Oat in a Healing Ointment: 21st Century Evidence for the Use of Avena sativa

Vincent Richer, MD, FRCPC^1,2

¹Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
²Pacific Derm, Vancouver, BC, Canada

Conflicts of interest: Vincent Richer participates in clinical trials, advisory boards and/or acts as a speaker for Abbvie/Allergan Aesthetics, Bausch Health, Galderma, Kenvue, Leo Pharma, L’Oréal and Merz Aesthetics.

ABSTRACT
Skin barrier dysfunction and its effects on wound healing continue to be significant challenges worldwide. Oat (Avena sativa) has been used for skin health for more than 4000 years, but it was not until the 1990s that colloidal oatmeal was introduced commercially in leave-on lotions. The three components of oat leverage different characteristics to restore skin barrier integrity: occlusive, humectant, emollient, endogenous production of epidermal lipids, healthy microbiome support and dampening of inflammation. Along with the expanded spectrum of oat-based products, advances in formulation have improved efficacy and cosmetic acceptability. The recently introduced Aveeno Healing Ointment^® is composed of 40% glycerin, shea butter and Triple oat. It is a semi-occlusive healing ointment well suited to patients with sensitive skin that may experience fissures or scaling and want to avoid petrolatum products due to their sticky texture or sourcing. This semi-occlusive formula has the potential to enhance compliance when recommending a healing ointment and to effectively support patients in rebuilding their skin barrier when it is compromised.

Keywords: oats, skincare, skin barrier

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Introduction

Despite ongoing scientific and therapeutic advances, skin barrier dysfunction and its effects on wound healing continue to be a significant challenge worldwide with consequences including but not limited to xerosis, dermatitis, delayed wound healing and secondary skin infections.¹ Once believed to be primarily a complex physicochemical barrier composed of critical elements such as ceramides, hyaluronic acid and filaggrin, the epidermal barrier is now understood to be more structurally complex than “bricks and mortar”, with the microbiome (“fauna and flora”) contributing to intricate host-environment interactions. Research has yielded a more complete understanding of the molecular pathophysiology, including new therapeutic targets, which has also unmasked the scientific underpinnings behind time-honored treatments such as the use of oats in skin care.

History

Oat (Avena sativa) has been used for skin health for more than 4000 years. It was first formally studied for dermatologic use in the 1930s and formulated as a bath preparation at the Mayo Clinic in 1945.² Its first mention in the medical literature occurred in 1953,³ but it was not until the 1990s that colloidal oatmeal was introduced commercially in leave-on lotions. Colloidal oatmeal is acknowledged by the US FDA as a safe and effective skin protectant. It is also the sole medicinal ingredient acknowledged by Health Canada that can claim to temporarily protect against and help relieve the symptoms of eczema. This institutional recognition is the culmination of several studies that evaluated the safety and efficacy of colloidal oatmeal to improve clinical outcomes of atopic dermatitis.⁴

Mechanism of Action of Moisturizers and Healing Ointments

Traditionally, ingredients within moisturizers are believed to restore the skin barrier by performing three primary roles:

• Occlusive: prevents or delays epidermal water loss/evaporation while protecting against environmental irritants
• Humectant: binds to and holds water within the skin
• Emollient: physically occupies superficial cutaneous irregularities to smoothen skin surface

The modern scientific understanding of moisturizers acknowledges that they not only serve as external replacement agents for water, but their components can:⁵

• Stimulate endogenous production of elements, including ceramides and filaggrin,
• Support a healthy microbiome by affecting skin-commensal bacteria, and
• Regulate inflammatory mediators to dampen inflammation.

For simple wound care such as cuts/scrapes or after procedures on the skin, routine recommendations are to apply an occlusive healing ointment after thoroughly cleansing the area with soap and water. The occlusive layer serves as a physical barrier against environmental irritants and pathogens, while simultaneously creating a favorable matrix for fibroblast activity. Until now, minimal attention has been given to humectant or emollient mechanisms of action benefiting the skin surrounding wounds.

Components of Oat

Oat has three components (Triple oat) that leverage these different mechanisms to restore the skin barrier:

• Oat oil: occlusive, humectant and endogenous stimulator of ceramides. Oat oil was demonstrated to induce ceramide synthesis in keratinocytes via the activation of the peroxisome proliferator-activated receptors (PPAR) pathway.⁶
• Oat flour: normalizes/buffers pH⁷, which supports a healthy microbiome population⁸. Oat flour behaves as a prebiotic, increasing the growth rate and metabolism of commensal bacteria Staphylococcus epidermidis over pathogens such as Staphylococcus aureus.⁹
• Oat extract: blocks the production of cytokines and reduces inflammatory mediators. Oat extract is rich in avenanthramides, the principle polyphenolic antioxidants in oats.⁴ Avenanthramides exert their benefits via nuclear factor-kappaB (NF-kB) and inhibit tumor necrosis factor (TNF)-alpha and interleukin (IL)-8 release.

Healing Ointments in Dermatology: Addressing Challenges in the Therapeutic Landscape

Dermatologic scientific societies have long advocated as their recommendations for wound healing and post-procedure care¹⁰ to: 1) cleanse the area with soap/water (avoiding routine use of antiseptics like peroxide that may also damage healthy cells) and 2) apply antibiotic-free ointments to the wound (minimizing allergic contact dermatitis to antibiotics and antibiotic resistance). Petrolatum-based healing ointments are routinely employed by dermatologists for this purpose, due to their excellent occlusive properties. However, they do face real-life compliance issues due to experiential drawbacks such as a sticky or tacky texture that does not “vanish”, an unwanted shiny appearance of the skin that can transfer to clothes and objects, or the development of acneiform lesions. These factors negatively impact compliance, which pose a significant challenge with the use of topicals in dermatology at large. An ideal healing ointment would provide long-lasting hydration to rebuild the skin barrier while enabling repair. More recently, patients and consumers have raised concerns and preferences about the sourcing, origin and use of petrolatum in skin care products. Consequently, a healing ointment that optimizes the patients’ textural experience and does not rely on petrolatum addresses an unmet need.

Aveeno Healing Ointment^®

Aveeno Healing Ointment^® is composed of 40% glycerin, shea butter and Triple oat. It is a semi-occlusive healing ointment well suited to patients with sensitive skin that may experience fissures or scaling. The absence of petrolatum, lanolin, fragrance, mineral oil, dyes and parabens has the potential to enhance tolerance on the skin and patient acceptance. Beyond the benefits of oat extract, oat oil and oat flour discussed previously, both glycerin and shea butter are occlusive while also demonstrating humectant and emollient properties. The ability to also draw moisture in – and to foster a healthy skin barrier via multiple mechanisms – differentiates its formulation from the use of single-ingredient petrolatum ointments. It also provides a more elegant consumer experience that may foster adherence, including at body sites like the face, lips and folds where use of healing ointments can be more challenging. In an internal study, 288 of 419 (69%) of subjects preferred Aveeno Healing Ointment^® over petrolatum ointment. After three days of use, there was a 61% improvement in skin hydration (data on file, Kenvue Brands LLC 2025). The typical patient profile for this product is broad: individuals of any Fitzpatrick skin phototype, with sensitive skin, seeking to avoid fragrances as well as ingredients like petrolatum or lanolin in skin care, looking for a healing ointment to moisturize and repair the skin while avoiding a greasy texture.

Conclusion

Healing ointments are routinely recommended by dermatologists, however patient concerns with heavy/sticky texture on the skin, shiny appearance or the development of acneiform lesions may limit their use. Consumer concern about the sourcing and origin of petrolatum in skin care may further negatively impact compliance. Aveeno Healing Ointment^® is a petrolatum-free alternative that builds on the traditional occlusive properties of healing ointments by adding humectant and emollient properties with a formulation containing Triple oat, 40% glycerin and shea butter. This formulation also leverages the endogenous production of ceramides, hyaluronic acid and filaggrin while supporting a healthy skin microbiome and reducing inflammatory mediators. This semi-occlusive preparation represents an advance in formulation that has the potential to enhance compliance when recommending a healing ointment and to effectively support patients in rebuilding their skin barrier when it is compromised.