Novel Antibacterial and Emollient Effects of Coconut and Virgin Olive Oils in Adult Atopic Dermatitis

Vermén M. Verallo-Rowell; Kristine M. Dillague; Bertha S. Syah-Tjundawan

Dermatitis. 2008;19(6):308-315.

Conclusion

A history of safe topical use and no known or reported cases of contact dermatitis, along with its dual effects as moisturizer and antiseptic, opens up more research and clinical possibilities for virgin coconut oil (VCO) and monolaurin. In the laboratory, VCO and monolaurin have also shown antimicrobial effects on fungi^[36] and enveloped viruses^[37] that (like Staphylococcus aureus) may infect or colonize sites of atopic dermatitis.

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Acknowledgments

Patients were seen and examined at the two charity clinics of the Skin and Cancer Foundation, Inc., in Pasig, Rizal, and Makati, Rizal, Philippines. The microbiologic testing was done at the microbiology laboratory of the Quirino Memorial Medical Center, Pasig, Rizal, Philippines.
Skin Sciences Laboratory, Inc., of Pasig, Rizal, Philippines, provided material support by supplying and packaging virgin coconut oil and virgin olive oil in uniform bottles.

Reprint Address

Verme'n M. Verallo-Rowell, MD, VMV Skin Research Centre + Clinics (VSRC), 117 C. Palanca, Legaspi Village, Makati, Rizal, Philippines; E-mail: vmvrmd@gmail.com

References

Demographics and Characteristics of Patients With Atopic Dermatitis (Modified Hanifin Criteria) in the Coconut Oil and Olive Oil Study Groups
Characteristic	Coconut Oil	Olive Oil	p Value*
Characteristic	(N = 26)	(N = 26)	p Value*
Age in years
Mean ± SD	32 ± 3	31 ± 4	-
Range	29–35	21–39	-.76^† (NS)
Sex
Male	13 (50%)	14 (54%)	-
Female	113 (50%)	12 (46%)	-.78^† (NS)
Duration in years (mean ± SD)	15 ± 3	18 ± 5	.09^† (NS)
Pruritus	25 (96%)	23 (88%)	.515^† (NS)
Lesion morphology			(NS)
Childhood: facial/extensor	12 (46%)	13 (54%)	0.58^†
Adult: flexures/lichenification	21 (81%)	22 (85%)	1.00^†
AD in family
YES	12 (46%)	8 (31%)	-
NO	14 (54%)	18 (69%)	-.26^† (NS)

AD = atopic dermatitis; NS = not statistically significant.
*Significant p-value if < .05.
^†Computed using statistical software Epi-Info V6 for tests of proportions, independent samples t-test, and chi-square test.

Demographics and Characteristics of Patients With Atopic Dermatitis (Modified Hanifin Criteria) in the Coconut Oil and Olive Oil Study Groups
Characteristic	Coconut Oil	Olive Oil	p Value*
Characteristic	(N = 26)	(N = 26)	p Value*
Age in years
Mean ± SD	32 ± 3	31 ± 4	-
Range	29–35	21–39	-.76^† (NS)
Sex
Male	13 (50%)	14 (54%)	-
Female	113 (50%)	12 (46%)	-.78^† (NS)
Duration in years (mean ± SD)	15 ± 3	18 ± 5	.09^† (NS)
Pruritus	25 (96%)	23 (88%)	.515^† (NS)
Lesion morphology			(NS)
Childhood: facial/extensor	12 (46%)	13 (54%)	0.58^†
Adult: flexures/lichenification	21 (81%)	22 (85%)	1.00^†
AD in family
YES	12 (46%)	8 (31%)	-
NO	14 (54%)	18 (69%)	-.26^† (NS)

Relative Risk for Colonization by Staphylococcus Aureus*
Group	Baseline		Post Intervention			Relative Risk^†
Group	Baseline		SA (+)	SA (-)	Total	Relative Risk^†
VCO	SA (+)	20 (77%)	1 (5%)	19 (95%)	20	Rt = 1/20 = 0.05
	SA (-)	6 (23%)	-	-	6	-
Total		26 (100%)			26
VOO	SA (+)	12 (46%)	6 (50%)	6 (50%)	12	Rc = 6/12 = 0.50
	SA (-)	14 (54%)	-	-	14	-
Total		26 (100%)			26	RR = 0.10 (95% CI, .01–0.73) p = .0028

Rc = risk of (+) colonies with virgin olive oil treatment; RR = relative risk; Rt = risk of (+) colonies with virgin coconut oil treatment; SA = Staphylococcus aureus; VCO = virgin coconut oil; VOO = virgin olive oil.
*Based on positive/negative colony readings (number and percentage) at baseline and 4 weeks after topical use of VCO versus VOO.
^†Rt (.05)/Rc (.50) = 0.10 (< 1, treatment benefits; > 1, treatment is harmful); absolute risk reduction (ARR) = Rt - Rc; number needed to treat is 1/ARR = 2.2.

Objective SCORAD Index Scores at Baseline and Post Intervention
Objective SCORAD Index	VCO Group (N = 26) (%)	VOO Group (N = 26) (%)	Mean Difference (%)	p Value
Baseline	39.2 ± 6.4	36.6 ± 6.3	2.6	.15 (NS)
Post intervention	22.6 ± 3.6	26.7 ± 5.7	-4.1	.004*^†
Mean difference	16.6	9.9	-	-
Percent reduction	46.8	30.1	-	-

NS = not statistically significant; SCORAD = SCORing Atopic Dermatitis; VCO = virgin coconut oil; VOO = virgin olive oil.
*Significant difference at p < .05.
^†Mann-Whitney U test.The drop in objective SCORAD index score from baseline was statistically significant within both the VOO group (36.6 to 26.7 points) and the VCO group (39.2 to 22.6 points), both Wilcoxon signed ranks (p < .005), although percent reduction with VCO is more than that with VOO.

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