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Postnatal maturation of skin barrier function in premature infants
1Department of Dermatology and Allergy, Clinical Research Center for Hair and Skin Science, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Insights
Preterm infant skin barrier development varies by body region. The diaper area shows impaired skin barrier function, unlike other regions, indicating delayed maturation.
Area of Science:
- Neonatal dermatology
- Infant skin physiology
- Premature infant care
Background:
- Skin barrier maturation in preterm infants exhibits significant regional differences.
- Understanding these variations is crucial for appropriate infant skincare.
Purpose of the Study:
- To longitudinally characterize postnatal skin barrier development in preterm infants.
- To compare skin barrier maturation in covered, uncovered, and diapered regions.
Main Methods:
- Measured transepidermal water loss (TEWL), stratum corneum hydration (SCH), pH, and sebum.
- Evaluated forehead, abdomen, thigh, and buttock in preterm infants (30-37 weeks GA) at 1-7 days and 2-7 weeks.
- Maintained a standard minimal skin care regimen.
Main Results:
- TEWL increased on the buttock but remained stable elsewhere.
- SCH and sebum were stable across all regions with age.
- Buttock pH increased, while other regions showed a decrease.
- The buttock region exhibited significantly higher TEWL and SCH compared to other areas.
Conclusions:
- Stable TEWL, SCH, and sebum suggest incomplete skin barrier maturation.
- Decreasing skin pH indicates acid mantle formation.
- Distinct skin barrier development in the diaper area suggests impaired function.
Background:
In preterm infants, skin barrier maturation entails regional variability.
Objectives:
To characterize postnatal skin barrier development in covered, uncovered and diapered regions in healthy premature infants over a longitudinal observation period.
Methods:
Transepidermal water loss (TEWL), stratum corneum hydration (SCH), pH and sebum were measured at postnatal ages of 1-7 days and 2-7 weeks on the forehead, abdomen, thigh and buttock of preterm infants (gestational age 30-37 weeks; n = 48) under monitored ambient conditions. A standard minimal skin care regimen was practised.
Results:
TEWL increased significantly on the buttock (p = 0.007), while remaining stable on the forehead, abdomen and thigh. SCH and sebum remained stable in all studied body regions with increasing age. On the buttock, pH increased (p = 0.049), while other body regions exhibited a significant decrease (p ≤ 0.019). TEWL (p < 0.001) and SCH (p ≤ 0.002) revealed significantly higher values on the buttock, compared to other body regions.
Conclusions:
Stable TEWL, SCH and sebum values may indicate a lack of skin barrier maturation. Postnatal decrease in skin pH suggests an adaptation process with acid mantle formation. Differences in skin barrier development were observed between anatomical regions. SCH, TEWL and pH values demonstrated a distinct course in the diaper area, indicating an impaired skin barrier function in this region.
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