Applying virgin coconut oil before using alcohol-based hand sanitizer helped maintain transepidermal water loss (TEWL) and moisture level in the skin, and also prevented protein loss and inflammation, according to study findings published in the Journal of Cosmetic Dermatology. The findings may encourage use of virgin coconut oil to reduce hand skin damage from increased hand sanitizer use in the age of COVID-19.

For an in-home usage, randomized controlled study spanning 15 days, investigators separated volunteers 1:1 into a control group that applied a 70% ethanol in water solution as an alcohol-based hand sanitizer to their hands 6 times a day, and a test group that applied 4 to8 drops of commercially available virgin coconut oil to their hands before bed while also applying ABHS 6 times a day. On days 0 and 15, volunteers performed the World Health Organization (WHO) Hand Skin Self-Assessment tool. A separate questionnaire-based assessment was developed in consultation with a dermatology expert for the virgin coconut oil group with questions on moisturization, hand-feel, and safety.

Investigators separated the mid-volar forearms of a smaller subset of volunteers into 3 circular sites to test for biomarkers and moisture level. Each volunteer first received distilled water as the placebo on 1 forearm and virgin coconut oil as the test on the other forearm. On one of the 3 circular sites, investigators applied either distilled water as placebo, 70% ethanol solution once, or 70% ethanol solution 6 times with an hour between each application. Investigators used tewameter and corneometer probes on each site to measure transepidermal water loss and moisture level, respectively, and standard D-Squame tape for 6 consecutive tape strippings at each site to test for protein content and TNF-a levels as a marker of skin inflammation.


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Investigators also evaluated infrared (IR) spectroscopy on the lower portion of hands in a subset of volunteers, scanning them with an IR spectrophotometer then exposing them to close contact with alcohol-based hand sanitizer for 15 minutes before scanning their hands once more. Investigators performed these scans on days 0, 1 and 15, and instructed volunteers to apply 4 to8 virgin coconut oil drops nightly for those 15 days.

The in-home usage leg of the study included 60 Asian volunteers, 43% men, and aged 18 to 60 years. There were 2 individuals in the virgin coconut oil group who did not complete the study.

The WHO Skin Assessment Scale evaluates 4 skin characteristics: appearance, intactness, moisture content, and sensation, rated on a 7-point scale. Ratings for all characteristics except moisture content did not change significantly during the duration of the study. However, ratings for moisture content decreased by 11.8% toward dryness in the control group (P <.05) and increased by 15.4% in the virgin coconut oil group (P <.05). According to responses from the virgin coconut oil questionnaire, volunteers perceived an average of about 11 hours of hand skin protection from virgin coconut oil.

The skin moisture and biomarker leg of the study included 5 women and 7 men aged 18 to 60 years. TEWL values increased significantly in the control group, but did not change significantly in the virgin coconut oil group after 6 applications of alcohol-based hand sanitizer.

There were no significant changes in moisture level among the 3 circular sites in either group. The average protein content stripped out increased in the control group with increased alcohol-based hand sanitizer exposure, while the virgin coconut oil group’s protein content did not change significantly.

The average TNF-a level increased in the control group with 6 consecutive cycles of alcohol-based hand sanitizer (P <.05), but no significant change was seen in the virgin coconut oil group for the same number of cycles (P >.05).

For IR spectroscopy, the percent change in integrated intensity between pre- and post- alcohol-based hand sanitizer  exposure spectra was higher when volunteers’ hands were untreated with virgin coconut oil , and decreased with progressive virgin coconut oil  application, with a significant change in all 3 peak intensities by the end of 15 days of VCO use (P <.05).

“Based on the findings, a regimen of overnight virgin coconut oil application on hands as a natural prophylactic against the increased frequency of [alcohol-based hand sanitizer] usage is recommended,” the study authors wrote.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures. 

Reference

Saraogi P, Kaushik V, Chogale R, Chavan S, Gode V, Mhaskar S. Virgin coconut oil as prophylactic therapy against alcohol damage on skin in COVID times. J Cosmet Dermatol. Published online June 13, 2021. doi:10.1111/jocd.14258