The skin of a newborn is different from adult skin. When you choose a topical skin treatment used on an infant’s skin parents must take these differences into consideration. An infant’s skin is about 50% thinner than compared to adult skin and has a more alkaline rather than an acidic pH. It takes about one year for an infant’s skin to mature to adult skin. These differences make it more difficult to keep good things in and bad things out.
Skin plays a role in infection protection, body hydration, electrolyte and water function. When an infant is born, the vernix (vernix caseosa) found on the body of an infant born after 36 weeks of gestation helps the infant stay healthy. It fights infection and has antimicrobial properties that help prevent infection. It is important to leave the vernix on for the immediate period after delivery and not remove it with bathing during the first day of life. It provides a hydrating and naturally moisturizing function.
The top layer of an infant’s skin is low in collagen and the adhesion between the two top layers (epidermis and dermis) of infant skin is less than in adult skin. The skin is also alkaline in pH as opposed to an acidic pH for adult skin. An acidic pH helps protect adult skin from infection.
The large area of skin coverage relative to body mass in an infant compared to an adult is why infants are prone to heat and water loss as well as the passage of substances across the skin barrier. Certain topical exposures are especially dangerous to babies. This is why it is important for parents to read labels to find out the composition of the topical agent. Rashes due to contact can be triggered by these agents.
Topical corticosteroids can lead to skin atrophy, and neomycin can lead to neural deafness. Silvadene can cause kernicterus and providone-iodine can cause hypothyroidism. Surfactants and antiseptics included in these topical agents can cause irritant dermatitis reactions and fragrances, preservatives, surfactants and parabens can cause contact sensitization after multiple exposures. Preservatives are often blamed but are essential to increase shelf life for many of these topical agents.
Some topical agents describe so-called organic or natural agents as being safer and healthier. Not all organic or natural agents are equally safe and the definition of what is organic is often vague. Sunflower oil appears to be better than olive oil, which may cause some disruption in the skin barrier. Botanical oils can cause skin sensitization reactions, and fragrance free products may have a masking agent that makes the product fragrance free, while still having a sensitizing agent present.
Parents must read labels and decide what topical agents are helpful and necessary in the care of their infant. The use of topical agents in infants who have a personal or family history of skin reactions should limited. The general rule in infant skin care is less is best. Early exposure increases an infant’s risk of skin sensitization and reading labels is always the best way to prevent future problems.