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Allergic Contact Dermatitis and Babies Skin

The skin of infants and young babies is physiologically different when compared to that of older children and adults in terms of structure, composition and function. This means that baby skin is much more vulnerable than adult skin.

Infant stratum corneum is about 30% thinner than that of an adult, and the formation of the other layers of the epidermis is incomplete [1, 2]. Because of this baby skin needs special care [3].

Any product applied to the skin and not rinsed off can be readily absorbed. The absorption of such substances in contact with the skin is greater in newborns and infants for three reasons: their skin is thinner, there is a high ratio between skin surface area and body weight and the skin is covered by a sort of down that increases the absorbent surface [4].

For this reason it is preferable that water alone is used for cleaning newborn and young infant skin, i.e. no chemical cleansing agents, lotions of medicated wipes should be used on infant skin [8].

Allergic contact dermatitis develops when someone touches an allergen (a substance that causes an allergic reaction), potentially leading to redness and swelling, rash, itching, bumps or in more severe cases blisters that may ooze fluid and make the skin peel. Common causes of allergic contact dermatitis include cosmetics, dyes in clothing, fragrances and preservatives in baby products [9].

The most familiar form of allergic contact dermatitis in young infants is nappy rash [4]. Up to 50% of all young infants will suffer from at least one episode nappy rash at some time [7].

One of the most common reasons for the development of nappy rash is the contact of chemical ingredients with delicate skin many times a day [4].

Fragrances and preservatives are the most frequent allergens in baby wipes; however, all chemical ingredients should be considered as potential allergens [5, 8].

The preservatives that are used in baby wipes very commonly cause an allergic reaction with an itchy rash around the nappy area. A preservative called methochloroisothiazolinone / methylisithiazolinone, or MCI/MI has been reported to cause allergic contact dermatitis from baby wipes [10].

Other common allergens present in baby wipes include, but are not limited to, tocopheryl acetate, petrol-based propylene glycol, fragrances, 2-bromo-2-nitropropane-1,3-diol, and parabens. Allergic contact dermatitis from baby wipes most commonly appears as a red, irritated bottom on young infants. It can occur anywhere in which baby wipes are used, on both infants and adults. Some examples include contact dermatitis around the eyes of adults if baby wipes are used to remove makeup, hand dermatitis in mothers of young children who use baby wipes, this usually establishes more at the fingertips as dry, cracked, blistery fingertips.

Prevention is based on a number of factors including the use of mild, perfume-free, preservative-free, pH neutral cleansing agents to clean the skin of young infants, preferably plain water [8]

 

References

  1. Carder KR: Hypersensitivity reactions in neonates and infants. Dermatol Ther 2005, 18:160-75.
  2. Stamatas G, Nikolovski J et al. Infant skin microstructure assessed in-vitro differs from adult skin in organisation and at the cellular level. Paediatric Dermatology, 2009
  3. Martin KM. New research on the characteristics of infant skin functionality. 110th Annual Meeting of the Japan Paediatric Society, 2009
  4. P. Pigatto, A.Martelli, C. Marsili, A.Fiocchi. Contact dermatitis in children. Pigatto et al. Italian Journal of Paediatrics 2010, 36:2
  5. P. González-Munoz, L. Conde-Salazar, S. Vanó-Galvána. Allergic Contact Dermatitis Caused by Cosmetic Products. Actas Dermosifiliogr. 2014;105(9):822-832
  6. Epidermis. Medicinenet.com. 2013 Ref Type: Electronic Citation
  7. Aherton D, Mills K. What can be done to keep babies’ skin healthy? RCM Midwives 2004;7: 288-290
  8. Postnatal Care: Routine Postnatal Care of Women and Their Babies. NICE Guidelines, No. 37.
  9. National Collaborating Centre for Primary Care (UK). Royal College of Practitioners (UK); 2006 July
  10. American College of Allergy, Asthma & Immunology. Electronic citation
  11. Boyapati A1, Tam M, Tate B, Lee A, Palmer A, Nixon R. Allergic contact dermatitis to Methylisothiazolinone: exposure from baby wipes causing hand dermatitis. Australas J Dermatol. 2013 Nov;54(4):264-7. doi: 10.1111/ajd.12062. Epub 2013 May 29.

 

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