A Consensus About the Importance of Ceramide Containing Skincare for Normal and Sensitive Skin Conditions in Neonates and Infants

August 2020 | Volume 19 | Issue 8 | Original Article | 769 | Copyright © August 2020


Published online July 31, 2020

Lawrence A. Schachner MD FAAD FAAP,a Anneke Andriessen PhD,b Latanya Benjamin MD FAAP FAAD,c Alanna F. Bree MD,d Peter A. Lechman MD MBA FAAP,e Ayleen A. Pinera-Llano MD,f Leon Kircik MD FAADg

aDivision of Pediatric Dermatology, Department of Dermatology & Cutaneous Surgery, Department of Pediatrics, Leonard M. Miller School of Medicine, University of Miami, FL bRadboud UMC, Nijmegen and Andriessen Consultants, Malden, The Netherlands cFlorida Atlantic University, Boca Raton, FL dBaylor College of Medicine and Texas Children’s Hospital, Houston, TX; A Children’s House for Pediatric Dermatology, Houston, TX eNorthwestern Medical Group, Chicago, IL; Northwestern University Feinberg School of Medicine, Chicago, IL fKing Bay Pediatrics, Maimi, FL, General Pediatrics, Nicklaus Children’s Hospital, Miami, FL gIchan School of Medicine at Mount Sinai, New York, NY; Indiana University Medical Center, Indianapolis, IN; Physicians Skin Care, PLLC, Louisville, KY; DermResearch, PLLC, Louisville, KY



containing barrier lipids may help maintain the protective skin barrier and soothe with long-term moisturizing benefits.1-3

The current consensus paper explores challenges, and current treatment approaches in neonatal and infant normal and sensitive skin conditions and the role of ceramides containing moisturizers.

SCOPE

The current consensus paper explores challenges, and current treatment approaches in neonatal and infant normal and sensitive skin conditions. The statements and recommendations aim to provide information for pediatric dermatologists, dermatologists, and pediatric healthcare providers treating neonates and infants. Other skin conditions that differ from neonatal and infant normal and sensitive skin conditions are outside the scope of this publication.

METHODS

Literature Review
A literature review explored present clinical guidelines, treatment options, and therapeutic approaches addressing neonatal and infant normal and sensitive skin conditions. For this purpose, searches were made in PubMed and on Google Scholar, on 13-15 January 2020, for English-language literature (2010– 2020) using the following terms:

Pediatric skin; maturation; skin physiology of neonates and Infants; vernix; infant skin barrier physiology; function; pathology; dysfunction; epidermal maturation's markers; protection infant skin barrier; fragility of epidermis in infants; depletion of stratum corneum lipids; atopic dermatitis (AD); AD pathogenesis; skin barrier function; skin microbiome in AD; pediatric AD guidelines; algorithm; pediatric AD consensus recommendations; prevention; treatment; maintenance; topical treatment; moisturizers; emollients; skincare in newborns and infants; ceramides; ceramide containing skincare; skin maturation and moisturization.

The selected publications were manually reviewed for additional resources.

The searches yielded 106 papers deemed clinically relevant to neonatal and infant normal and sensitive skin conditions. After the exclusion of duplicates and articles not related to neonatal and infant skin, 64 papers were included (Figure 1). Of the selected articles, there were twelve guidelines (Table 1), one epidemiology study, twenty-four reviews that included six systematic reviews. (Table 2). Twenty-one clinical trials were selected, which addressed neonatal and infant skin conditions. Table 3 illustrates the selected papers on newborn and infant skin barrier function.

Role of the Panel
The expert panel of pediatric dermatologists and dermatologists who commonly treat pediatric skin conditions convened for a one-day meeting (February 7, 2020; Miami Beach, FL), to define statements on neonatal and infant normal and sensitive skin conditions and the role of ceramides containing moistur-