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Effects of Liquid and Bar Soaps on the Skin of Brazilian Newborns: A Randomized Controlled Trial
Mily Constanza Moreno Ramos1, Maria Valeria Robles Velasco2, Mariana Bueno3
1Graduate Program in Nursing, University of Guarulhos, Guarulhos, Brazil.
Insights
Liquid soap improved newborn skin health by increasing skin acidification and hydration compared to bar soap. This study highlights the importance of appropriate cleansing products for infant skin care.
Area of Science:
- Neonatal Dermatology
- Pediatric Skin Health
- Dermatology
Background:
- Newborn skin has unique characteristics like thinner epidermis and higher transepidermal water loss, increasing susceptibility to skin issues.
- While liquid soaps are known to be safe for newborns, the effects of bar soaps, common in certain regions, remain understudied.
- These skin differences necessitate careful selection of cleansing products to maintain skin integrity and health in newborns.
Purpose of the Study:
- To compare the effects of liquid soap versus bar soap on the skin of term newborns.
- To evaluate key skin parameters including pH, hydration, and barrier function after bathing with different soap types.
- To provide evidence-based recommendations for infant skincare practices, particularly concerning cleansing agents.
Main Methods:
- A randomized controlled, single-blind clinical trial involving 100 healthy term newborns in Brazil.
- Participants were assigned to either a liquid soap (experimental) or bar soap (control) group for bathing.
- Skin assessments (pH, hydration, water loss, sebum, condition) were conducted at multiple time points up to 28 days postpartum, alongside maternal perception evaluation.
Main Results:
- Newborns using liquid soap showed significantly improved skin acidification (p < 0.001) and stratum corneum hydration (p < 0.001) compared to those using bar soap.
- No significant differences were observed in transepidermal water loss, sebum content, or visible skin conditions like dryness or erythema between the groups.
- Maternal perceptions regarding the use of either soap type did not differ significantly between the experimental and control groups.
Conclusions:
- Liquid soap use in newborns leads to superior skin acidification and enhanced stratum corneum hydration compared to bar soap.
- The findings suggest that liquid soap is a more beneficial choice for maintaining optimal skin barrier function in newborns.
- This study provides valuable insights for healthcare providers and parents regarding the selection of appropriate bathing products for infant skincare.
Introduction:
Compared to adults, newborns' skin has a thinner epidermis and stratum corneum with decreased hydration levels, higher transepidermal water loss, and a pH variation between 5.5 and 7.5. These characteristics can predispose to the occurrence of dryness, infections, and dermatological conditions. Water and liquid soap with adequate formulation have shown to be beneficial and safe for newborns' skin. However, studies evaluating the effect of bar soap, products widely used in Brazil and Latin America, are unknown. Therefore, the objective of this study was to compare the effects of liquid and bar soaps on the term newborns' skin.
Methods:
This randomized controlled, parallel, single-blind clinical trial was conducted at a public university hospital in São Paulo, Brazil. 100 healthy term newborns with no congenital anomalies, acute diseases, or dermatological conditions were randomized to use liquid soap (experimental group) or bar soap (control group). Skin pH, transepidermal water loss, stratum corneum hydration, sebum content, and skin condition were assessed before and after the first bath, at 48 h, 14 days, and 28 days after birth. These evaluations were performed on the forearm, abdomen, buttocks, and thigh. In addition, the mother's perception of soap use was also evaluated.
Results:
Data of 100 newborns were analyzed by intention to treat. The rate of retention was 53%. Newborns exposed to the liquid soap presented significantly better skin acidification (p < 0.001) and significantly better stratum corneum hydration (p < 0.001) than the skin of newborns exposed to the bar soap, regardless of the area evaluated. There were no significant differences in transepidermal water loss, sebum content, dryness, erythema, or skin breakdown and the mother's perceptions of the use of the soaps.
Conclusion:
Newborns in the experimental group presented better skin acidification and stratum corneum hydration when compared to newborns in the control group.
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