Improving newborn skin health: Effects of diaper care regimens on skin pH and erythema

Jennifer Gustin, Lisa Bohman, Julie Ogle, Gina Fadayel, Maria C Mitchell, Vivek Narendran, Marty O Visscher, Andrew N Carr, Jennifer Gustin, Lisa Bohman, Julie Ogle, Gina Fadayel, Maria C Mitchell, Vivek Narendran, Marty O Visscher, Andrew N Carr

Abstract

Background/objective: Newborn infant skin is functional but immature, and diapering products can play a significant role in infant diapered skin health. Previous work demonstrated a regimen consisting of a diaper with an emollient and apertures on the inner liner (topsheet) with an acidic, pH-buffered wipe (Regimen A) lowered newborn skin pH and reduced the enzymatic activity on skin post-stool cleaning versus a regimen without these features (Regimen B). This study extends these findings to determine the impact of Regimen A on diaper area erythema severity over a 2-week use period.

Methods: This IRB-approved, blinded, randomized, crossover study enrolled newborn infants >7 days and ≤8 weeks. Participants exclusively used two unique diaper and wipe combinations, Regimen A and Regimen B (non-emollient, non-aperture containing topsheet and wipe with limited buffering capacity), each for 14 days and preceded by a 3-day washout regimen.

Results: Diapered skin pH was reduced during Regimen A use to values similar to that of a non-diapered control site (chest), while use of Regimen B was associated with a more alkaline skin pH. Regimen A resulted in significantly fewer severe erythema episodes. At the site of highest erythema, the perianal space, the average erythema score was significantly lower and more newborns were free of erythema while using Regimen A vs. Regimen B (P < .05).

Conclusions: These findings demonstrate that diapering products can have a significant impact on newborn skin. They reinforce the need to support the physiological normalization of skin pH and protection from skin irritation and damage.

Keywords: diaper dermatitis; diaper skin; erythema; neonatal skin; skin pH.

Conflict of interest statement

Jennifer Gustin, Lisa Bohman, Gina Fadayel, Maria Mitchell and Andrew Carr are employees of The Procter and Gamble Company. Julie Ogle is a retired employee of Procter & Gamble.

© 2021 Procter & Gamble. Pediatric Dermatology published by Wiley Periodicals LLC.

Figures

FIGURE 1
FIGURE 1
Comparison of perianal skin pH after 2 wk of product use and immediately and 15 min post wipe use. Skin pH at the perianal region was significantly lower for Regimen A vs. Regimen B after 2 wk of use. Skin pH was further lowered immediate post‐wiping and remained lower 15 min afterward. The pH values for Regimen A and B were lower than during washout product use. (*P < .05 vs Regimen B)
FIGURE 2
FIGURE 2
Erythema improvement after 2 wk of regimen use. Percent of infants showing improvement (lowering) in erythema scores at the perianal site A, and intertriginous site B
FIGURE 3
FIGURE 3
A, Percent of infants who exhibited perianal erythema scores of 0 or 0.5. B, Number of more severe erythema events during 2‐week regimen use. The number of more severe erythema events (≥2.0) scored in the diapered area were significantly lower, while infants used Regimen A. (*P < .05 vs Regimen B, Washout)

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Source: PubMed

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