| GEO Health|
Lotions, oils may be hazardous for baby skin
| Updated at: 1059 PST, Thursday, September 30, 2010|
LONDON: The appearance of eczema in very young babies is one of the most common worries for new parents — and there is evidence that it is becoming increasingly common.
In the 1940s, the condition affected 4 per cent of newborns, but now the figure is around 25 per cent.
It can lead to other skin problems, such as psoriasis, and make sufferers more prone to other conditions, including asthma.
New research by a leading expert indicates that modern-day bath oils and lotions used on babies’ skin during the first few weeks of life might be to blame for much of this increase.
Professor Richard Cork, head of academic dermatology at the School of Medicine and Biomedical Sciences at Sheffield University, says there appears to be a six-week ‘window’ after a baby is born.
During this period, babies with a genetic predisposition to eczema, caused by a hereditary gene defect, can have their immune system made more sensitive, and this makes them more likely to develop eczema.
‘These babies are born with a defective skin barrier, which means that their skin can be sensitised — made prone to an allergic reaction — much more easily if the “wrong” treatments are used,’ says Professor Cork.
‘The outer layer of the skin, called the stratum corneum, provides a barrier which normally prevents the penetration of irritants and allergens.
‘But in babies who are predisposed to atopic eczema, this does not work as effectively, allowing loss of water from the corneocytes (cells in the skin), which shrink and allow cracks to open between them, so irritants and allergens can penetrate, leading to lesions from eczema.
‘The use of soap on the skin leads to a further deterioration of the barrier, because it breaks down the cells which are still forming in babies’ skin.’
Today, babies and children are exposed to harsher soaps and detergents, containing more synthetic ingredients, than they were 60 years ago. Even so-called baby products can contain detergents too harsh for these at-risk children, says Professor Cork.
Worse still, he believes the very creams prescribed by doctors to treat the eczema might actually be making things worse. Indeed, he believes one particular treatment — aqueous cream — is ‘extremely damaging’ to the skin.
Although aqueous cream is prescribed to thousands of eczema patients as a moisturiser, it was actually developed as an alternative to soap and was not designed as a ‘leave-on’ cream.
Yet this product is on most GPs’ prescribing formularies, and is widely used because it is cheap for the NHS.
One biochemist consulted by Professor Cork described aqueous cream as ‘an insane formulation’ for babies’ skin.
Another substance commonly applied to babies’ skin is olive oil — but Professor Cork says this is also unsuitable as it has a very poor balance of oleic and linoleic oil, which is damaging to skin before it develops properly.
The acid-alkali balance in these oils (measured on the pH scale) is not suitable for a baby’s sensitive skin, as it hydrates it for several minutes but then has a drying effect.
‘We need much better, high-quality, randomised controlled trials to identify which products are best for young babies’ skin,’ says Professor Cork.
He also believes that health professionals, such as midwives and health visitors, need to be more aware of the latest guidelines on treating eczema in young babies, as in some cases they do not even know about the guidelines.
Margaret Cox, chief executive of the National Eczema Society, says that eczema typically develops at the age of around two months in babies, and once it appears, it can lead to other conditions, such as asthma and food allergies.
‘There needs to be more awareness of the best way to care for babies’ skin in the first six months after they’re born, and more education for parents in picking up the early signs of eczema,’ she says.
So what creams should parents be using on their affected babies’ skin?
Professor Cork says parents must avoid all perfumed or scented products. He also advises avoiding natural or organic products which don’t contain preservatives.
‘These can be hazardous to children with eczema because they can become contaminated with bacteria.’
Medical moisturisers such as white soft paraffin, liquid paraffin 50/50, or emulsifying ointments are the best bet, although parents might need to experiment until they find one that works for their child.
Margaret Cox also urges parents to ask their GPs for an alternative to aqueous cream.
Some emollients are less likely to irritate because they don’t contain the detergent s odium lauryl, which can further upset sensitive skin. These include Doublebase, EpiDerm, Dermamist, Hydromol, Dexeryl and Emollin.
Meanwhile, Professor Cork and his colleagues are planning to publish further evidence later this year that some products, such as aqueous cream, are very damaging for babies’ skin, and he hopes this might lead to tighter guidelines from NICE or the Department of Health