What’s Best for Eczema (Atopic Dermatitis): Coconut Oil vs. Mineral Oil vs. Vaseline

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Last updated: • 6 min read

Image Credit: Chelsea shapouri / Unsplash. This image has been modified.

Natural topical remedies for eczema, including licorice root gel, St. John’s Wort cream, and emollients such as coconut oil, mineral oil, and petroleum jelly, are put to the test.

Despite the availability of drugs with proven efficacy for eczema, like topical steroids, many patients seek out natural alternatives. Which plant, then, should be used for which skin disease? In the case of eczema, two appeared to beat out placebo. One was licorice root. As you can see at 0:24 in my video Eczema Treatment with Coconut Oil vs. Mineral Oil vs. Vaseline, smearing on a placebo gel didn’t appear to help much with clearing redness or itchiness after one week or two weeks, but a 1 percent licorice gel and especially a 2 percent gel did seem to clear the symptoms in most patients. The researchers concluded that licorice extracts could be considered an effective eczema treatment agent.

The other successful trial was with a St. John’s wort cream, showing a reduction in eczema severity scores week by week superior to that of placebo, as you can see at 0:49 in my video. So, it works better than nothing, but does it work better than drugs? Better than the topical steroids? That we don’t know. Sometimes, the drugs don’t work on so-called recalcitrant atopic dermatitis, so researchers in Japan asked patients to drink four cups of oolong tea every day for a month. Most patients “showed marked to moderate improvement,” starting after one or two weeks, and then most remained better even five months after they stopped. The problem is there was no control group, so we don’t know how many would have gotten better on their own. But, since drinking tea is healthy anyway, why not give it a try? 

Let’s get back to topical treatments. As you can see at 1:43 in my video, a vitamin B12 cream showed better results than the same cream without vitamin B12. Most of the patients and doctors rated the results of the B12 cream as “good,” which was better than they scored the placebo cream. 

Regardless of what topical agent you use, steroid or otherwise, “first and foremost, it is essential that the skin barrier is protected and maintained with the use of emollients,” meaning moisturizers, ideally once or twice a day, especially right after showering, to lock in the moisture. Petroleum jelly, like Vaseline, is highly effective, but it “is greasy and can be messy,” so what about something like coconut oil, which is less greasy? It was found to improve skin dryness, though no better than mineral oil, which is cheaper. Is mineral oil safe, though?

Exposure to mineral oil was found to be associated with rheumatoid arthritis, but that was occupational exposure to industrial mineral oils, like hydraulic fluid. The same group of researchers subsequently found that cosmetic grade mineral oil did not seem to carry the same risk. In general, topically applied mineral oil shouldn’t present any health risk, but that doesn’t mean…you can safely inject it into your penis, as that “may have devastating cosmetic and sexual function consequences.” There is, however, evidently one good use for mineral oil on the penis, and that’s for “penile zipper entrapment.” Skin of the penis “is susceptible to entrapment in the zipper of careless young boys, particularly those who fail to wear undergarments. Understandably, this mishap provokes distress in the unfortunate victim, in his parents, and ultimately in the health care provider charged with the task of liberating the organ.” A recommended textbook approach is surgery, believe it or not, but if you simply dose liberally with some mineral oil, you can just slip the zipper off and “physical and psychologic trauma is minimized for all parties involved…”

But, just because mineral oil works as well as coconut oil for dry skin, doesn’t mean it works as well for eczema. Head-to-head topical virgin coconut oil works better than topical mineral oil at decreasing eczema severity, with twice as many children experiencing an excellent response after two months treatment. Thus, among pediatric patients with mild to moderate eczema, topical application of virgin coconut oil was superior to mineral oil, but what about compared to virgin olive oil? As you can see at 4:19 in my video, olive oil worked, dropping eczema severity, but coconut oil worked better. 

As I discussed previously in my video What about Coconuts, Coconut Milk, and Coconut Oil MCTs?, we know that coconut oil has a lot of saturated fat, so we don’t want to consume it, but the saturated fat isn’t absorbed into your skin unless you are a baby, when your skin is so thin that you can actually absorb saturated coconut fat into your bloodstream. But, in older children and adults, using coconut oil on your skin or hair is considered safe. 

What about treating eczema with just plain Vaseline? People with eczema already know it can be expensive to deal with. The average out-of-pocket costs can be $274 a month, which is more than a third of a typical family’s disposable income. In contrast, you can rub a kid from head to toe with petroleum jelly for about four cents, whereas coconut oil or some of the fancier over-the-counter moisturizers can be many times more expensive, though not as bad as some prescription moisturizers that can cost more than a hundred dollars per tube and work no better than the over-the-counter stuff, as you can see at 5:50 in my video. There is simply no evidence “prescription device moisturizers” are superior to the traditional, petroleum jelly-based over-the-counter products that can be 65 times cheaper.

Doesn’t virgin coconut oil have active ingredients, though, whereas petroleum jelly is just inert? Vaseline has been around since 1872, but it took the scientific community 144 years to put it to the test. We now know it isn’t inert at all, significantly upregulating genes that fight infection, inducing the expression of genes that help with barrier function, increasing the thickness of the protective outer layer of skin, and actively reducing inflammation. Yes, but is it safe? Not… if you inject it into your penis. (What is it with men injecting stuff into their penis?!) “In the less severe cases, the problem [this self-injection creates] could be solved by basic surgery. Otherwise, it may require major reconstruction. Evidently, “Vaseline self-injection of the penis” is done a lot by prisoners, giving a whole new meaning to the term “Jailhouse Rock.” An unbelievable one in six inmates at the largest prison in Hungary admitted to “Vaseline self-injection.” Or how about actual rocks, the surgical implantation of stones in the penis, which has also been reported? What about injecting industrial silicone? (I will never look at silicone caulk the same way ever again.) When men were asked why they were injecting cod liver oil, a fishy substance, into their penises, most explained it was because they felt underendowed, as you can see at 7:40 in my video, but one guy said he “just want[ed] to try.” Um…okay. Why inject cod liver oil into your penis, though, when you can just inject the mercury directly and cut out the middlefish?

Back to eczema! Based on 77 studies of moisturizers for eczema, researchers “did not find reliable evidence that one moisturizer is better than another,” though a consensus of experts concluded that petroleum jelly may be best for skin barrier function protection.

What about eating coconut oil? See Coconut Oil and the Boost in HDL “Good” Cholesterol and What About Coconuts, Coconut Milk, and Coconut Oil MCTs?.

What about the swallowing oil supplements? That was the topic of my video, Eczema Treatment with Evening Primrose Oil vs. Borage Oil vs. Hempseed Oil.

I have more on eczema coming up, so make sure you’re subscribed so you don’t miss anything.

In health, 

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

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