Petrolatum

Petrolatum is a very effective moisturizer that helps hydrate the skin by preventing water loss. Despite claims to the contrary, it is safe when used in cosmetics and does not cause cancer or lead to acne breakouts.

Effects


Grade Level of Evidence
A Multiple double-blind, controlled clinical trials.
B 1 double-blind, controlled clinical trial.
C At least 1 controlled or comparative clinical trial.
D Uncontrolled, observational, animal or in-vitro studies only.
Grade Effect Size of Effect Comments

C

Increased skin hydration

Strong

Among the best moisturizers, petrolatum helps the skin retain its moisture by dramatically reducing transepidermal water loss.

C

Enhanced barrier function

Strong

Speeds up the recovery of the skin barrier in compromised skin by initiating the production of intercellular lipids. Also protects the skin against the effects of various skin irritants.

C

Dermatitis treatment

Moderate

Can help prevent diaper dermatitis and rash in infants, and improve the skin condition of children who have or are predisposed to atopic dermatitis. May also be helpful as an adjuvant in patients undergoing topical corticosteroid therapy for atopic dermatitis.

C

Increased skin elasticity

Moderate

A petrolatum-depositing body wash improved skin elasticity significantly less than 5 days of use.

C

Less visible scars

Moderate

8 weeks' treatment with white petrolatum improved scar appearance by at least 50% in 42% of patients who had undergone shave biopsies.

D

Healing

Moderate

Often used in postoperative wound care, including after dermatologic procedures such as laser resurfacing.

D

Photoprotection

Mild

Suppresses the formation of skin tumours and sunburn cells in addition to inhibiting dermal damage caused by UV rays, equivalent to an SPF of 2.

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Scientific Research


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Table of contents:

1. Sources

Petrolatum, also known as petroleum jelly, is a semisolid mixture of hydrocarbons derived from the residue of distilled petroleum. It is a light-coloured gel that becomes fluid and transparent near body temperature. Its discoverer called it Vaseline and patented the process of its manufacture in 1872, citing its uses for treating leather, styling hair and for treating chapped hands.[1] Since then, petrolatum's beneficial properties for skin care and treatment have been extensively studied and reported.[2]

2. Bioavailability

It is commonly assumed that petrolatum stays on the surface of the skin, but results from 2 independent studies challenge this notion, showing that it does penetrate the stratum corneum.[3][4] In fact, petrolatum seems to penetrate more easily and deeply into the stratum corneum than jojoba oil, paraffin oil and sweet almond oil. This has been suggested to be due to the chemical similarity of the petrolatum constituents and that of the stratum corneum lipids. Another plausible explanation is that the occlusion elicited by petrolatum induces mercerization and destabilization of the structure of the stratum corneum, rendering it more susceptible to lipid penetration.[4]

3. Effects on the skin

3.1 Improved skin hydration

Petrolatum belongs to the class of moisturizers known as the occlusives. Occlusives work by forming a hydrophobic layer on the surface of the skin, providing a barrier to water loss. Because they prevent the evaporation of water from the skin, they have the most pronounced effect when applied to slightly dampened skin.[5]

Although not aesthetically pleasing because of its greasy feel, petrolatum is one of the most effective moisturizers. A concentration of just 5% petrolatum is sufficient to reduce transepidermal water loss (TEWL) by more than 98%. This is much higher than other occlusives such as lanolin, mineral oil and silicones, which are able to reduce TEWL by only 20-30%.[5] Petrolatum also reduced water loss by 50% in another study, compared to just 16% for 2 moisturizing creams.[6]

However, it may be that petrolatum's hydrating effect does not last as long as 10 hours, since no hydrating effect as measured by optothermal infrared spectroscopy was observed 10 hours after treatment of human skin with petrolatum in a study of 42 women.[7]

Procter & Gamble has developed petrolatum-depositing body washes that deliver a greater amount of petrolatum to the skin. Unlike regular body washes, cleansers and soaps that deplete the stratum corneum of water, these products have been shown to improve stratum corneum hydration and relieve dry skin in several controlled and uncontrolled leg wash studies.[8][9][10][11][12][13] The increased skin moisturization was evident even under challenging environmental conditions, defined as exposure to the sun, wind, and/or chlorine in water during swimming.[14]

3.2 Improved skin barrier

Petrolatum accelerates the restoration of the skin barrier by penetrating into the upper layers of the stratum corneum and initiating the production of intercellular lipids, including free sterols, sphingolipids and free fatty acids.[15] Apart from decreasing transepidermal water loss and hence hydrating the skin, this also enables petrolatum to provide protection against various skin irritants. It is very effective against sodium lauryl sulphate, sodium hydroxide and lactic acid, and provides moderate protection against toluene.[16]

Studies conducted by Procter & Gamble have repeatedly shown that petrolatum-depositing body washes improve the barrier function of the stratum corneum as measured by transepidermal water loss,[8][11][12][13] an effect that has been linked to improved stratum corneum cohesion.[17]

Petrolatum is supposedly able to improve the appearance of fine lines caused by dehydration,[15][18][19] and to act as an emollient, filling in the spaces between desquamating corneocytes to make the skin soft and smooth,[15] but we were not able to find any published data to substantiate these claims.

There is 1 study on women with dry leg skin that indicates that a petrolatum-depositing body wash can improve skin elasticity. Elastic distension and recovery were measured with a cutometer, and revealed significant improvement in elastic recovery of >10% in less than 5 days, compared to treatment with water. Elastic distension had also significantly improved by more than >10% after 6-7 days of use compared to the water control.[17]

3.4 Dermatitis treatment

Dry skin (xerosis) is frequently linked to an impaired skin barrier function, observed for example in atopic dermatitis and contact dermatitis.[20] Petrolatum therefore appears to be a good treatment adjunct.

Indeed, pure petrolatum significantly increased skin capacitance, a measure of skin hydration, from 2% to 7% after application 4 times daily for just 2 days, in a study on 186 normal infants and 37 atopic infants.[21] Moreover, an over-the-counter petrolatum-based moisturizer (Aquaphor Healing Ointment) has been shown to be as efficacious as two prescription barrier repair creams (Atopiclair and EpiCeram) in treating children with mild-to-moderate atopic dermatitis.[22] Children aged 2-6 years who have dry skin and who are predisposed to atopic dermatitis can also have their skin condition improved by daily application of petrolatum-based emollients, though pressed ice plant juice (PIPJ)-based emollients would be even more effective.[23] One study however found that topical 2% niacinamide was more effective than petrolatum in hydrating the stratum corneum of atopic dry skin.[24]

Diapers often cause dermatitis in children that use them. Topical administration of a petrolatum formulation via the inner layer of diapers significantly decreased the severity of erythema and diaper rash in 2 independent, blinded and controlled clinical trials involving a total of 391 children aged 8-24 months.[25] A separate clinical study confirmed these findings, noting a lower incidence of diaper rash in the group using petrolatum compared to the control group.[26]

A double-blind study sponsored by Procter & Gamble investigated the tolerance to a petrolatum-depositing body wash in subjects undergoing treatment for atopic dermatitis with a topical corticosteroid. 60 women with mild-to-moderate active atopic dermatitis were enrolled and randomly assigned to use a high petrolatum-depositing body wash or a dermatologist-recognized synthetic detergent bar for cleansing. According to a dermatologist's assessments of the subjects' skin condition at baseline and at 2 and 4 weeks, treatment response was judged to be better in a higher percentage of subjects using the body wash, as 93% of those who used the body wash showed clearing of their atopic dermatitis after 4 weeks, compared to just 24% of those who used the bar. The body wash was also better-tolerated (93% versus 24%) than the bar. Both differences were statistically significant.[27]

3.5 Wound healing

Petrolatum-based topical agents are used as standard therapy in the management of postoperative wounds.[28] In a 2013 survey of skin cancer and reconstructive surgeons, 73% used petrolatum or a petrolatum-based topical emollient immediately post-operation. 69% and 38% also recommended that patients use petrolatum or a petrolatum-based product at home to keep the wound moist.[29]

Petrolatum is commonly used to treat superficial wounds created during dermatologic procedures. A petrolatum-containing ointment (Aquaphor Healing Ointment) significantly improved erythema, epithelial confluence, general wound appearance in 18 days when applied thrice daily to laser wounds. In addition, it reduced transepidermal water loss to a greater extent than other wound care ointments containing antibiotics.[30] Aquaphor Healing Ointment was also effective in healing wounds made by laser resurfacing,[31] the removal of skin lesions[32] or seborrheic keratoses.[33] However, petrolatum-based products can also cause wound redness and swelling, though this is more frequently seen when wounds are treated with Aquaphor Healing Ointment than with plain white petrolatum.[34]

Petrolatum also helps prevent excessive scarring in patients undergoing various surgical procedures. In one study, twice-daily application of petrolatum after reepithelialization led to at least a 50% global improvement in scar appearance in 42% of subjects who had received cutaneous shave biopsies.[35]

Importantly, the use of petrolatum in postprocedural wound care also has a low infection rate and low risks of inducing allergies or skin irritation.[36][37]

3.6 Photoprotection

Petrolatum can protect the skin from UV rays. It inhibited skin tumorigenesis by a striking 95% when applied on albino hairless mice, which is much better than lanolin (54% inhibition) and mineral oil (40% enhancement), protected against dermal damage, and reduced the number of sunburn cells formed after UV irradiation. This sunscreen effect amounts to an SPF of only about 2 however.[38]

4. Side Effects

The greasy feel of petrolatum often lead people to believe that it causes acne breakouts, but despite many claims to the contrary, petrolatum is actually non-comedogenic and safe to use on acne-prone skin. In fact, it has been recommended as a moisturizer for acne patients.[39][40]

Petrolatum is also non-irritant. While 1 study found that it induced dermal irritation in rabbits, this was not true in the case of mice, rats or minipigs.[41] More importantly, petrolatum has been demonstrated to protect against irritation by sodium lauryl sulphate, sodium hydroxide, lactic acid and toluene in humans.[16]

Although petrolatum itself is non-allergenic, it can be problematic when used in a formulation containing potential allergens such as lanolin, as it tends to trap not just moisture but also other cosmetic ingredients under the skin. This can lead to stronger allergic reactions if allergens are present in the formulation.[42]

Another common misconception about petrolatum is that it causes cancer. This stems from the fact that the petroleum from which it is derived contains polycyclic aromatic hydrocarbons (PAHs), some of which have been identified as carcinogenic. However, petrolatum used in cosmetic and personal care products is highly refined, purified and is required to meet the standards set by the United States Pharmacopeia (USP). The amount of PAHs it contains, if any, is therefore extremely low.

Scientific References


  1. Chesebrough RA. Improvement in products from petroleum. US Patent 127568 (1872)
  2. Mathur R, Lawrence N. Methods, uses and compositions of fluid petrolatum. US Patent 6309664 (1999)
  3. Ghadially R, Halkier-Sorensen L, Elias PM. Effects of petrolatum on stratum corneum structure and function. J Am Acad Dermatol. (1992)
  4. Stamatas GN, et. al. Lipid uptake and skin occlusion following topical application of oils on adult and infant skin. J Dermatol Sci. (2008)
  5. Kraft JN, Lynde CW. Moisturizers: what they are and a practical approach to product selection. Skin Therapy Lett. (2005)
  6. Lodén M. The increase in skin hydration after application of emollients with different amounts of lipids. Acta Derm Venereol. (1992)
  7. Petersen EN. The hydrating effect of a cream and white petrolatum measured by optothermal infrared spectrometry in vivo. Acta Derm Venereol. (1991)
  8. Ertel K, et. al. Expanding the range of possible skin effects from moisturizing body washes. J Am (2006)
  9. Ertel K, et. al. New petrolatum-depositing body washes to optimize in-use experience and clinical benefit. J Am Acad Dermatol. (2006)
  10. Ertel K, et. al. Testing a new petrolatum-depositing body wash in a regression-type protocol. J Am Acad Dermatol. (2006)
  11. Ertel K, et. al. A dual stream petrolatum-depositing body wash improves dry skin in African Americans. J Am Acad Dermatol. (2007)
  12. Ertel K, et. al. High-petrolatum depositing body wash cleans efficiently and improves dry skin condition. J Am Acad Dermatol. (2008)
  13. Wei K, et. al. Impact of advanced petrolatum-depositing body wash on stratum corneum barrier function and a healthy skin appearance: Skin biomarker measures. J Am Acad Dermatol. (2014)
  14. Ertel K, et. al. Petrolatum-depositing body wash to improve dry skin under challenging conditions. J Am Acad Dermatol. (2006)
  15. Nolan K, Marmur E. Moisturizers: reality and the skin benefits. Dermatol Ther. (2012)
  16. Wigger-Alberti W, Elsner P. Petrolatum prevents irritation in a human cumulative exposure model in vivo. Dermatology. (1997)
  17. Biehle S, et. al. Improvements in skin elasticity and cohesion from a petrolatum depositing bodywash. J Am Acad Dermatol. (2010)
  18. Draelos ZD. Active agents in common skin care products. Plast Reconstr Surg. (2010)
  19. Zheng Lu M, Kalafsky RE, Duggan MC. Compositions and delivery methods for the treatment of wrinkles, fine lines and hyperhidrosis. US Patent 6866856 (2005)
  20. Lodén M. Role of topical emollients and moisturizers in the treatment of dry skin barrier disorders. Am J Clin Dermatol. (2003)
  21. Matsumoto T, et. al. Skin capacitance in normal and atopic infants, and effects of moisturizers on atopic skin. J Dermatol. (2007)
  22. Miller DW, et. al. An over-the-counter moisturizer is as clinically effective as, and more cost-effective than, prescription barrier creams in the treatment of children with mild-to-moderate atopic dermatitis: a randomized, controlled trial. J Drugs Dermatol. (2011)
  23. Schario M, et. al. Children with Dry Skin and Atopic Predisposition: Daily Use of Emollients in a Participant-Blinded, Randomized, Prospective Trial. Skin Pharmacol Physiol. (2014)
  24. Soma Y, et. al. Moisturizing effects of topical nicotinamide on atopic dry skin. Int J Dermatol. (2005)
  25. Odio MR, et. al. Continuous topical administration of a petrolatum formulation by a novel disposable diaper. 2. Effect on skin condition. Dermatology. (2000)
  26. Alonso C, et. al. Efficacy of petrolatum jelly for the prevention of diaper rash: a randomized clinical trial. J Spec Pediatr Nurs. (2013)
  27. Draelos ZD, et. al. High-petrolatum depositing body wash benefits mild to moderate active atopic dermatitis. J Am Acad Dermatol. (2008)
  28. Chung VQ, et. al. Onion extract gel versus petrolatum emollient on new surgical scars: prospective double-blinded study. Dermatol Surg. (2006)
  29. Nijhawan RI, Smith LA, Mariwalla K. Mohs surgeons' use of topical emollients in postoperative wound care. Dermatol Surg. (2013)
  30. Trookman NS, Rizer RL, Weber T. Treatment of minor wounds from dermatologic procedures: a comparison of three topical wound care ointments using a laser wound model. J Am Acad Dermatol. (2011)
  31. Sarnoff DS. A comparison of wound healing between a skin protectant ointment and a medical device topical emulsion after laser resurfacing of the perioral area. J Am Acad Dermatol. (2011)
  32. Taylor SC, Averyhart AN, Heath CR. Postprocedural wound-healing efficacy following removal of dermatosis papulosa nigra lesions in an African American population: a comparison of a skin protectant ointment and a topical antibiotic. J Am Acad Dermatol. (2011)
  33. Draelos ZD, Rizer RL, Trookman NS. A comparison of postprocedural wound care treatments: do antibiotic-based ointments improve outcomes? J Am Acad Dermatol. (2011)
  34. Morales-Burgos A, Loosemore MP, Goldberg LH. Postoperative wound care after dermatologic procedures: a comparison of 2 commonly used petrolatum-based ointments. J Drugs Dermatol. (2013)
  35. Kircik LH. Comparative study of the efficacy and tolerability of a unique topical scar product vs white petrolatum following shave biopsies. J Drugs Dermatol. (2013)
  36. Smack DP, et. al. Infection and allergy incidence in ambulatory surgery patients using white petrolatum vs bacitracin ointment. A randomized controlled trial. JAMA. (1996)
  37. Trookman NS, Rizer RL, Weber T. Irritation and allergy patch test analysis of topical treatments commonly used in wound care: evaluation on normal and compromised skin. J Am Acad Dermatol. (2011)
  38. Kligman LH, Kligman AM. Petrolatum and other hydrophobic emollients reduce UVB-induced damage. J Derm Treatment. (1992)
  39. Fulton JE Jr, Pay SR, Fulton JE 3rd. Comedogenicity of current therapeutic products, cosmetics, and ingredients in the rabbit ear. J Am Acad Dermatol. (1984)
  40. Kligman AM. Petrolatum is not comedogenic in rabbits or humans: A critical reappraisal of the rabbit ear assay and the concept of "acne cosmetica". J Soc Cosmet Chem. (1996)
  41. Chandra SA, et. al. Dermal irritation of petrolatum in rabbits but not in mice, rats or minipigs. J Appl Toxicol. (2013)
  42. Oldhoff JM, et. al. Atopy patch test in patients with atopic eczema/dermatitis syndrome: comparison of petrolatum and aqueous solution as a vehicle. Allergy. (2004)