Skin Barrier Properties in the Newborn

Abstract

Relative permeabilities of newborn and adult skin to small molecules were determined by measuring emission of carbon dioxide and water vapor through skin. Transepidermal water loss (TEWL) measured on the forearm of 22 term infants was lower than that observed in 30 control adults (0.31 ± 0.09 vs. 0.39 ± 0.15 mg/cm²/h). There was no significant difference between newborn carbon dioxide emission rates (CDER) and adult CDER. When environmental temperature was raised from 74 to 80 °F, large dramatic increases in adult TEWL were observed in contrast to small increases in newborns. This phenomenon suggests diminished eccrine activity in the newborn. No correlation of TEWL or CDER with respect to birth weight, sex, age or gestational age was observed. Similar permeability to carbon dioxide in neonates and adults and a decreased TEWL in neonates compared to adults suggest that even at birth the skin functions as an efficient barrier to these molecules, penetration rates, in adults, of other polar compounds should be similar to those in neonates.

Water loss from the skin of term and preterm babies.

“…Term babies (group 1) had low rates of evaporation over most of the body but water losses from the palms and the soles were high. Cunico et al (1977) suggested that the higher values at these sites in a comfortable thermal environment were due to mild sweating. In both adults and babies, skin water loss and basal metabolic rate are directly related (Levine and Marples, 1930;Hey _ and Katz, 1969), so the higher water loss in adults might simply be due to the fact that they have higher *.…”

“…Total insensible water loss from the skin and respiratory tract has been measured using a metabolic chamber Zweymuller and Preining, 1970), or by measurement of weight loss Fanaroff et al, 1972;Wu and Hodgman, 1974;Marks et al, 1977). Measurements of skin water loss from isolated sites have been made using a ventilated capsule (Foster et al, 1969;Cunico et al, 1977). Results suggest that skin water loss is low in term babies, but that in preterm ones, whether nursed naked in standard incubators or under radiant warmers or phototherapy, losses are high.…”

Infant skin maturation: Preliminary outcomes for color and biomechanical properties

“…Full term newborn infant skin has a thick epidermis, well-formed stratum corneum (SC), and low transepidermal water loss, indicating a highly effective barrier (1). It undergoes maturational changes for months after birth, including a rapid decrease then increase in SC hydration, decreasing surface acidity with acid mantle development and appearance of functional toll-like receptors (TRP3, during gestation and postnatally) for innate immunity (2–5).…”

An in vitro Skin Penetration Model for Compromised Skin: Estimating Penetration of Polyethylene Glycol [¹⁴C]-PEG-7 Phosphate

“…Using TEWL as the gold standard, the literature evidence shows that full-term neonates have completely developed permeability barrier function at birth. High TEWL was shown in the first 4 h after birth, while TEWL afterwards returned to values of lower than 10 g/m 2 /h (normal range for healthy skin under basal conditions), suggesting ongoing drying of the skin immediately after birth [3,4,9,20]. However, depending on the exposure conditions (open to air, semiocclusive, occlusive) and the physicochemical properties of the permeants and the composition of the vehicle, dermal penetration and systemic bioavailability may be increased for compromised skin conditions such as premature infant skin, or in diaper dermatitis areas.…”

“…TEWL measures the steady-state water flux that passes through the epidermal layer to the surrounding atmosphere via diffusion and evaporation [9,10]. TEWL has been used as an indicator of skin integrity deficiencies, like damage from chemical or physical irritants or changes under occlusive conditions [11,12,13,14].…”