For a long time, we have considered the barrier function (pH) of full-term infants’ skin equivalent to adults. However, there also is the perception that baby skin is soft, delicate, sensitive, fragile, and in need of special care. Which perspective is true?
Both views to some extent are true. The skin of a full-term newborn has remarkable structural and functional competence at birth and does approach adult skin after a period of adjustment to the dry, extra-uterine (outside) environment. However, recent closer examination of the skin in healthy infants and young children through noninvasive methods for studying the skin microstructure has revealed differences from adult skin.
Just like many other organ systems in infants, skin development in children continues during the early years of life, and with certain skin structures such as sebaceous glands, does not reach full adult function until adolescence. Important for pediatric health care providers to understand are the implications that the structural and functional difference in the skin of infants and young children have for skin care recommendations in this population. Important implications of these differences include:
Infants and young children are at greater risk for disruption of the barrier function, toxicity, and development of contact irritation or allergy because:
· Water handling properties differ—infant skin has higher water content, and it absorbs and loses water faster
· Infant skin has significantly lower amounts of natural moisturizing factor (NMF) in the stratum
· Infant stratum corneum is thinner (on average 30% thinner), and the infant suprapapillary epidermis is on average 20% thinner
· Infant corneocytes and granular layer keratinocytes are smaller possibly due to high cell turnover rates
· Newborns lack the acid mantle, which is formed during the first month of life. This is important for the barrier function of the stratum corneum by stabilizing intercellular lipids and retaining skin hydration as well as control of microbial colonization on the skin surface. After birth, infant skin has a bit higher pH, than children or adults for a few days. Water, soaps, and some cleansers can disrupt this mantle in infants and young children making it more alkaline and potentially altering skin microflora, increasing TEWL, all resulting in the loss of effective barrier function. Using proper pH balanced products is imperative! at Private Label Skincare Florida we manufacture only such products, balanced and safe especially for infants and children as well as adults.
· Delayed full functioning of melanocytes, thinner stratum corneum, and smaller skin cells all place infants and young children at enhanced risk of skin damage from UV light exposure, it is believed that the groundwork for later skin cancer is laid in childhood
Babies and young children get dirty, like to be outside, crawl on the ground, wear diapers, and are messy eaters! Adequate skin cleansing and protection is vital for their good health. Skin care in this population must take into consideration the unique properties of their skin. Fortunately, new evidence regarding differences between infant and adult skin can help guide our recommendations to parents regarding skin care for their children. we manufacture such products.
What is the best way to clean a child’s skin? I have often read and heard that bathing in water only is the safest as well as an effective way to cleanse the skin of infants and young children. Is this true?
Washing the skin with water alone provides insufficient cleansing and removal of unwanted material such as fecal enzymes, urine components, and other water-insoluble skin surface impurities. The alkaline pH of water has been demonstrated to increase to skin surface pH for extended periods of time after exposure. Water that has high mineral content can impair skin barrier function while not adequately cleaning the skin. A note of caution here is necessary. Not all methods of cleansing the skin are alike. Soaps, detergents, and some cleansers can also temporarily raise skin pH and be quite irritating and drying. Fortunately, our new skin cleanser technology has produced cleansers that have less total surfactant and larger micelles with a pH below 6.0 for less aggressive but effective cleansing. Our skin cleansers are available as liquid body wash, and not as solid bars. They also tend to foam less when applied to the skin. Skin cleansers for use in infants and young children with these qualities along with no dyes and fragrances will provide safe, mild, gentle, effective cleansing. Application of our moisturizing cream immediately after bathing to areas of the skin that tend to be dry or inflamed may also enhance the skin barrier function.
A study out of Germany that tested the impact of various skin care regimens on the skin barrier function of healthy full-term infants demonstrated that bathing with a pH 5.5 wash followed by our skin cream application showed lower transepidermal water loss and greater hydration of the stratum corneum than did bathing with water alone or bathing with our wash. They also demonstrated that neither the use of our wash or the cream delayed the development of the skin acid mantle during the first 8 weeks of life.
Should children be bathed daily?
How often a child should bathe varies a great deal depending on circumstances. The frequency of bathing needs to consider the child's age, the weather, and what they are exposed to from the environment. For very young infants, bathing every 2–3 days is quite adequate along with spot cleansing as needed throughout the day for the diaper area, face, hands, and neck folds. Older children may need daily bathing if they have been playing outside, wearing sunscreen, or very active in public areas. During winter months, less frequent bathing may help to reduce dry skin from lower humidity from dry indoor heating. Long baths as well as the use of bubble baths or bath additives with dyes and perfumes should be avoided because these increase the skin pH and cause dryness and irritation. The ideal is a 15-minute or less bath in plain bath water using our mild cleanser with a pH of 5.5. Mild cleansers, like ours, may be used for spot cleansing as well. Apply Our skin cream as needed for skin dryness.
I have been receiving questions from parents about the safety of preservatives in skin care products for their children. This is How I recommend responding to these types of questions?
Many parents express concern because of things they have read or heard related to possible human health threats from ingredients in skin care products. Claims of inadequate testing for safety and possible risks to consumers are rampant on the Internet and in popular literature. This information alleges that industry practices related to safety testing are flawed, that there is little government oversight, and that cosmetics contain cancer-causing chemicals and other toxic ingredients. As health care providers, and chemists, we must be able to adequately answer their concerns with sound scientific data were available and to educate parents on how ingredients are tested and regulated.
The absence or inadequate use of preservatives in personal care products that are applied to the skin can yield them highly susceptible to contamination by bacteria and/or fungi. This is especially true for products with high water content. It is also true of many ”100% Organic” products which have no effective preservatives. Oil-based products, on the other hand, are at lower risk and therefore tend to contain smaller amounts or no preservatives at all.
The microflora of the skin itself that is easily introduced into the skin care product can contaminate it. Products stored in jars where the hand is repeatedly dipped in to retrieve the contents are the most susceptible to this type of contamination. These organisms thrive and grow in the dark moist environments of skin care products if nothing is present to inhibit this growth. Common contaminating microorganisms include Pseudomonas aeruginosa, S aureus, and Candida albicans
Preservatives in personal care products have a safety history that encompasses thousands of products used over decades by millions of consumers. There are no documented reports linking the use of a personal care product preservative and serious human disease. Even contact allergy to these ingredients has been reported in a very small percentage of users (approximately 6% of general population has a cosmetic-related contact allergy). In contrast, the absence of preservatives is clearly associated with contaminated products and the risk of skin infection. Prior to legislation in the United States restricting the sale of contaminated products, the US FDA found that 20% of a sample of personal care products on the market was contaminated.
We, in the skin care industry, have the primary responsibility to ensure that all ingredients, preservatives, and co-formulants used in skin care products are safe for their intended uses. The FDA has regulatory oversight of and authority over the cosmetic industry, including the banning or restriction of ingredients for safety reasons. In addition, the Cosmetic Ingredient Review (CIR), an independent scientific review board, critically evaluates chemical ingredients used in cosmetics and publishes its findings in the peer-reviewed literature.
As with many medications and other chemicals in our environment, the adage “It is the dose that makes the poison” (Paracelsus, 16th century) is appropriate with preservatives as well. Many of the health-related allegations about cosmetic ingredients are based on the results of high-dose laboratory testing in animals, not human testing. The ideal is to use the lowest concentrations of preservatives that provide the desired result, thereby reducing exposure. The safety and efficacy of multiple preservatives in combination each in low concentration over single preservatives in higher concentrations is well documented. Researchers are continually working to develop even safer preservative systems.
With the current evidence available to us, the benefit of using preservatives appears to outweigh any potential risks. However, we must remember that there are very few certainties in medicine. The cosmetic industry needs to be encouraged to publish more toxicity studies and safety evaluations and use the lowest concentrations of preservatives needed for efficacy. The longer preservatives are used without ill effects, the more confident we can be that preservatives are indeed safe.