Epidermal Barrier Treatments Based on Vernix Caseosa

Abstract

Background/Aims: Premature infants lack the vernix caseosa, have an incompetent stratum corneum (SC) barrier and are predisposed to infection. Use of topical agents to improve barrier function has had mixed outcomes. The aim was to determine the effect of vernix versus common barrier creams on the rate and quality of the epidermal barrier repair following controlled wounding. Methods: Minor wounds were created with (1) laser ablation in the minipig and (2) tape stripping of mother’s volar skin as a model for premature skin. Native vernix was applied to the mother’s tape-stripped skin. Treatments were no occlusion (NO), vernix and a petrolatum-based cream (PBC) in the pig, and NO, vernix, PBC, an oil-in-water cream (OWC), a semipermeable film (SP) and full occlusion (FO) in adults. Results: Outcomes for both trials were barrier recovery and skin hydration (moisture accumulation rate, MAT), initial hydration, erythema and dryness in adults. Vernix and PBC produced greater barrier repair than NO in the pig. SP produced greater recovery than NO and FO in adults. Vernix yielded greater recovery than FO and was similar to PBC, OWC and NO. Vernix had a directionally higher MAT than OWC and directionally higher initial hydration than NO. Conclusions: The findings suggest that vernix-based topical creams would be effective for the treatment of epidermal wounds and show promise to augment SC repair and maturation in infants.

Silicones as Nonocclusive Topical Agents

“…blocking the permeability to water vapor - induced by the applied products. In addition, skin hydration assessments evaluate the moisturizing capacity [26,27,28,29,30]. …”

Skin Care in Young Children: Innovative Approaches

“…После рождения Vernix выполняет несколько важных функций. Он содержит антимикробные пептиды, такие как лизоцим и лактоферрин, которые активны против грибковых и бактериальных патогенов [16,17]. Помимо этого, сыро-видная смазка содержит цитокины (ИЛ-1α, ИЛ-1β), фактор некроза опухоли альфа (ФНО-α), интерлейкин-6 (ИЛ-6), интерлейкин-8 (ИЛ-8) и моноцитарный хемотаксический белок 1 (MCP1) [18], а также холестерин, церамиды и ряд жирных кислот (включая олеиновые, линолевые и длин-ноцепочечные кислоты) [19].…”

“…Гидролипидная мантия кожи представляет собой смесь себума (кожного сала), пота, остаточных веществ от процесса кератинизации (ороговения) и кожной микрофлоры, которые поддержи-вают кислый рН кожи и тем самым не позволяют болез-нетворным микроорганизмам нарушить защитную функ-цию кожи [21]. Исследования также демонстрируют повышение заживляющей способности кожи при использовании Vernix caseosa при лечении ран [15][16][17]. Наличие сыровидной смазки также препятствует про-никновению протеолитического фермента химотрипси-на, который обнаруживается в меконии [22].…”

Vernix Caseosa and Its Substitutes: Lipid Composition and Physicochemical Properties

“…Untreated (no occlusion) sites served as controls [ 105 ] . TEWL values after wounding and prior to treatment ranged from 29 to 50 g/m 2 /h, comparable to values for infants <30 weeks gestation [ 106 ] .…”

“…In a human trial, tape-stripped maternal volar forearm skin (a common model for premature skin) was used to compare the effects of vernix, a petrolatum-based cream (Aquaphor ® ), and an oil-in-water cream (Hand Medic ® , GOJO Industries, Inc., Akron, OH, USA) on the rate of SC barrier repair, skin hydration, erythema, and dryness [ 105 ] . Vernix and the creams were applied twice daily at 2.5 mg/cm 2 .…”