The quick summary:

There are multiple published clinical studies on the antimicrobial properties of virgin coconut oil (VCO) and its derivatives, and they’ve been around longer than you may think.

We asked a leading dermatologist and dermatopathologist, Dr. Vermén Verallo-Rowell, who is a specialist in contact dermatitis, psoriasis, and its secondary infections — and whose regularly-cited studies on virgin coconut oil and monolaurin have helped us understand their clinical, nutritional, and cosmetic applications — for a review of these studies to help us better understand how virgin coconut oil and its derivatives really hold up against some of the most common microbes.

Her review spanned laboratory and clinical disinfection studies on VCO and derivatives compared with alcohol since the 1970s.

It seems that VCO and its derivatives are as effective as alcohol in typical hand sanitizers but with some important differences.

Her detailed review follows below but this simple summary shares the highlights of how coconut derivatives compare against alcohol, the all-time classic against viruses.

1. Alcohol, at very high concentrations, kills viruses

Alcohol is virucidal, significantly so at 85%, less so at 70-80%. Check your hand sanitizer to make sure it that it contains alcohol at these concentrations.

2. VCO and its derivatives are as effective as 85% alcohol, but at much lower concentrations due to how they work

Alcohol works by denaturing the virus’s protein materials. VCO and its derivatives are as effective but they act in a different way: they act on lipids so they directly disintegrate the viral envelope, which destroys the rest of the virus.

Lauric acid monoglyceride as 2% monolaurin has been shown to kill not just viruses but also fungi as well as gram (+) and (-) bacteria, and some of their resistant strains.

3. Pros and cons of alcohol versus VCO and its derivatives

VCO, its derivatives, and alcohol all have immediate effects but alcohol evaporates quickly (is transient). VCO and its derivatives are lipids (fats). They stay longer on surface skin and mucosa, so their antimicrobial effects last longer.

VCO can also be used to gargle with, and our clinic and research center regularly prescribes monolaurin pellets to be taken orally as daily supplements.

A virtually-pure monolaurin (96%) in hand sanitizers and other leave-on products is an excellent alternative. Its studies are so consistent that VMV Hypoallergenics uses monolaurin in the majority of our products as part of our proprietary self-preserving system and to protect skins with compromised barrier functions (such as in psoriasis and eczema) from microbial colonization.

These products are more expensive than alcohol-based ones but their antiviral action on the breakdown of enveloped viruses and other microbes, combined with their moisturizing and longer-lasting effects, are desirable, especially with frequent use. These can be applied to hands and nostrils, including the inside mucosa that can be easily reached.

4. What about price?

If 80-85% alcohol is available, that’s great and usually very affordable. If not, and if clean water is available, a hand or body wash with sodium laurel sulfate (SLS), is better to use than diluted alcohol. SLS is a relatively cheap coconut oil derivative made with lauric acid. It is often found as a saponifier in bar soaps (read ingredient labels for its presence) and in some hair and body washes. Just make sure to choose products with lower concentrations of SLS and with no allergens or irritants in the formulation. While not an allergen, SLS (just like alcohol) can be irritating as its concentration increases.

As an alternative, VCO can be used. When we do medical outreaches, the doctors we work with teach patients to make their own coconut oil, if coconuts are more readily available than other options. We then instruct them to massage the VCO well — rubbing it into the skin — to help the lipases in non-/pathogenic microbes in the skin break down the VCO into its monoglycerides and fatty acids, especially into lauric acid and monolaurin. The slippery feel of the oil disappears quickly because 65% of its fatty acids are short to medium chain.

What about on 2019-nCoV (coronavirus)?

In January, 2020, The Potential of Coconut Oil and its Derivatives as Effective and Safe Antiviral Agents Against the Novel Coronavirus (nCoV-2019), a study by Professor Emeritus Dr. Fabian Antonio Dayrit and Dr. Mary Newport, explored “the potential use of coconut oil as a safe antiviral agent against the novel coronavirus.” It posed the question…

“Several researchers have been designing drugs to specifically target protease enzymes in coronavirus, but testing for these drugs is many months away. What if there is a treatment candidate against the coronavirus that might already be available and whose safety is already established?”

They continue: “Lauric acid (C12) and monolaurin, its derivative, have been known for many years to have significant antiviral activity. Lauric acid is a medium-chain fatty acid which makes up about 50% of coconut oil; monolaurin is a metabolite that is naturally produced by the body’s own enzymes upon ingestion of coconut oil and is also available in pure form as a supplement. Sodium lauryl sulfate, a common surfactant that is made from lauric acid, has been shown to have potent antiviral properties. Lauric acid, monolaurin, and sodium lauryl sulfate (which is also known as sodium dodecyl sulfate) are used in a wide range of products for their antiviral properties.”

How is monolaurin a compelling candidate for novel coronavirus?

Doctors Dayrit and Newport explain lauric acid and monolaurin’s antiviral mechanisms: “first, they cause disintegration of the virus envelope; second, they can inhibit late maturation stage in the virus replicative cycle; and third, they can prevent the binding of viral proteins to the host cell membrane.”

Monolaurin works by disintegrating the virus membrane.

Both the 2020 study and Dr. Verallo-Rowell’s review point to the antiviral studies of lauric acid and monolaurin from as early as 1979. A 1982 study by Hierholzer & Kabara “showed that monolaurin was able to reduce infectivity of 14 human RNA and DNA enveloped viruses in cell culture by >99.9%” with monolaurin working specifically by disintegrating the virus envelope (later validated by further studies; see review).

Because monolaurin works by preventing maturation, it prevents replication.

A 2001 study on fatty acids against the Junin virus (JUNV; the cause of Argentine hemorrhagic fever) showed that lauric acid was the most effective at inhibiting “a late maturation stage in the replicative cycle of JUNV.”

As a result, this may slow down the increase in viral load in the body.

Monolaurin prevents the virus from binding to our cells.

Instead of influencing protein synthesis in the viral membrane, lauric acid prevents binding to the host cell.

Doctors Dayrit and Newport cite a 1994 study showing that lauric acid prevented infectious vesicular stomatitis by preventing the viral proteins from binding to the healthy host’s cells’ membranes. Furthermore, removing the lauric acid removed the antiviral effect.

It is important to emphasize that, to our knowledge as of this writing, monolaurin has not been tested on nCoV-2019 specifically (neither has alcohol). This information is compelling but needs validation on this particular virus. The available evidence seems to suggest similar efficacy to alcohol in destroying enveloped viruses. Follow your doctor’s instructions, and rely on trusted sources such as the World Health Organization, Centers for Disease Control and Prevention, and your country’s department of health. For the study review of VCO, monolaurin and other coconut oil derivatives as antivirals, antibacterials and antifungals, continue reading. 

Study Review: Broad Spectrum Anti-Virals, -Bacterials, -Fungals From Coconut Oil And Its Derivatives by Vermén M. Verallo-Rowell, MD, FPDS, FAAD, FASDP, FADA

Since 2007, Dr. Verallo-Rowell has treated, disinfected, and prevented recurrences on H. simplex Virus 1 and 2, Verrucae, Molluscum contagiosum, and various other skin infections using 96% monolaurin in oral pellets, 2-4% monolaurin in topical preparations, and 1% monocaprin topical preparations, with high efficacy and very rare adverse reactions.

She often combines the use of these monolaurin products with the daily application of cold-pressed, organic virgin coconut oil (VCO) which, in addition to its broad-spectrum antimicrobial properties, has humectant, occlusive, lipid cell membrane and skin barrier repair capabilities, from its unique fatty acids and glycerin.

She also regularly uses 2-4% monolaurin in hand gels and in petrolatum for antibacterial, antiviral, and antifungal antisepsis.

The summary of her study review states: “Virgin coconut oil and its derivatives are shown in laboratory and translational clinical studies to have a broad-spectrum, antimicrobial effectivity on viruses, bacteria and fungi. Most of the studies are published in international, a few in regional journals. Still fewer are pilot trials that similarly show these antimicrobial effects against various organism types.”

Introduction to virgin coconut oil and its derivatives

“Like all vegetable oils, coconut oil (CO) is made up of triglycerides which have three fatty acids (FAs) linked to the three carbons in its core glycerin molecule.

Lipase enzymes of non-pathogenic microbes present normally in the skin, and pathogens that may invade it, break down the links, first to a di- then a mono-glyceride, and lastly, into its glycerin and three-fatty acid components.

VCO has about 50% Lauric acid, and 7% Capric acid. The monoglycerides of these two fatty acids have broad-spectrum antimicrobial effects as seen in a few pilot studies; and in laboratory studies and clinical trials published in international and regional journals since the 1970s.

In our studies, we use virgin coconut oil (VCO) that is cold pressed with no heat, certified organic, and freshly harvested to ensure purity, maximum content of important fatty acids, its monoglycerides, fatty acids, and its anti-oxidants .”

Monolaurin, Monocaprin and VCO Anti-Viral Laboratory and Clinical Studies

The antiviral activities of Lauric acid and monolaurin were first noted by Sands and co-worker in 1979. In 1982, monolaurin was shown to be highly antiviral, at times, at 10 times less concentration, than its Lauric Fatty acid. Five years later in 1987, monolaurin is confirmed as highly anti-viral at concentrations 10 times less than Lauric acid. This study also showed that both monolaurin and Lauric acid inactivate viruses by cell membrane disintegration. A 1994 study showed that Lauric acid had a dose-dependent, reversible inhibition of infectious vesicular stomatitis virus production. When Lauric acid was absent, this antiviral effect disappeared. Lauric acid did not influence viral membrane (M) protein synthesis, but prevented binding to the host cell membrane. In 1999, monocaprin was shown to be a feasible mucosal microbicide to prevent sexually transmitted infections such as Neisseria gonorrhea, Chlamydia and HIV.

In the 2000s, studies were published on coconut oil for HIV-AIDS (repeated in 2016 with forty HIV subjects with CD4+ T lymphocyte counts divided into a VCO group and control group (no VCO). The VCO group showed significantly higher average age CD4+ T lymphocyte counts versus control after 6 weeks. Monolaurin for Molluscum contagiosum (a skin virus), and monolaurin in a gel is highly active on repeated high viral loads of Simean immunodeficiency virus in macaques. A study in 2001 on saturated C10 to C18 fatty acids against JUNV (an enveloped virus and the causative agent of Argentine hemorrhagic fever) infection showed Lauric acid as the most active inhibitor. Mechanistic studies from transmission electron microscopic images from 2012 concluded that Lauric acid inhibited a late maturation stage in the replicative cycle of JUNV.

In 2007, monoglycerides were tested on respiratory syncytial virus (RSV) and human parainfluenza virus type 2 (HPIV2) at different concentrations, times, and pH levels, with monocaprin (even as low as 0.06-0.12%) showing the most activity against influenza A virus.

From 2015 onwards, studies show monolaurin’s efficacy in a wider range of viruses, from avian influenza virus in chickens, to the female genital tract in Rhesus macaques. Further studies show coconut oil and its derivatives as safe and effective antiviral compounds in both humans and animals against envelope viruses, causing complete envelopes, plasma membranes, and viral particles to disintegrate, lyse, and cause the death of cultured cells. Because of the antiviral and antibacterial protection that it provides to animals, coconut oil, as well as lauric acid and monolaurin, are used in farm animals and pets as veterinary feed supplements in chicken, swine and dogs.

Studies Reviewed:
  1. Sands JA, Auperin LD, Reinhardt A. Enveloped virus inactivation by fatty acid derivatives. Antimicrob Agents Chemother. 1979;15(1):134–136. doi:10.1128/aac.15.1.134.
  2. Hierholzer JC, Kabara JJ. In vitro effects of monolaurin compounds on enveloped RNA and DNA viruses. J Food Safety 1982;4:1–12.
  3. Thormar H et al. Inactivation of enveloped viruses and killing of cells by fatty acids and monoglycerides. Antimicrob Agents Chemother. 1987 Jan;31(1):27-31.
  4. Thormar H, Isaacs CE, Brown HR, Barshatzky MR, Pessolano T. Inactivation of Enveloped Viruses and Killing of Cells by Fatty Acids and Monoglycerides. Antimicrobial Agents and Chemotherapy, 1987; 31(1): 27-31.
  5. Hornung B, Amtmann E, Sauer G. Lauric acid inhibits the maturation of vesicular stomatitis virus. Journal of General Virology, 1994; 75: 353-361.
  6. Thormar H, Bergsson G, Gunnarsson E, et al. Hydrogels containing monocaprin have potent microbicidal activities against sexually transmitted viruses and bacteria in vitro. Sex Transm Infect. 1999;75(3):181–185. doi:10.1136/sti.75.3.181
  7. Kristmundsdóttir T, Arnadóttir SG, Bergsson G, Thormar H. Development and evaluation of microbicidal hydrogels containing monoglyceride as the active ingredient. Journal of Pharmaceutical Science, 1999; 88(10): 1011-1015.
  8. Dayrit CS. Coconut Oil in Health and Disease: Its and Monolaurin’s Potential as Cure for FOR HIV/AIDS. XXXVII Cocotech Meeting. Chennai, India. July 25, 2000.
  9. Bartolotta S, Garcí CC, Candurra NA, Damonte EB. Effect of fatty acids on arenavirus replication: inhibition of virus production by lauric acid. Archives of Virology, 2001; 146(4): 777-790.
  10. Chua EO, Verallo-Rowell VM. Coconut oil extract 2% Monolaurin cream in the treatment of Molluscum contagiosum. A randomized double-blind vehicle-controlled trial. Scientific Poster presentation Semi-Finalist. In Abstracts, World Congress of Dermatology October 1-5 2007, Buenos Aires, Argentina.
  11. Hilmarsson H, Traustason BS, Kristmundsdóttir T, Thormar H. Virucidal activities of medium- and long-chain fatty alcohols and lipids against respiratory syncytial virus and parainfluenza virus type 2: comparison at different pH levels. Archives of Virology 2007: 152(12):2225-36.
  12. Li Q, Estes JD, Schlievert PM, et al. Glycerol monolaurate prevents mucosal SIV transmission. Nature. 2009;458(7241):1034–1038. doi:10.1038/nature07831.
  13. Grant A, Seregin A, Huang C, Kolokoltsova O, Brasier A, Peters C, Paessler S. Junín Virus Pathogenesis and Virus Replication. Viruses, 2012; 4: 2317-2339.
  14. van der Sluis W. Potential antiviral properties of alpha-monolaurin. Poultry World. Downloaded from https://www.poultryworld.net/Nutrition/Articles/2015/12/Potential-antiviral-properties-of-alpha-monolaurin-2709142W/.
  15. Widhiarta KD. Virgin Coconut Oil for HIV – Positive People. Cord, 2016; 32 (1): 50-57.
  16. Kirtane AR, Rothenberger MK, Frieberg A, et al. Evaluation of vaginal drug levels and safety of a locally administered glycerol monolaurate cream in Rhesus macaques. Journal of Pharmaceutical Science 2017; 106(7):1821-1827.
  17. Baltić B, Starčević M, Đorđević J, Mrdović B, Marković R. Importance of medium chain fatty acids in animal nutrition. IOP Conf. Series: Earth and Environmental Science 2017; 85: 012048.
  18. Verallo-Rowell V.M., Katalbas S.S., Evangelista M.T., Dayrit J.F. Curr. Dermatol. Rep., 2018, 7: 24.
  19. Yan B, Chu H, Yang D, et al. Characterization of the Lipidomic Profile of Human Coronavirus-Infected Cells: Implications for Lipid Metabolism Remodeling upon Coronavirus Replication. Viruses. 2019;11(1):73. Published 2019 Jan 16. doi:10.3390/v11010073
  20. De Sousa ALM, Pinheiro RR, Araújo JF, et al. Sodium dodecyl sulfate as a viral inactivator and future perspectives in the control of small ruminant lentiviruses. Arquivos do Instituto Biológico, 2019; 86. Epub Nov 28, 2019.
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