Eczema, also known as atopic dermatitis, is a common inflammatory skin condition characterized by dry, intensely itchy patches of skin. Many people search for natural, accessible remedies, and extra virgin olive oil (EVOO) frequently appears as a potential topical solution due to its moisturizing properties. This article examines the science behind EVOO and its suitability for managing eczema.
Understanding the Compromised Skin Barrier in Eczema
The skin’s outermost layer, the stratum corneum, functions as the primary barrier, often described using the “bricks and mortar” analogy. Skin cells are the bricks, and the intercellular lipids, which are a mix of ceramides, cholesterol, and fatty acids, act as the mortar holding everything together. In individuals with eczema, this barrier is inherently defective, often due to genetic factors and inflammation.
A compromised skin barrier allows for increased transepidermal water loss (TEWL), meaning moisture escapes easily, leading to excessive dryness and scaling. This defect also makes the skin highly permeable, allowing irritants, allergens, and microbes to penetrate the deeper layers. The infiltration of these foreign substances triggers an immune response, which causes the characteristic inflammation, redness, and itching associated with eczema.
Key Compounds in Extra Virgin Olive Oil and Their Role
Extra virgin olive oil is primarily composed of triacylglycerols, which are molecules made of fatty acids. The composition is dominated by monounsaturated fatty acids, particularly oleic acid (55% to 83%). It also contains the polyunsaturated omega-6 essential fatty acid, linoleic acid, usually ranging from 3.5% to 21%.
Linoleic acid is recognized as a precursor for ceramide synthesis, a major component of the skin barrier’s intercellular lipids. Oils rich in linoleic acid are considered beneficial for repairing the compromised barrier in eczema. EVOO also contains a minor fraction (1–2%) of compounds like polyphenols, including oleocanthal and hydroxytyrosol, and the antioxidant Vitamin E.
These minor components possess antioxidant and anti-inflammatory qualities that could theoretically help soothe irritated skin. Polyphenols in EVOO may help reduce oxidative stress and inflammation, which contribute to eczema flares. These properties are often why EVOO is traditionally seen as a healing agent for skin issues.
The Impact of Oleic Acid on Skin Barrier Integrity
Despite the presence of beneficial compounds, the primary fatty acid in extra virgin olive oil, oleic acid, poses a significant risk to the eczematous skin barrier. Oleic acid is a monounsaturated fatty acid that acts as a penetration enhancer, effectively disrupting the structure of the stratum corneum’s lipid matrix.
By inserting itself into the organized lipid layers, oleic acid creates temporary pathways that increase the skin’s permeability. While this allows for deeper penetration, it also severely compromises the barrier function, leading to increased transepidermal water loss. Research has demonstrated that topical application of EVOO can reduce the integrity of the stratum corneum and induce mild redness.
This barrier disruption can exacerbate existing eczema symptoms and potentially even promote the development of atopic dermatitis, particularly in individuals with sensitive or compromised skin, such as infants. Oleic acid may also negatively alter the skin’s delicate pH balance, which is vital for maintaining a healthy skin microbiome and barrier function. The high concentration of oleic acid in EVOO, often 70% or more, outweighs the potential benefits of its linoleic acid content.
Current Dermatological Consensus and Safer Alternatives
The current dermatological consensus advises against the routine topical use of extra virgin olive oil for managing eczema, especially for infants or individuals experiencing a flare-up. The high oleic acid content can damage the skin barrier and worsen symptoms, outweighing any theoretical benefit from its minor compounds. Organizations like the National Eczema Association do not recommend its use.
For individuals seeking natural oil alternatives, dermatologists typically recommend options with a significantly higher linoleic acid-to-oleic acid ratio. Oils such as sunflower seed oil preserve the stratum corneum’s integrity, improve skin hydration, and reduce inflammation. Virgin coconut oil is another alternative, which is rich in saturated fatty acids that help decrease Staphylococcus aureus colonization, a common issue in eczema.
The most recommended and cost-effective topical treatment for barrier repair remains thick, greasy occlusives, such as petroleum jelly, or moisturizers containing ceramides. These products physically seal moisture into the skin and support the lipid barrier without the damaging effects of high oleic acid. Before applying any new product, a patch test is prudent, and consulting a dermatologist is the best step for personalized eczema care.