Could coconut oil help combat the depigmented patches of vitiligo?

The coconut oil is a plant-derived oil rich in medium-chain saturated fatty acids, the predominant component of which is lauric acid. This unique lipid composition endows it with emollient, occlusive and protective properties for the skin barrier. Long used in its pure form, the coconut oil is now incorporated into numerous dermatological formulations for its nourishing, soothing effects and its antimicrobial potential. Its ability to limit transepidermal water loss and to support the integrity of the stratum corneum explains its usefulness for the dry skin or compromised skin.

To date, however, no clinical study has demonstrated any effect of coconut oil on the progression of vitiligo nor on the repigmentation of depigmented areas.

In practice, coconut oil can only help to improve skin comfort by nourishing it and providing it with an antioxidant and anti-inflammatory protection. These effects may be of indirect interest in vitiligo, a condition notably characterised by an oxidative stress and local inflammation, factors involved in the destruction of melanocytes. By reducing skin dryness and the production of certain inflammatory mediators, coconut oil can thus support skin health. Nevertheless, these actions remain purely supportive: they neither restore destroyed melanocytes nor restart melanin production.

Coconut oil therefore cannot be regarded as a natural solution to repigment skin affected by vitiligo.

Although coconut oil, when used alone and appropriately, is generally well tolerated on the skin, its combination with certain home remedies and sun exposure can lead to potentially serious consequences. A case report published in the Dermatology Online Journal illustrates this risk associated with practices disseminated on social media.

In this case, a 36-year-old woman with vitiligo applied to her patches a mixture of crushed bakuchi seeds (Psoralea corylifolia) and coconut oil, following advice found online, before exposing the area to sunlight. Less than an hour after exposure, an intense erythema, pain and burning sensation developed, followed by blister formation on the depigmented lesions. Clinical examination led to a diagnosis of phototoxic reaction induced by bakuchi seeds. The patient required medical management with strict photoprotection, a short course of oral corticosteroids, an antihistamine and topical treatment, resulting in healing within one week.

This reaction can be explained by the presence in bakuchi seeds of furocoumarins such as psoralen and isopsoralen. These photosensitising molecules can interact with UV radiation and provoke inflammatory cellular damage that may sometimes be severe. In this situation, coconut oil did not play a protective role: used as a lipid carrier, it actually facilitated the application and retention of the photosensitising compounds on the skin, contributing to the intensity of the reaction.

This type of incident emphasises the risks associated with using home remedies, particularly in a complex disease such as vitiligo.

It emphasises the importance of relying on the advice of qualified healthcare professionals and avoiding self-medication based on recommendations from the Internet or social media, which can lead to adverse reactions of varying severity.

• EVANGELISTA M. T. & al. The effect of topical virgin coconut oil on SCORAD index, transepidermal water loss, and skin capacitance in mild to moderate pediatric atopic dermatitis: A randomized, double-blind, clinical trial. International Journal of Dermatology (2014).

• JHA N. Phototoxic reaction to Bakuchi seeds tried as a home remedy in a patient of vitiligo. Dermatology Online Journal (2020).

• DANESHFARD B. & al. Potential therapeutic effects of virgin coconut oil on COVID-19. Tanaffos (2022).

• GEW L. T. & al. A comprehensive review of plant-based cosmetic oils (virgin coconut oil, olive oil, argan oil, and jojoba oil): Chemical and biological properties and their cosmeceutical applications. ACS Omega (2024).