Effect of Diaper Cream and Wet Wipes on Skin Barrier RESEARCH · November 01, 2014 TAKE-HOME MESSAGE The authors of this single-center, prospective trial assessed the skin barrier function of 89 healthy 9-month-old infants exposed to three diaper care regimens. One group used water-moistened washcloths alone (group 1; 30 infants) and a second group followed the same regimen with the addition of diaper cream applied twice daily (group 2; 28 infants). A third group used wet wipes at each diaper change and diaper cream applied twice daily (group 3; 31 infants). The primary outcome variable, transepidermal water loss, was reduced in the group that used wet wipes (group 3). Skin hydration decreased in groups 2 and 3, and skin pH increased. The incidence of diaper dermatitis was similar among the 3 groups.Infants who received diaper cream had lower skin hydration and lower transepidermal water loss, which may be favorable because over-hydration is thought to contribute to diaper dermatitis. The zinc oxide in diaper cream may be associated with the lower skin hydration in infants who received diaper cream, but longer observation periods and more study are needed throughout skin barrier maturation. – Sarah Churton, MD ABSTRACT The effect of different diaper care procedures on skin barrier function in infants has been minimally investigated and may be assessed using objective methods. In a single-center, prospective trial, 89 healthy 9-month-old infants (±8 wks) were randomly assigned to three diaper care regimens: group I used water-moistened washcloths at diaper changes (n = 30), group II additionally applied diaper cream twice daily (n = 28), and group III used wet wipes and diaper cream twice daily (n = 31). Transepidermal water loss (TEWL), skin hydration (SCH), skin pH, interleukin 1α (IL-1α) levels, and microbiologic colonization were measured in diapered skin (upper outer quadrant of the buttocks), nondiapered skin (upper leg), and if diaper dermatitis (DD) occurred, using the most affected skin area at day 1 and weeks 4 and 8. Skin condition was assessed utilizing a neonatal skin condition score and diaper rash grade. On diapered skin, SCH decreased in groups II and III, whereas TEWL values were reduced in group II only. Skin pH increased in groups II and III. In general, SCH, skin pH, and IL-1α levels were higher in healthy diapered skin than in nondiapered skin. The incidence and course of DD was comparable in all groups. Areas with DD had greater TEWL and skin pH than unaffected skin areas. Infants who received diaper cream had lower SCH and TEWL and higher pH levels in the diapered area than on nondiapered skin. No correlation with the occurrence of DD was found. Pediatric DermatologyEffect of Diaper Cream and Wet Wipes on Skin Barrier Properties in Infants: A Prospective Randomized Controlled TrialPediatr Dermatol 2014 Nov 01;31(6)683-691, N Garcia Bartels, L Lünnemann, A Stroux, J Kottner, J Serrano, U Blume-Peytavi
Posted on: Fri, 12 Dec 2014 05:10:57 +0000