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The Long-Term Effects Of Compromised Infant Skin And Preventive Measures

Studies have found that maintaining a healthy skin barrier in infants has a long-term impact on the health of an individual. Healthy skin can help in preventing allergies, skin disorders and various other diseases such as allergic rhinitis, food allergy etc.

Impact of compromised baby skin

Diaper dermatitis and atopic dermatitis (AD) is generally found to be associated with impaired barrier function of skin in infants (1). A disrupted barrier allows the penetrations of microbes, allergens, toxins, irritants and pollutants, thereby causing inflammation, allergen sensitization and bacterial colonization (2).

  • In a prospective cohort study, it was observed that male infants with eczema were at an increased risk of developing asthma (adjusted odds ratio, 2.45; 95% CI, 1.31-4.46).
  • Atopic Dermatitis (AD) is also associated with the development of food allergy and allergic rhinitis (Figure 1) (3).

Figure 1: Association between atopic dermatitis and other allergic conditions.

Factors affecting infant skin

External and environmental factors that are largely responsible for increasing dryness, roughness and fragility of the infant skin are as follow:

  • House dust mites
  • Weather
  • Hard water
  • Adult soaps and detergents

The tropical humid conditions, such as that in India, support the growth of house dust mites. The infant skin is therefore exposed to such parasites (4).

AD is prevalent in regions having hard water. Hard water may contain irritant chemicals and/ or larger amount of soap and detergents. One of the most common causes of contact dermatitis of the hands is the use of adult soaps and detergents (4). Surfactants damage the skin by eliciting scaling, dryness, roughness, erythema, and swelling. They may increase the Trans Epidermal Water Loss (TEWL) by solubilizing the skin lipids, thus disrupting the skin barrier (4).

Soap and detergents cause the release of pro-inflammatory cytokines from the corneocytes, thereby exhibiting the acute irritant effect. However, the most compelling effect of soap and detergents is that on the skin pH (4). White et al. demonstrated the SC-thinning effect of soap and detergents in normal and non-lesional eczematous skin (4).

How can you help as a healthcare professional?

The opportunity to prevent skin barrier defects is often missed because of the use of harsh cleansers like adult soaps/detergents and patients NOT following a moisturizing regimen. Recent developments in baby skin care products include specialized baby soaps and washes. The skin barrier function can be further improved by using emollient creams and lotions (4).

  • Recommending patients an emollient which has pure ingredients that provides 100% gentle care from day 1.
  • Recommending patients clinically proven mild cleansers can help in improving skin barrier function (4) and prevent the onset of AD.

In conclusion, infant skin is not only different from adult skin but also has a long-term impact on the health of an individual. Hence, it needs extra care to maintain hydration, skin barrier function and prevent disease progression. Use of mild cleansers and an emollient regimen should be recommended for infants for the long-term well-being of an individual. 

Reference

1.     Stamatas GN, Nikolovski J, Mack MC, Kollias N. Infant skin physiology and development during the first years of life: a review of recent findings based on in vivo studies. International Journal of Cosmetic Science. 2011 Feb 1;33(1):17–24.

2.     Barnes KC. An Update on the Genetics of Atopic Dermatitis: Scratching the Surface in 2009. J Allergy Clin Immunol. 2010 Jan;125(1):16–31.

3.     Asher MI, Montefort S, Björkstén B, Lai CK, Strachan DP, Weiland SK, et al. Worldwide time   trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys. The Lancet. 2006 Aug 26;368(9537):733–43.

4.     Cork MJ, Danby SG, Vasilopoulos Y, Hadgraft J, Lane ME, Moustafa M, et al. Epidermal Barrier Dysfunction in Atopic Dermatitis. J Invest Dermatol. 2009 Aug 1;129(8):1892–908.

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