Cultivation of olive trees dates back more than 7000 years with ancient Greek literature revealing uses for body health (1). Olive oil has an extensive history of being used to achieve healthy skin with Cleopatra using it, along with shea butter, as her main cosmetic for skin beauty. However modern science has only seriously investigated the biological properties of the over 75 chemical compounds found in olive oil that have been proven to have profound effects on human health (1). In fact, it wasn’t until 2004 that the Food and Drug Administration (FDA) allowed a claim on olive oil towards the benefits on the risk of coronary heart disease due to the monounsaturated fatty acids in olive oil (2) while in 2007 Health Canada listed olive oil as a medicated skin care product (3).
The beneficial effects of olive oil on the skin, particularly for people with diabetes, are even more recent. In 2015 a double-blind controlled randomized clinical trial demonstrated, with statistical significance, that 73% of patients treated daily with topical olive oil had complete healing of diabetic foot ulcers in less than 30 days (4). A multi-center randomized triple-blind controlled clinical trial, also in 2015, showed olive oil treated pressure ulcers with statistical significance, a common skin problem for people with diabetes, just as well as the current treatment (5).
The benefits olive oil brings to the skin are many and powerful. For example in radiotherapy oil skin burns are common and olive oil has been shown to have a very promising effect on this assault on the skin (6).
Most of the therapeutic potential of virgin olive oil is attributed to the anti-oxidant compounds vitamin E, polyphenols, and phytosterols (1,7). However, its scientifically proven ability to have anti-inflammatory, anti-microbial and other healing properties make it ideal for people with diabetes and why it is the key active medicinal ingredient in T2S skin balm (8).
Coconut oil has been used in tropical regions for thousands of years to treat skin infections. While the oil has definite moisturizing properties, it is the antimicrobial activity that makes it an attractive ingredient in a skincare product (1).
The skin of people with diabetes is more susceptible to damage and thus becoming a possible entrance for pathogens such as bacteria and fungi. As noted by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) a blister or dry cracked skin can allow for microorganisms to enter the skin and the higher blood glucose (sugar) level can feed these germs causing the infection to become worse (2). It is therefore crucial that people with diabetes keep problem skin areas moisturized after washing with a mild soap.
While there are several beneficial compounds in this oil, it is the three uncommon medium chain fatty acids; capric acid, caprylic acid, and Lauric acid, which all lend coconut oil its powerful antimicrobial activity (3). Capric acid has been documented in both dermatology and dental journals to work against various microorganisms(4). Caprylic acid is very effective at preventing the growth of germs. As an antimicrobial agent used as a food contact surface sanitizer in commercial food handling, its uses have expanded to being used as a disinfectant in health care facilities and schools (5). Lauric acid is the most common fatty acid in coconut oil and has been shown to have anti-bacterial and anti-fungal activity (3).
Overall, while coconut oil has definitive anti-oxidant and skin softening properties, it is its antimicrobial activity that makes this ingredient particularly important for people with diabetes.
Shea butter comes from the nut of the karate tree that is indigenous to Africa where its healing properties were first harnessed thousands of years ago. Its ability to have an incredible effect on the skin can be traced back to Ancient Egypt where it was used to both enhance the softness of the skin and to protect the skin from the sun and hot dry desert winds.
The two primary benefits of shea butter are its intense skin lubricating properties, which come from 5 essential fatty acids (mainly oleic acid and stearic acid) and skin healing/anti-inflammatory properties, derived from a high content of vitamins A and E as well as allotonin and triterpenes (1). The US Food and Drug Administration approve allantoin as a barrier ingredient to temporarily prevent and protect chapped, cracked and wind burned skin by speeding up the natural healing processes and increasing water content (2). Tripertene cinnamates and acetates are well-known plant compounds shown to have extremely powerful anti-inflammatory effects that would reduce redness and irritation in the skin. So far 8 of these have been discovered in shea butter (1) while other strong connections understanding the biochemistry of how this works is being discovered (3) Interestingly, the strength of shea butter’s anti-inflammatory effects can be observed in a 1979 clinical trial where subjects with moderate to complete nasal blockage had their airways cleared in as little as 30 minutes when a small amount was applied to the inside of the nose, with the effect lasting up to 8 hours (4). Shea butter is still used today throughout Africa as a very effective nasal decongestant.
People with diabetes have to be especially careful about having inflamed dry skin and shea butter is proven to be very effective at addressing inflammation.
Beeswax has been regarded as both a skin softener and wound healer since Ancient Egyptians and Romans used it for these purposes. In modern times Beeswax is the Mayo Clinic’s recommended treatment for chapped lips care and prevention (1) while beeswax candles are well known to alleviate many airborne allergies (2).
When applied to the skin, beeswax forms a barrier that helps protect it from the harsh environment while also holding in moisture and reducing dryness. Because it is noncomedogenic (does not clog pores) it allows the skin to breathe despite the formation of this barrier. Furthermore, beeswax acts as a humectant, drawing moisture to the skin.
Beeswax is made of chain alcohols and fatty acids that have been shown to decrease both prostaglandins and leukotrienes, resulting in strong anti-inflammatory actions. Early clinical studies in 2014 demonstrated that a mixture of beeswax alcohols was able to reduce pain and joint stiffness by 55% and 77% respectively after 6 weeks of treatment in patients with osteoarthritis (3).
With anti-allergenic and anti-inflammatory properties, along with the ability to draw in moisture and seal it in, beeswax is an ideally suited ingredient in skin care for people with diabetes. By providing an extra layer of protection on skin that is susceptible to dryness and cracking, it optimizes the ability for skin to remain moisturized for an extended period of time.
Calendula is an herbaceous plant in the daisy family that has been used for its skin healing abilities since at least the 1100s, according to the University of Maryland Medical Center (1). The flower was applied to cuts and wounds to stop bleeding, prevent infection and dress wounds to promote healing during the American Civil War and in World War I. Today the US National Institute of Health states there is ‘good scientific evidence’ for the efficacy of topical use of Calendula in protecting the skin of patients undergoing radiation treatment (2).
Scientific studies find that calendula oil speeds the healing of skin wounds with much of the healing properties attributed high levels of carotenoids (vitamin A-like compounds) and flavonoids. Furthermore, it contains sterols that are common components of human skin oils that help improve the texture of skin (3).
Although this oil is last on the list of ingredients in T2S balm, clinical data supports the properties of calendula oil in topical applications of 2 to 10 percent. The essential oils of this herb have been reported to be ‘highly medicinal’ in peer-reviewed medical journals with anti-inflammatory, anti-microbial and wound healing properties being most predominant. In fact, a 2008 published study demonstrated calendula oil to be extremely effective against fungus, killing all 23 clinical fungi strains it was tested against (4).
It is interesting to point out that a clinical study examining calendula extract ointment, applied twice daily for 3 weeks, demonstrated statistically significant acceleration of wound healing in the treatment of leg ulcers (5). Rough, dry and cracked skin is a serious condition for anyone with diabetes. Having calendula oil compounds, especially in the susceptible lower legs and feet, has the ability to contribute healthy skin.
While seed oils represent some of the earliest cosmetic products used by humans, sunflower oil may have a relatively short history, but its effects on improving skin health are undeniable.
Sunflower oil has a very high amount of linoleic acid which is one of the only two essential fatty acids, with the other being alpha-linolenic acid. In fact, these two fatty acids were originally designated ‘vitamin F’ when discovered in 1923 (1). ‘Essential refers to the fact the human body cannot synthesize them, but they are an absolute necessity for proper health and skin function. Deficiency in linolenic acid within the skin include abnormal barrier structure, hyperproliferation, and an altered production of anti-inflammatory compounds (2); resulting in a large variety of skin problems including atopic eczema, psoriasis and other conditions related to rough skin.
Topical linolenic acid has been shown to improve the structure and function of cell membranes and improve skin barrier function (3). Improving skin barrier function reduces transdermal water loss, leaving the skin more hydrated, moisturized and protected. While other moisturizers may improve skin dryness, roughness, and water loss, they are often temporary and do not biologically strengthen the skin barrier as linolenic acid does.
Topical sunflower oil is well documented to increase the linolenic acid content of the epidermis (top layer of skin) resulting in normalized transdermal water loss and reduced rough skin after 2 weeks of treatment (4). In fact, topical application is a more effective way of delivering for skin effects, especially if there is a deficiency in obtaining in the diet (4). To highlight this point, essential fatty acid deficiency has been treated via topical sunflower oil applications (4).