The Efficacy of Colloidal Oatmeal Cream 1% as Add-on Therapy in the Management of Chronic Irritant Hand Eczema: A Double-Blind Study

The big idea:

Irritant contact dermatitis (ICD) is the most frequent cause of hand eczema (HE). There is promising evidence regarding the use of topical oatmeal compounds in the management of inflammation and itch-responses associated with diverse dermatologic conditions.

What the study asked:

The study aimed to evaluate the clinical benefit of colloidal oatmeal cream in the management of chronic irritant hand eczema.

What the study did:

• A double-blind study was conducted to understand the effectiveness of colloidal oatmeal cream 1% in treating chronic irritant hand eczema.

  • Double-blind study: a rigorous clinical research design where neither the participants nor the researchers know who is receiving a particular treatment or a placebo.

• The study compared the effects of hand eczema severity between a group of patients who used only the base cream to another group who also used the colloidal oatmeal cream 1%.

• Colloidal oatmeal cream 1% was used as an adjunct treatment alongside a topical corticosteroid:

  • Participants in both the intervention and control groups received fluocinolone 0.025% ointment twice daily for the first 2 weeks of the 6-week study period before switching to the oatmeal or base cream alone for the remaining 4 weeks.

Introduction to colloidal oatmeal creams:

• Relieves Intense Itching (Anti-Pruritic):

  • Colloidal oatmeal contains compounds that provide immediate relief from the itching and discomfort often associated with eczema.

• Reduces Inflammation and Redness:

  • It contains antioxidants, such as Vitamin E and avenanthramides, which reduce inflammation, calm irritated skin, and fight oxidative stress.

• Balances Skin Microbiome:

  • Reduce Staphylococcus aureus (staph) bacteria—which often exacerbates eczema—and promotes healthier skin microbiome.

  • Colloidal oatmeal acts as a prebiotic that supports the growth of beneficial microorganisms like S. epidermidis, which helps produce lactic acid and lowers the pH to a healthier, more acidic level.

• Maintains Skin pH:

  • It helps balance the skin’s natural pH, which is often disturbed in eczema-prone skin.

  • The proteins (globulins and prolamines) and carbohydrates in colloidal oatmeal act as pH buffers that effectively reduce the high pH (alkalinity) of damaged skin.

What the study found:

1. Greater improvement in hand eczema symptoms for those who used colloidal oatmeal cream 1%.

   1. Over the course of the study, patients using the colloidal oatmeal cream showed a more sustained reduction in hand eczema severity scores than those using the base cream.

   2. In the control group, symptoms tended to return toward baseline by week 6, but this did not happen in the oatmeal group.

2. Less itching (pruritus):

   1. Participants treated with colloidal oatmeal had significantly lower itch scores compared with the control group during the study period.

3. Minimal side effects

   1. Few participants in the intervention group (used colloidal oatmeal cream 1%) mentioned cases of burning sensations/redness but the number was comparable to that of those who only used the base cream.

   2. Additionally, none of the reported side effects were serious and did not lead to complications, showing that colloidal oatmeal cream 1% is generally well tolerated. 

What this means for eczema:

Colloidal oatmeal 1% cream is generally and safe and effective treatment for chronic irritant hand eczema when paired with adjunct treatments such as topical corticosteroids.

Link to study:

https://pubmed.ncbi.nlm.nih.gov/32273745/