Olive Oil

Many families use olive oil (Olea europaea) on their babies’ and toddlers’ skin. Natural oils are used for neonatal skin care around the world (Danby 2013), and UK midwives commonly recommended it for newborn dry skin. Its fatty-acid profile is dominated by Oleic Acid and contains comparatively little Linoleic Acid. The Vaughn 2018 review says this low linoleic:oleic ratio makes oleic-rich oils “detrimental to skin-barrier function”. Vaughn describes oleic acid as “irritating”. For a child with Skin Barrier Dysfunction, that means olive oil adds to the problem instead of repairing it.

Oleic Acid [part-of] Olive Oil Oleic Acid [worsens] skin barrier Olive Oil [part-of] Herbal and Home Remedies for Eczema

Adult evidence: Danby 2013. In randomised forearm-controlled studies in 19 adults with and without a history of Atopic Dermatitis, six drops of olive oil twice daily for 4–5 weeks significantly reduced stratum corneum integrity and caused mild erythema. This happened in volunteers with and without AD. On the other forearm, Sunflower Seed Oil preserved integrity. The authors concluded that olive oil “has the potential to promote the development of, and exacerbate existing, atopic dermatitis” and that its use for dry skin and infant massage “should therefore be discouraged”. The Karagounis 2019 paediatric review agrees that olive oil may make xerosis and AD worse.

Olive Oil [worsens] Atopic Dermatitis Olive Oil [causes] Skin Barrier Dysfunction

Neonatal evidence: Cooke 2016 (OBSeRvE pilot RCT). 115 healthy term newborns were randomised to olive oil, sunflower oil or no oil twice daily for 4 weeks. Babies given olive oil had better stratum corneum hydration but significantly less development of lipid-lamellae structure than babies given no oil. Transepidermal Water Loss, pH and erythema did not differ. Lead author Alison Cooke said: “Oil prevents this mortar from developing as quickly and this could be linked to the development of conditions such as eczema.” The pilot was not powered for eczema outcomes. Note that it found the same lamellae effect with sunflower oil, so the neonatal case against olive oil is not unique to olive oil.

Olive Oil [worsens] skin barrier Olive Oil [relates] Atopic March

Guideline position. NICE quality standard QS44 (statement 4, emollients) tells clinicians to be “sensitive to the cultural practices of families”. It gives olive oil “as a skin treatment (which is likely to be harmful to a child’s skin)” as the example, and asks clinicians to explain the recommended emollients respectfully. One trial points the other way. In Verallo-Rowell 2008, an adult AD RCT that used virgin olive oil as the comparator for Coconut Oil, objective SCORAD fell significantly on olive oil too (36.6 → 26.7) (unverified). However, half of the olive-oil subjects who were colonised with Staphylococcus aureus were still culture-positive at 4 weeks. This was an adult study with no barrier measures and no untreated control, so it does not outweigh the barrier data.

NICE [opposes] Olive Oil Olive Oil [relates] Staphylococcus aureus

Nut-based oils are a separate, additional hazard

Olive oil is not a nut oil. But “natural” baby oils that blend olive with almond, peanut (arachis) or other nut oils add a sensitisation risk. Lack 2003 (NEJM, ALSPAC cohort, n=13,971) linked skin preparations containing peanut oil to later peanut allergy (OR 6.8, 95% CI 1.4–32.9), probably through inflamed eczematous skin. Avoid nut-derived oils on a toddler with eczema. See Peanut Oil Sensitisation.

Peanut Oil Sensitisation [relates] Food Allergy

What parents report (evidence: anecdotal). In Reddit parenting threads, olive oil mostly comes up in lists of things parents tried before something else worked, for example “We used aquaphor, Vaseline, olive oil. Breast milk baths, oatmeal baths…“. Nobody in the threads reviewed credited olive oil with clearing a child’s eczema. One adult with eczema said an olive oil and sugar scrub was “fine” for her skin (unverified). That is a single anecdote about occasional exfoliation, not regular leave-on use on a toddler. The main source of olive-oil use in UK infants appears to be professional advice, not parent folklore: the Manchester team found that most midwives were recommending it (Cooke 2016 press release).

Connections

• Emollient Therapy — NICE advises against, source: NICE QS44
• Herbal and Home Remedies for Eczema — oleic-rich oil that damaged the barrier in 4 weeks; avoid, source: Danby 2013; Karagounis 2019
• Oleic Acid — dominant fatty acid; barrier-disrupting, source: Vaughn 2018
• Sunflower Seed Oil — linoleic-rich comparator that spared adult barrier, source: Danby 2013
• skin barrier — delayed lipid-lamellae maturation in newborns, source: Cooke 2016
• Coconut Oil — beat olive oil on SA decolonisation in adult AD, source: Verallo-Rowell 2008
• NICE — QS44 “likely to be harmful to a child’s skin”, source: NICE QS44
• Peanut Oil Sensitisation — nut-oil blend hazard, source: Lack 2003