Related Experiment Videos
Barrier properties of the newborn infant's skin
Insights
The skin barrier in newborn infants matures rapidly after birth. Premature infants have less effective skin barriers initially, but their skin barrier function improves significantly within weeks.
Area of Science:
- Neonatal Dermatology
- Developmental Biology
- Pediatric Skin Health
Background:
- The skin barrier is crucial for newborns, protecting them from environmental factors and preventing water loss.
- Immature skin in premature infants may have compromised barrier function, impacting their health and susceptibility to complications.
- Understanding the development of skin barrier properties is essential for neonatal care and management.
Purpose of the Study:
- To investigate the development of skin barrier properties in newborn infants across a range of gestational ages.
- To assess percutaneous drug absorption and transepidermal water loss (TEWL) as indicators of skin barrier function.
- To correlate skin barrier development with gestational age and postnatal maturation.
Main Methods:
- Evaluated 223 studies involving 70 newborn infants (25-41 weeks' gestation, 1 hour to 26 days old).
- Measured percutaneous drug absorption using phenylephrine and skin water loss with an evaporimeter on abdominal skin.
- Observed the impact of skin trauma from adhesive tape and electrode fixation on barrier function.
Main Results:
- Infants ≥37 weeks' gestation exhibited effective skin barriers with low drug absorption and water loss.
- Infants ≤32 weeks' gestation showed significant drug absorption and high water loss, indicating defective barriers.
- Skin barrier function in preterm infants improved markedly, reaching mature levels by approximately 2 weeks of age.
- Skin trauma significantly increased drug absorption and water loss in the affected areas.
Conclusions:
- Neonatal skin barrier properties develop rapidly post-birth, with immature infants showing significant improvement within weeks.
- Gestational age is a key determinant of initial skin barrier function, with prematurity associated with compromised barrier properties.
- The stratum corneum's development and maturation are critical factors influencing neonatal skin barrier effectiveness.
- Careful handling of neonatal skin is advised to prevent trauma that can further impair barrier function.
Abstract:
The barrier properties of the skin were examined in 223 studies in 70 newborn infants of 25 to 41 weeks' gestation, aged from 1 hour to 26 days. Percutaneous drug absorption was studied by observing the blanching response to solutions of 1% and 10% phenylephrine applied to a small area of abdominal skin. Skin water loss was measured at the same site using an evaporimeter. Infants of 37 weeks' gestation or more showed little or no drug absorption and had low skin water losses, indicating that their skin is an effective barrier. By contrast, infants of 32 weeks' gestation or less showed marked drug absorption and high skin water losses in the early neonatal period, indicating that their skin is defective as a barrier. Both drug absorption and water loss in these infants fell steadily; by about 2 weeks of age the skin of the most immature infants functioned like that of mature infants. The varying barrier properties can be explained by the poor development of the stratum corneum in the more premature infants at birth and its rapid maturation after birth. The trauma caused to the skin by use of adhesive tape and the fixation of transcutaneous oxygen electrodes resulted in increased drug absorption and water loss from the damaged area.