Emollient Therapy for Newborn Infants—A Global Perspective

Maintaining Skin Integrity in Neonates with Sunflower Seed Oil and Liquid Vaseline: A Prospective Randomized Controlled Study

OBJECTIVE

To test the effectiveness of sunflower seed oil (SSO) and liquid Vaseline (LV) in maintaining skin integrity in term and preterm neonates in the neonatal ICU. Because the skin of the neonate is still immature, disruption of skin integrity is a commonly observed problem.

METHODS

In this randomized controlled study, 90 preterm and term neonates in the neonatal ICU of a state hospital were equally divided into three groups. The skin condition of the neonates in all three groups was assessed using the Neonatal Skin Condition Score (NSCS); assessments were made a total of nine times at 48-hour intervals. The skin of the neonates in the first group was moisturized with SSO, and the second group was moisturized with LV, once a day, a total of 16 times. Moisturizer was not applied to the skin of the third group of neonates (the control group).

RESULTS

The median gestational age was 37.0 weeks (range, 36.0-38.0 weeks). After the third evaluation, the median NSCS scores for the neonates in the SSO and LV groups were significantly lower than for those in the control group (P < .001). The control group's median NSCS scores did not change throughout the period of the study.

CONCLUSIONS

Both SSO and LV are harmless to the skin of neonates and can be used to maintain their skin integrity. More advanced studies are needed to evaluate the effects of topical oils on maintaining skin integrity.

Comparison of transepidermal water loss and skin hydration in diabetics and nondiabetics

BACKGROUND

Pruritus is common in patients with diabetes mellitus (DM), and may lead to complex dermatological conditions if left untreated. Pruritus can be caused by increased transepidermal water loss (TEWL) and reduced skin hydration.

AIMS

To compare TEWL and skin hydration in patients with DM and controls, and to investigate associations between TEWL and skin hydration with glycated haemoglobin (HbA1c), fasting blood sugar (FBS), treatment, peripheral neuropathy (PN) and age in patients with diabetes.

METHODS

This was a prospective, case-control study carried out at a tertiary medical centre in Kuala Lumpur, Malaysia. TEWL and skin hydration measurements were taken at six different body sites in both groups.

RESULTS

In total, 146 patients (73 cases, 73 controls) were included (24 men and 49 women in each group). No significant difference in TEWL or skin hydration was seen between patients with DM and controls, but there were significant reductions in skin hydration in patients with DM who had FBS > 7 mmol/L (P < 0.01) or PN (P < 0.01). There was a reduction in TEWL over the anterior shin in patients with HbA1c levels > 6.5% (P < 0.02) and an increase in TEWL on the flank in patients on insulin injections at doses of > 1 U/kg/day (P < 0.01). In participants > 45 years old, there was a significant reduction in TEWL (P = 0.04) and hydration (P < 0.04) in the DM and control groups, respectively.

CONCLUSION

There was no difference in TEWL and skin hydration in patients with DM compared with controls. In the DM group, reduction in skin hydration was associated with uncontrolled FBS and PN but not with HbA1c or DM treatment, whereas TEWL was lower in patients with FBS > 8 mmol/L and increased in patients with higher insulin requirement.

Infant Skin Care Products: What Are the Issues?

BACKGROUND

Infant skin is susceptible to dryness and irritation from external factors, including topical skin care products not formulated for the infant's skin. This may increase the risk of contact dermatitis. Parents frequently express concern regarding potential harm from ingredients in skin care products and seek information. This is complicated by several skin care myths.

PURPOSE

The purpose of this literature review was to provide evidence-based information to educate parents on the use of products for preterm and term infants.

SEARCH STRATEGY

Multiple searches using PubMed were conducted including the search terms "infant skin care," "infant products," "infant bath," "emollients," "diaper skin care," and "diaper wipes." Reference lists of comprehensive reviews were also scanned. Google searches were used to assess consumer information, product information, and regulatory guidelines.

FINDINGS

There is little scientific evidence to support safety of natural/organic products on infant skin. Raw materials originate from different sources, complicating testing and comparisons of ingredients. Research shows that cleansers formulated for infant skin do not weaken the skin barrier the way harsher soaps and detergents can. Oils with the lowest oleic acid content provide a lower risk of irritant contact dermatitis.

IMPLICATIONS FOR PRACTICE

Nurses must be informed about natural and organic products, preservatives, and fragrances and know the definition of commonly used marketing terms.

IMPLICATIONS FOR RESEARCH

Decisions regarding the use of infant products in preterm and term infants should be evidence based. More research is needed to support claims regarding the safety of products used on infant skin.