Indicators of skin barrier integrity among newborns massaged with mustard oil in rural Nepal

OBJECTIVE: The objective of this study was to determine the skin barrier changes during postnatal month 1 among infants receiving routine mustard oil massage in the humid conditions of rural Nepal. STUDY DESIGN: This was an observational study among 500 live-born neonates receiving mustard oil massage. Skin integrity such as erythema, rash, dryness, skin pH, stratum corneum protein concentration and transepidermal water loss was measured on days 1, 3, 7, 14 and 28. RESULTS: Erythema and rash increased (worsened) during weeks 1 and 2, then decreased over weeks 3 and 4. Skin pH (6.1 +/- 0.5 to 5.0 +/- 0.6) and stratum corneum protein (16.6 +/- 7.9 to 13.5 +/- 5.9 mu g cm(-2)) decreased. Transepidermal water loss increased from 33.2 +/- 23.5 to 43.0 +/- 24.5 g m(-2) h(-1) at day 28. Skin pH and stratum corneum protein were higher for early versus late premature infants. CONCLUSION: Premature and full-term skin condition was generally poor especially during the first 2 weeks, improving thereafter. Maturational changes were evident.