431.
   3. Bratt, K.; Sunnerheim, K.; Bryngelsson, S.; Fagerlund, A.; Engman, L.; Andersson, R.E.; Dimberg, L.H. Avenanthramides in oats (Avena sativaL.) and structure-antioxidant activity relationships. J. Agric. Food Chem.2003, 51, 594–600.
   4. Southall M, Pappas A, Nystrand G, Nebus J. Oat oil improves the skin barrier. The Dermatologist. 2012;(suppl):1-4.
   5. Nachbar F, Korting HC. The role of vitamin E in normal and damaged skin. J Mol Med. 1995;73:7-17.
   6. Ilnytska O, Kaur S, Chon S, et al. Colloidal Oatmeal (Avena Sativa) Improves Skin Barrier Through Multi-Therapy Activity. J Drugs Dermatol. 2016;15(6):684-690.
   7. Vipawee S. Chat, BS; Shelley K. Uppal, BS; Donovan G. Kearns, BS; and Jashin J. Wu, MD, FAAD. Colloidal Oatmeal in the Treatment of Atopic Dermatitis Is this plant-based intervention an effective treatment alternative? Practical Dermatology. August 2020. 58-59
   8. 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):569-74.7.
   9. Chon SH, Tannahill R, Yao X, Southall MD, Pappas A. Keratinocyte differentiation and upregulation of ceramide synthesis induced by an oat lipid extract via the activation of PPAR pathways. Exp Dermatol. 2015 Apr;24(4):290-5..
   10. Makdisi J, Kutner A, Friedman A. Oats and Skin Health. In: Oats Nutrition and Technology. Chichester, UK: John Wiley & Sons Ltd; 2013:311-331.
   11. Guo W, Wise ML, Collins FW, et al. Avenanthramides polyphenols from oats, inhibit IL-1ß induced NK-kß activation in endothelial cells. Free Radic Biol Med. 2008;44:415-429.
   12. Dimberg LH, Theander O, Lingert H (1993) Avenanthramides- a group of phenolic antioxidants in oats. Cereal Chem 70:637–641
   13. Liu-Walsh F, Tierney NK, Hauschild J, et al. Prebiotic Colloidal Oat Supports the Growth of Cutaneous Commensal Bacteria Including S. epidermidis and Enhances the Production of Lactic Acid. Clin Cosmet Investig Dermatol. 2021;14:73-82.
   14. Fowler JF Jr. Colloidal oatmeal formulations and the treatment of atopic dermatitis. J Drugs Dermatol. 2014;13(10):1180-1185.
   15. FDA. Skin Protectant Drug Products for Over-the-Counter Human Use; Final Monograph. 68FR33362.June 4, 2003. Available from: http://www.fda.gov/downloads/Drugs/DevelopmentApprovalProcess/DevelopmentResources/Over-the-CounterOTCDrugs/StatusofOTCRulemakings/ucm091520.pdf Accessed 12.14.21
   16. Health Canada: Medicated Skin Care Products Monograph: http://webprod.hc-sc.gc.ca/nhpid bdipsn/atReq.do?atid=skin_peau&lang=eng Accessed 12.14.21
   17. Capone K, Kirchner F, Klein SL, Tierney NK. Effects of colloidal oatmeal topical atopic dermatitis cream on skin microbiome and skin barrier properties. J Drugs Dermatol. 2020;19(5):524-531.
   18. Parikh-Das A, Ganopolsky I, Moreira L, Vaught C. A clinical trial to determine the therapeutic benefit of an investigational over-the-counter cream on dry, itchy skin of adults and children with atopic dermatitis. JAAD. 2017;76(6 suppl 1):AB10.
   19. Clinical assessment of Aveeno® Eczema Therapy to alleviate dry to very dry skin or skin prone to atopic dermatitis and to improve the patients’ quality of life (n=75). Study sponsored by Johnson & Johnson do Brasil ind.Com. Prod. Para Saúde Ltda. Principal Investigator. Dr Lucia Helena Favaro de Arruda. Preliminary data presented by Dr Maria João Lopes at the ESPD Congress, Istanbul 2012.
   20. Nebus J, Nystrand G, Schmalenberg K, et al. Comparing the effectiveness of Aveeno® Eczema Therapy Moisturizing Cream and a leading prescription skin barrier emulsion in improving skin moisturization and barrier function in moderate to severe dry skin (n=27). J Am Acad Dermatol. 2011; 64:AB71.
   21. Lisante T, Nuñez C, Zhang P. Efficacy and safety of an over-the-counter 1% colloidal oatmeal cream in the management of mild to moderate atopic dermatitis in children: a double-blind, randomized, active-controlled study. J Dermatolog Treat. 2017 Nov;28(7):659-667.
   22. Moncrieff, G., Lied-Lied, A., Nelson, G. et al. Cost and effectiveness of prescribing emollient therapy for atopic eczema in UK primary care in children and adults: a large retrospective analysis of the Clinical Practice Research Datalink. BMC Dermatol 18, 9 (2018).
   23. Kalaaji AN, Wallo W. A randomized controlled clinical study to evaluate the effectiveness of an active moisturizing lotion with colloidal oatmeal skin protectant versus its vehicle for the relief of xerosis. J Drugs Dermatol. 2014;13(10):1265-8.
   24. Nebus J, Wallo W. Safety and tolerance of skin protectant lotions with oatmeal in patients with diabetes. Presented at American Academy of Dermatology (AAD) 66th Annual Meeting; February 1-5, 2008; San Antonio, TX.
   25. Nollent V, Nebus J, Lisante TA. Tolerance and subject satisfaction of an over the counter colloidal oatmeal (Avena sativa) lotion in patients with psoriasis and sensitive skin. Poster presented at: American Academy of Dermatology (AAD) Annual Meeting; March 20-24, 2020; Denver, CO.
   26. Nebus J, Adenaike A, McGuire T, et al. Safety and efficacy of an Avena sativa (oat) skin care regimen for therapy-related xerosis and pruritus in adult oncology patients undergoing systemic cancer treatments. Poster presented at: American Academy of Dermatology (AAD) Virtual Meeting Experience (VMX); April 23-25, 2021.
   27. 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(1):71-74. doi:10.1111/j.1365-2230.2006.02285.
   28. Rudge, R. (2016). Colloidal oatmeal emollient as an alternative skincare approach in radiotherapy: A feasibility study. Journal of Radiotherapy in Practice, 15(4), 322-333. doi:10.1017/S1460396916000315

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