What’s Best for Eczema (Atopic Dermatitis): Coconut Oil vs. Mineral Oil vs. Vaseline

Natural topical remedies for eczema, including licorice root gel, St. John’s Wort cream, and emollients such as coconut oil, mineral oil, and petroleum jelly, are put to the test.

Despite the availability of drugs with proven efficacy for eczema, like topical steroids, many patients seek out natural alternatives. Which plant, then, should be used for which skin disease? In the case of eczema, two appeared to beat out placebo. One was licorice root. As you can see at 0:24 in my video Eczema Treatment with Coconut Oil vs. Mineral Oil vs. Vaseline, smearing on a placebo gel didn’t appear to help much with clearing redness or itchiness after one week or two weeks, but a 1 percent licorice gel and especially a 2 percent gel did seem to clear the symptoms in most patients. The researchers concluded that licorice extracts could be considered an effective eczema treatment agent.

The other successful trial was with a St. John’s wort cream, showing a reduction in eczema severity scores week by week superior to that of placebo, as you can see at 0:49 in my video. So, it works better than nothing, but does it work better than drugs? Better than the topical steroids? That we don’t know. Sometimes, the drugs don’t work on so-called recalcitrant atopic dermatitis, so researchers in Japan asked patients to drink four cups of oolong tea every day for a month. Most patients “showed marked to moderate improvement,” starting after one or two weeks, and then most remained better even five months after they stopped. The problem is there was no control group, so we don’t know how many would have gotten better on their own. But, since drinking tea is healthy anyway, why not give it a try? 

Let’s get back to topical treatments. As you can see at 1:43 in my video, a vitamin B12 cream showed better results than the same cream without vitamin B12. Most of the patients and doctors rated the results of the B12 cream as “good,” which was better than they scored the placebo cream. 

Regardless of what topical agent you use, steroid or otherwise, “first and foremost, it is essential that the skin barrier is protected and maintained with the use of emollients,” meaning moisturizers, ideally once or twice a day, especially right after showering, to lock in the moisture. Petroleum jelly, like Vaseline, is highly effective, but it “is greasy and can be messy,” so what about something like coconut oil, which is less greasy? It was found to improve skin dryness, though no better than mineral oil, which is cheaper. Is mineral oil safe, though?

Exposure to mineral oil was found to be associated with rheumatoid arthritis, but that was occupational exposure to industrial mineral oils, like hydraulic fluid. The same group of researchers subsequently found that cosmetic grade mineral oil did not seem to carry the same risk. In general, topically applied mineral oil shouldn’t present any health risk, but that doesn’t mean…you can safely inject it into your penis, as that “may have devastating cosmetic and sexual function consequences.” There is, however, evidently one good use for mineral oil on the penis, and that’s for “penile zipper entrapment.” Skin of the penis “is susceptible to entrapment in the zipper of careless young boys, particularly those who fail to wear undergarments. Understandably, this mishap provokes distress in the unfortunate victim, in his parents, and ultimately in the health care provider charged with the task of liberating the organ.” A recommended textbook approach is surgery, believe it or not, but if you simply dose liberally with some mineral oil, you can just slip the zipper off and “physical and psychologic trauma is minimized for all parties involved…”

But, just because mineral oil works as well as coconut oil for dry skin, doesn’t mean it works as well for eczema. Head-to-head topical virgin coconut oil works better than topical mineral oil at decreasing eczema severity, with twice as many children experiencing an excellent response after two months treatment. Thus, among pediatric patients with mild to moderate eczema, topical application of virgin coconut oil was superior to mineral oil, but what about compared to virgin olive oil? As you can see at 4:19 in my video, olive oil worked, dropping eczema severity, but coconut oil worked better. 

As I discussed previously in my video What about Coconuts, Coconut Milk, and Coconut Oil MCTs?, we know that coconut oil has a lot of saturated fat, so we don’t want to consume it, but the saturated fat isn’t absorbed into your skin unless you are a baby, when your skin is so thin that you can actually absorb saturated coconut fat into your bloodstream. But, in older children and adults, using coconut oil on your skin or hair is considered safe. 

What about treating eczema with just plain Vaseline? People with eczema already know it can be expensive to deal with. The average out-of-pocket costs can be $274 a month, which is more than a third of a typical family’s disposable income. In contrast, you can rub a kid from head to toe with petroleum jelly for about four cents, whereas coconut oil or some of the fancier over-the-counter moisturizers can be many times more expensive, though not as bad as some prescription moisturizers that can cost more than a hundred dollars per tube and work no better than the over-the-counter stuff, as you can see at 5:50 in my video. There is simply no evidence “prescription device moisturizers” are superior to the traditional, petroleum jelly-based over-the-counter products that can be 65 times cheaper.

Doesn’t virgin coconut oil have active ingredients, though, whereas petroleum jelly is just inert? Vaseline has been around since 1872, but it took the scientific community 144 years to put it to the test. We now know it isn’t inert at all, significantly upregulating genes that fight infection, inducing the expression of genes that help with barrier function, increasing the thickness of the protective outer layer of skin, and actively reducing inflammation. Yes, but is it safe? Not… if you inject it into your penis. (What is it with men injecting stuff into their penis?!) “In the less severe cases, the problem [this self-injection creates] could be solved by basic surgery. Otherwise, it may require major reconstruction. Evidently, “Vaseline self-injection of the penis” is done a lot by prisoners, giving a whole new meaning to the term “Jailhouse Rock.” An unbelievable one in six inmates at the largest prison in Hungary admitted to “Vaseline self-injection.” Or how about actual rocks, the surgical implantation of stones in the penis, which has also been reported? What about injecting industrial silicone? (I will never look at silicone caulk the same way ever again.) When men were asked why they were injecting cod liver oil, a fishy substance, into their penises, most explained it was because they felt underendowed, as you can see at 7:40 in my video, but one guy said he “just want[ed] to try.” Um…okay. Why inject cod liver oil into your penis, though, when you can just inject the mercury directly and cut out the middlefish?

Back to eczema! Based on 77 studies of moisturizers for eczema, researchers “did not find reliable evidence that one moisturizer is better than another,” though a consensus of experts concluded that petroleum jelly may be best for skin barrier function protection.

What about eating coconut oil? See Coconut Oil and the Boost in HDL “Good” Cholesterol and What About Coconuts, Coconut Milk, and Coconut Oil MCTs?.

What about the swallowing oil supplements? That was the topic of my video, Eczema Treatment with Evening Primrose Oil vs. Borage Oil vs. Hempseed Oil.

I have more on eczema coming up, so make sure you’re subscribed so you don’t miss anything.

In health, 

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

Dietary Supplements for Eczema (Atopic Dermatitis)

Are there dietary supplements that can help with atopic dermatitis?

Atopic dermatitis, more commonly known as eczema, ranks “as the skin disease with the greatest health burden worldwide” because it’s just so common, affecting maybe one in ten kids and about 3 percent of adults, causing patches of red, itchy skin. Topical steroids, like cortisone cream, have been “the mainstay treatment” since their Nobel Prize-winning discovery in 1950.

People are scared of steroids, though, and “it is not uncommon for patients to express irrational fear and anxiety about using topical corticosteroids”—steroid creams and ointments. This phobia may arise from confusing topical steroids with oral or injected steroids, which have different effects. Really potent topical steroids can thin your skin, but skin thickness should return to normal a month after stopping. So, yes, topical steroids can cause side effects, but the concern people have “seems out of proportion” to the small risk they actually pose. Still, if there’s a way you can resolve a problem without drugs, that’s generally preferable. What did they do for eczema before the 1950s?

In the 1930s, some researchers tried using vitamin D dissolved in corn oil, and to their surprise, it worked—but so did the corn oil without the vitamin D they were using as a control. Others reported cases improving after feeding flaxseed oil and even ingesting lard, from a study “aided by a grant from the National Live Stock and Meat Board,” which apparently did not want to be left out of the action. The problem is that none of these studies had a control group. So, yes, after feeding someone corn oil for 12 to 18 months, they got better—but maybe they would have gotten better anyway. You don’t know until you put it to the test. 

Nearly all of those researchers who claimed benefit from the use of the various fats apparently “lack[ed]…any great interest in a controlled series,” but one researcher tested some oils and found no evidence of benefit over routine treatment. Indeed, as you can see at 2:06 in my video Eczema Treatment with Evening Primrose Oil vs. Borage Oil vs. Hempseed Oil, most got better either way, which suggests that the previous “benefits claimed may be due to the usual treatment, with perhaps a dash of enthusiasm.”

By then, hydrocortisone was out, so the medical community gave up on dietary approaches—until a letter was published in 1981 about the treatment of eczema with supplements of evening primrose oil, which contains gamma linolenic acid, an anti-inflammatory omega-6. And, indeed, when it was put to the test, it seemed to help, but then a subsequent larger study found no effect. Whenever there are conflicting findings, it helps to do a meta-analysis, where you put all the studies together. So, there was the study that showed benefit, the one that didn’t, and seven other studies. What did those find? Seven out of the seven showed benefit. “The results show that the effects of Epogam [a brand of primrose oil supplement] are almost always significantly better than those of placebo.” Case closed, right? Well, the analysis was funded by the supplement company itself, which can be a red flag, and where exactly were the other seven studies published? They weren’t. The company just said it did those seven studies but never released them. When asked to hand them over, the company said it would but never did, even threatening a lawsuit against researchers who dared to question the studies’ efficacy.

An independent review failed to find evidence that evening primrose oil or borage oil worked better than placebo. “As we bid goodnight to the evening primrose oil story, perhaps we can awaken to a world where all clinical trial data…reach the light of day…” 

Borage oil actually has twice the gamma linolenic acid as evening primrose yet it still didn’t work, but that didn’t stop researchers from trying hempseed oil, which “has been used as a food and medicine for at least 3000 years in China.” Researchers tried giving about a quarter cup of hempseeds’ worth of oil to people every day for a few months and found significant improvements in skin dryness, itchiness, and the need for medications—but not compared to placebo. In fact, studies of dietary supplements across the board, whether fish oil, zinc, selenium, vitamins D, E, or B6, sea buckthorn oil, hempseed oil, or sunflower oil, overall, showed “no convincing evidence that taking supplements improved the eczema of those involved.” That’s disappointing, but wait a second. That’s just for oral supplements. What about natural remedies applied topically? I discuss that in my video Eczema Treatment with Coconut Oil vs. Mineral Oil, vs. Vaseline.

Meta-analyses can be skewed the other way, too, when negative results are quietly shelved so only positive findings are published. Antidepressant medications are a classic example of this publication bias. Check out my coverage of it in my video Do Antidepressant Drugs Really Work?.

As I queued up at the end, I cover topical natural treatments in my next video, Eczema Treatment with Coconut Oil vs. Mineral Oil vs. Vaseline.

What about skipping the lard and trying to eat more healthfully? See what happened in Treating Asthma and Eczema with Plant-Based Diets.

For more on skin health, check out:

In health, 

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

Dietary Cure for Hidradenitis Suppurativa

What is the role of dairy- and yeast-exclusion diets on arresting and reversing an inflammatory autoimmune disease?

A landmark study suggested that exposure to dietary yeast, like baker’s yeast, brewer’s yeast, and nutritional yeast, may worsen the course of Crohn’s disease, an autoimmune inflammatory bowel disease. The reason the researchers even thought to do the study was because Crohn’s patients tend to have elevated levels of antibodies to yeast, but Crohn’s is not the only autoimmune disease with increased yeast antibodies. The same has been found in lupus patients, found in rheumatoid arthritis, found in another joint disease called ankylosing spondylitis, found in autoimmune liver disease, and also found in autoimmune thyroid disease. So, might avoiding yeast help those conditions, too? They haven’t been put to the test, but hidradenitis suppurativa has. What is that? I discuss this in my video Dietary Cure for Hidradenitis Suppurativa.

Hidradenitis suppurativa can be a gruesome disease. It starts out with just pimples, typically along parts of the body where there are folds, such as the armpits, groins, buttocks, and under the breast. Then, painful nodules form that turn into abscesses and drain a thick, foul-smelling pus. And then? It gets even worse, forming active tunnels of pus inside your body.

And, it is not that rare. It has an estimated prevalence of about 1 to 4 percent, which is like 1 in 50. Clothes typically cover it up so it remains hidden, but you can often smell the pus oozing out of people. There are all sorts of surgical options and chemotherapy, but why did researchers even think to try diet for the condition? I mean, since Crohn’s is a disease of intestinal inflammation, you can see how a food you react to could make matters worse, but why a disease of armpit inflammation? Because there seems to be a link between hidradenitis suppurativa and Crohn’s disease. Having one may make you five times more likely to have the other, so there may be an “immunopathogenic link” between the two—they may share similar abnormal immune responses. Given that, if cutting yeast out of Crohn’s patients’ diets helps them, then maybe cutting it out of the diets of people with hidradenitis suppurativa might help them. A dozen patients with hidradenitis suppurativa were put on a diet that eliminated foods with yeast, like bread and beer, and they all got better, 12 out of 12. There was an “immediate stabilization of their clinical symptoms, and the skin lesions regressed,” that is, reversed, and went away within a year on the diet. Okay, but how do we know it was the yeast? By cutting out a food like pizza, you also may be cutting out a lot of dairy, and that also appears to help. Indeed, a dairy-free diet led to improvement in about five out of six patients.

See, those tunnels of pus are caused by the rupturing of the same kind of sebaceous glands that can cause regular acne. In hidradenitis suppurativa, however, they explode, and “[d]airy products contain 3 components that drive the process that blocks the duct [clogging your pores] and contributes to its leakage, rupture, and ultimate explosion.” First, there’s casein, which elevates IGF-1. (I have about a dozen videos on IGF-1.) Second, the whey and lactose, and third, the hormones in the milk itself—six hormones produced by the cow, her placenta, and mammary glands that end up in the milk. So, why not try cutting out dairy to see if things improve?

There is a whole series of nasty drugs you can use to try to beat back the inflammation, but as soon as you stop taking them, the disease can come roaring back. Even after extensive surgery, the disease comes back in 25 to 50 percent of cases, so we are desperate to research new treatment options. But, patients aren’t waiting. They’re getting together in online communities, sharing their trial and error though social media, and people have reported successes cutting out dairy and refined carbohydrates, like white flour and sugar. So, a dermatologist in New Hampshire decided to give dairy-free a try, and 83 percent of the hidradenitis suppurativa patients he tried it on started to get better. What’s more, he didn’t even try cutting the sugar and flour out of their diets. Now, he didn’t conduct a clinical trial or anything. He just figured why not give dairy-free a go? It’s not easy to conduct randomized, clinical, dietary interventions, but that doesn’t stop individual patients from giving things a try. I mean, you can understand why there have to be institutional review boards and the like when trying out new, risky drugs and surgeries, but if it’s just a matter of trying a switch from cow’s milk to soy milk, for example, why do they have to wait? “As patients search for an effective path to clearance [of this horrible disease], they need support and guidance to follow the most healthful diet available, free of dairy and highly processed sugar and flour. Nothing could be more natural.”

But what about the yeast? How do we know it was the yeast? In the study we discussed earlier, 8 of the 12 patients had just gone through surgery, so maybe that’s why they got so much better. It’s similar to when I hear that someone with cancer had gone through the conventional route of chemotherapy, surgery, and radiation before going to some questionable clinic and then attributes their cure to the wheatgrass colonics or whatever else they got. How do they know it wasn’t the chemo/surgery/radiation that saved them? Well, in this study, why do we suspect it was the yeast? Because not only did every single one of the patients get better, “all the patients demonstrated an immediate recurrence of skin lesions following accidental or voluntary consumption of beer or other foods” like bread. So, not only did the elimination of yeast result in “rapid stabilization” and “a slow, but complete, regression of the skin lesions within a year,” but, in every single case, within 24 to 48 hours of taking a little brewer’s yeast or other “yeast-containing foods,” BAM!—the symptoms were back. So, that’s why the researchers concluded a “simple exclusion diet could promote the resolution of the skin lesions involved in this disabling and [perhaps not so] rare disease.”

What was the response in the medical community to this remarkable, landmark study? “Why was there no mention of informed consent and ethics committee approval…?” Letter after letter to the editor of the journal complained that the researchers had violated the Declaration of Helsinki, which is like the Nuremburg Code or Geneva Convention to protect against involuntary human experimentation, and asked where was the institutional review board approval for this yeast-exclusion study? In response, the researchers simply replied that they had just told them to avoid a few foods. They had given them the choice: We can put you on drugs that can have side effects, such as liver problems, or you can try out this diet. “The patients preferred the diet.” Let’s not forget, I would add, that they were all cured!

Anyway, bottom line, by avoiding foods, like pizza, which contains both dairy and yeast, sufferers may be able to prevent the ravages of the disease.

This is the fourth and final installment of a video series on the role baker’s, brewer’s, and nutritional yeast may play in certain autoimmune diseases. If you missed any of the others, see:

For more on dairy hormones, see:

Check out our IGF-1 topic page if you’re unfamiliar with this cancer-promoting growth hormone, which I highlight in my video Animal Protein Compared to Cigarette Smoking.

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations: