Neonatal skin care

The skin has multiple functions crucial for well being and survival, including control of transcutaneous water fluxes, thermo-regulation, prevention of infections, exclusion of toxins, tactile sensations, and protection from ultraviolet radiation. As gestational age of surviving neonates decreases and developmental maturation of their epidermal barrier function is increasingly compromised, the potential importance of the skin as a barrier is magnified. Despite the importance of maintaining and promoting skin integrity and barrier function, few guidelines regarding optimal care of neonatal skin have been published. The authors review fundamental care and hygiene of neonatal skin, encompassing bathing and emolliation practices, prevention and management of skin injury, and reduction of transcutaneous loss of water and heat or percutaneous absorption of toxins. Particular reference is given to the very low-birth weight and the hospitalized neonate who require intensive care. Further optimization of these practices and the development of new approaches in skin care is one of the greatest challenges in pediatric dermatology and holds promise for improving neonatal outcome in the future.