An Algorithmic Approach to Skincare in Neonates and Infants

The skin of neonates and infants participates in a maturation process from birth and is susceptible to barrier disruption. A current algorithm established on a US-based consensus paper on skincare approaches using gentle cleansers and moisturizers in neonatal and healthy infant skin; summarized clinical information for healthcare providers treating neonates and infants.

This project utilized a modified Delphi process incorporating virtual discussions followed by an online follow-up, substituting the use of a questionnaire. During the virtual meeting, the systematic literature review outcomes and a draft algorithm addressing over-the-counter skincare for neonates and infants with healthy skin were debated and adopted using evidence integrated with the expert opinion and experience of the panel.

The highlights of the discussion are as follows-

• The algorithm focuses on three clinical signs: xerosis, erythema, and erosion/bulla. 
• Evidence supports the benefits of ongoing daily use of non-alkaline cleansers and ceramides incorporating moisturizers to lessen inflammation and maintain a healthy skin barrier function. 
• Diaper rash is often seen in infants, presenting as erythema or, as skin erosion in more severe cases. 
• Skin protection with a barrier cream and frequent diaper changes using disposable diapers can benefit most cases; however, if the rash continues despite appropriate care, ruling out a candida infection is vital.

Thus this current algorithm focuses on neonatal and infant healthy skin that can benefit from skincare. When applied from birth onwards, gentle cleansers and moisturizers containing barrier lipids can assist in preserving the protective skin barrier. 

J Drugs Dermatol. 2021 Nov 1;20(11):1195-1205. doi: 10.36849/jdd.6219. PMID: 34784132.