Transepidermal Water Loss in Newborns Within the First 24 Hours of Life: Baseline Values and Comparison with Adults

Abstract

The measurement of transepidermal water loss (TEWL) is important for evaluating the integrity of the barrier function of the stratum corneum. Normal TEWL values in healthy adults and in children ages 2 and older are well known, but few studies have been performed in infants and neonates. TEWL in healthy neonates younger than 24 hours old was assessed and compared with that of an adult study population. We also studied possible correlations between this parameter, gestational age, and mode of delivery. A prospective study was conducted in healthy newborns. The areas tested were the volar forearm and the popliteal fossa. Ninety-nine healthy newborns were enrolled and 33 healthy adults were analyzed as controls. Statistically significant differences were noted between newborns and adults in TEWL (p < 0.01). Newborns had a much higher mean TEWL than adults. Differences in the morphology and physiology between newborn and mature skin can explain the higher TEWL in newborns. Higher TEWL could also be due to the sudden functional adaptation of the skin immediately after delivery, when the newborn transits from a liquid to the dry, gaseous extrauterine environment. Functional evaluation of the neonatal skin barrier is important mainly because maintaining skin integrity facilitates cutaneous adaptation.

Development of stratum corneum chymotrypsin-like protease activity and natural moisturizing factors from birth to 4 weeks of age compared with adults

“…The status of epidermal barrier function at birth in healthy, full‐term neonates compared with adults remains inconclusively resolved. For example, reported in the literature are independent studies demonstrating reduced, equivalent or elevated TEWL at birth when measured using an open‐chambered evaporimeter. The results presented here using a closed‐chamber condenser system suggest epidermal barrier function in healthy, full‐term neonates is competent when assessed throughout the days immediately following birth.…”

Skin Barrier Function and Staphylococcus aureus Colonization in Vestibulum Nasi and Fauces in Healthy Infants and Infants with Eczema: A Population-Based Cohort Study

“…The apparent discrepancies between these studies may have several explanations. First, age may modify the results, as adults generally have lower TEWL than infants [44]. Also, sampling sites and circumstances were different.…”

Lipid mediator profile in vernix caseosa reflects skin barrier development

“…Accordingly, determining the skin lipid mediator composition at birth may provide insights into the integrity and functionality of this barrier in the newborn. However, given the ethical issues associated with the invasiveness of sample collection in newborns ( i.e., skin biopsies) 8 , skin functionality is usually assessed by the measurement of other surrogates such as the transepidermal water loss 9 .…”