The role of emollients is a plus in diaper dermatitis
https://doi.org/10.21518/ms2025-252
Abstract
In newborns and young children, the skin is characterized by relative morphofunctional immaturity, a reduced degree of differentiation of structural elements and the thickness of the epidermal and dermal layers, resulting in increased susceptibility to exogenous factors and an increased risk of pathogens, which increases the likelihood of infectious and inflammatory processes. Diaper dermatitis is a common inflammatory skin disease that significantly reduces the quality of life of the child and his parents. The main symptoms are redness, swelling and discomfort in the diaper area. Effective treatment and prevention of diaper dermatitis require restoration and strengthening of the skin barrier, as well as ensuring sufficient skin hydration. This article examines the anatomical and physiological features of the skin of newborns and young children that determine its increased sensitivity and vulnerability to external influences. The factors contributing to the development of diaper dermatitis are analyzed in detail, including increased humidity, friction, exposure to urine and feces, as well as a violation of the barrier function of the skin. Particular attention is paid to the role of emollients-plus – modern products containing not only moisturizing and softening components, but also additional ingredients such as prebiotics, antioxidants and anti-inflammatory substances for the prevention and treatment of diaper dermatitis.
About the Authors
I. N. Zakharova
Russian Medical Academy of Continuous Professional Education
Russian Federation
Russian Federation
Irina N. Zakharova - Dr. Sci. (Med.), Professor, Honored Doctor of the Russian Federation, Head of the Department of Pediatrics named after Academician G.N. Speransky, Russian Medical Academy of Continuous Professional Education.
2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993
O. V. Zaytseva
Russian University of Medicine (ROSUNIMED)
Russian Federation
Russian Federation
Olga V. Zaytseva - Dr. Sci. (Med.), Professor, Honored Doctor of the Russian Federation, Head of the Department of Pediatrics, Russian University of Medicine (ROSUNIMED).
4, Dolgorukovskaya St., Moscow, 127006
E. S. Fedenko
National Research Center – Institute of Immunology, Federal Medical-Biological Agency of Russia
Russian Federation
Russian Federation
Elena S. Fedenko - Dr. Sci. (Med.), Professor, Head of the Department of Allergology and Immunopathology of the Skin, National Research Center – Institute of Immunology, Federal Medical-Biological Agency of Russia.
24, Kashirskoye Shosse, Moscow, 115478
A. N. Pampura
Russian Medical Academy of Continuous Professional Education; Veltischev Research and Clinical Institute for Pediatrics and Pediatric Surgery of the Pirogov Russian National Research Medical University
Russian Federation
Russian Federation
Alexander N. Pampura - Dr. Sci. (Med.), Professor of the Department of Pediatrics named after Academician G.N. Speransky, Russian Medical Academy of Continuous Professional Education; Head of the Department of Allergology and Clinical Immunology, Veltischev Research and Clinical Institute for Pediatrics and Pediatric Surgery of the Pirogov Russian National Research Medical University.
2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993; 2, Taldomskaya St., Moscow, 125412
N. N. Murashkin
National Medical Research Center for Children’s Health; Central State Medical Academy of Department for Presidential Affairs of the Russian Federation; Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Nikolay N. Murashkin - Dr. Sci. (Med.), Professor, Head of the Research Institute of Pediatric Dermatology, Head of the Department of Dermatology with Laser Surgery Unit, Head of the Laboratory of Skin Pathology in Children of the Department of Scientific Research in Pediatrics, National Medical Research Center for Children’s Health; Professor, Central State Medical Academy of Department for Presidential Affairs of the Russian Federation; Professor, Sechenov First Moscow State Medical University (Sechenov University).
2, Bldg. 1, Lomonosovsky Ave., Moscow, 119926; 19, Bldg. 1А, Marshal Timoshenko St., Moscow, 121359; 8, Bldg. 2, Trubetskaya St., Moscow, 119048
V. V. Pupykina
Russian Medical Academy of Continuous Professional Education
Russian Federation
Russian Federation
Viktoria V. Pupykina - Assistant of the Department of Pediatrics named after Academician G.N. Speransky, Russian Medical Academy of Continuous Professional Education.
2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993
References
1. Rybkina NL. Modern approaches to skin care of the newborns: Tactics of pediatrician. Bulletin of Contemporary Clinical Medicine. 2014;7(6):84–89. (In Russ.) Available at: https://vskmjournal.org/images/Files/Issues_Archive/2014/Issue_6/VSKM_2014_N_6.pdf.
2. Blume-Peytavi U, Kanti V. Prevention and treatment of diaper dermatitis. Pediatr Dermatol. 2018;35(Suppl. 1):s19–s23. https://doi.org/10.1111/pde.13495.
3. Zaharova IN, Pshenichnikova II, Machneva EB. Proper skin care of newborns and young children: What the pediatrician needs to know. Pediatrics. Consilium Medicum. 2016;(1):24–30. (In Russ.) Available at: https://elibrary.ru/xbdylr.
4. Gao Z, Tseng CH, Pei Z, Blaser MJ. Molecular analysis of human forearm superficial skin bacterial biota. Proc Natl Acad Sci U S A. 2007;104(8):2927–2932. https://doi.org/10.1073/pnas.0607077104.
5. Blume-Peytavi U, Hauser M, Stamatas GN, Pathirana D, Garcia Bartels N. Skin care practices for newborns and infants: review of the clinical evidence for best practices. Pediatr Dermatol. 2012;29(1):1–14. https://doi.org/10.1111/j.1525-1470.2011.01594.x.
6. Stamatas GN, Nikolovski J, Luedtke M, Kollias N, Wiegand BC. Infant skin microstructure assessed in vivo differs from adult skin in organization and at the cellular level. Pediatr Dermatol. 2010;27(2):125–131. https://doi.org/10.1111/j.1525-1470.2009.00973.x.
7. Visscher MO, Barai N, LaRuffa AA, Pickens WL, Narendran V, Hoath SB. Epidermal barrier treatments based on vernix caseosa. Skin Pharmacol Physiol. 2011;24(6):322–329. https://doi.org/10.1159/000328744.
8. Stamatas GN, de Sterke J, Hauser M, von Stetten O, van der Pol A. Lipid uptake and skin occlusion following topical application of oils on adult and infant skin. J Dermatol Sci. 2008;50(2):135–142. https://doi.org/10.1016/j.jdermsci.2007.11.006.
9. Горланов ИА (ред.). Детская дерматовенерология. М.: ГЭОТАР-Медиа; 2017. 512 с. Режим доступа: https://djvu.online/file/hx2EWu9GhvD7e.
10. Воронцов ИМ, Мазурин АВ. Пропедевтика детских болезней. 3-е изд., доп. и перераб. СПб.: Фолиант; 2009. 1008 с. Режим доступа: https://djvu.online/file/4X70a8fYe0WhA.
11. Fluhr JW, Darlenski R, Lachmann N, Baudouin C, Msika P, De Belilovsky C, Hachem JP. Infant epidermal skin physiology: adaptation after birth. Br J Dermatol. 2012;166(3):483–490. https://doi.org/10.1111/j.1365-2133.2011.10659.x.
12. Zakharova IN, Pshenichnikova II, Tvorogova TM. Diaper dermatitis: differential diagnosis and prevention issues. Meditsinskiy Sovet. 2021;(1):14–19. (In Russ.) https://doi.org/10.21518/2079-701X-2021-1-14-19.
13. Эрнандес ЕИ, Альбанова ВИ, Калашникова НГ, Новицкая АВ, Уракова ДС. Атопический дерматит и псориаз в практике косметолога. М.: Косметика и медицина; 2020. 172 c.
14. Киясов АП. Homo sapiens под микроскопом. Казань: Изд-во Казан. ун-та; 2022. 428 с.
15. Liu J, Jin Y, Wei Q, Hu Y, Liu L, Feng Y, Jin Y, Jiang Y. The relationship between aquaporins and skin diseases. Eur J Dermatol. 2023;33(4):350–359. https://doi.org/10.1684/ejd.2023.4526.
16. Murashkin NN, Ambarchyan ET, Epishev RV, Materikin AI. Skin barrier properties in norm and pathology. Pediatriya – Zhurnal im G.N. Speranskogo. 2015;94(6):165–169. (In Russ.) Available at: https://pediatriajournal.ru/files/upload/mags/349/2015_6_4500.pdf.
17. Grice EA, Segre JA. The skin microbiome. Nat Rev Microbiol. 2011;9(4):244–253. https://doi.org/10.1038/nrmicro2537.
18. Capone KA, Dowd SE, Stamatas GN, Nikolovski J. Diversity of the human skin microbiome early in life. J Invest Dermatol. 2011;131(10):2026–2032. https://doi.org/10.1038/jid.2011.168.
19. Canchy L, Kerob D, Demessant A, Amici JM. Wound healing and microbiome, an unexpected relationship. J Eur Acad Dermatol Venereol. 2023;37(Suppl. 3):7–15. https://doi.org/10.1111/jdv.18854.
20. Zakharova IN, Kas’yanova AN. Skin microbiome: What is known today? Meditsinskiy Sovet. 2019;(17):168–176. (In Russ.) https://doi.org/10.21518/2079-701X-2019-17-168-176.
21. Šikić Pogačar M, Maver U, Marčun Varda N, Mičetić-Turk D. Diagnosis and management of diaper dermatitis in infants with emphasis on skin microbiota in the diaper area. Int J Dermatol. 2018;57(3):265–275. https://doi.org/10.1111/ijd.13748.
22. Lucky AW. Transient Benign Cutaneous Lesions in the Newborn. In: Eichenfield LF, Frieden IJ, Esterl NB (eds.). Neonatal Dermatology. 2nd ed. Philadelphia: WB Saunders; 2001, pp. 88−102. https://doi.org/10.1016/B978-1-4160-3432-2.50010-8.
23. Garanina SV, Soldatova ON, Tumaeva LA, Balykova LA. Modern understanding of the mechanisms and treatment of diaper dermatitis. Lechaschi Vrach. 2014;(9):59. (In Russ.) Available at: https://www.lvrach.ru/2014/09/15436047.
24. Murashkin NN, Materikin AI, Yepishev RV, Ambarchyan ET. Peculiarities of the Course and Prevention of Diaper Dermatitis in Newborns and Infants. Current Pediatrics. 2015;14(6):710–713. (In Russ.) https://doi.org/10.15690/vsp.v14i6.1481.
25. Stamatas GN, Tierney NK. Diaper dermatitis: etiology, manifestations, prevention, and management. Pediatr Dermatol. 2014;31(1):1–7. https://doi.org/10.1111/pde.12245.
26. Carr AN, DeWitt T, Cork MJ, Eichenfield LF, Fölster-Holst R, Hohl D et al. Diaper dermatitis prevalence and severity: Global perspective on the impact of caregiver behavior. Pediatr Dermatol. 2020;37(1):130–136. https://doi.org/10.1111/pde.14047.
27. Blume-Peytavi U, Lavender T, Jenerowicz D, Ryumina I, Stalder JF, Torrelo A, Cork MJ. Recommendations from a European Roundtable Meeting on Best Practice Healthy Infant Skin Care. Pediatr Dermatol. 2016;33(3):311–321. https://doi.org/10.1111/pde.12819.
28. Ribeiro-Mourão F, Martinho I, Machado S, Rêgo C. A Rare and Severe Form of Diaper Dermatitis. Port J Pediatr. 2021;52:162–163. Available at: https://www.researchgate.net/publication/351056829_A_rare_and_severe_form_of_diaper_dermatitis.
29. Klunk C, Domingues E, Wiss K. An update on diaper dermatitis. Clin Dermatol. 2014;32(4):477–487. https://doi.org/10.1016/j.clindermatol.2014.02.003.
30. Murashkin NN, Opryatin LA, Epishev RV, Materikin AI, Ambarchyan ET, Ivanov RA et al. Newborn Skin Care is the Basis for Prevention of Atopic Dermatitis Development. Current Pediatrics. 2021;20(5):383–389. (In Russ.) https://doi.org/10.15690/vsp.v20i5.2311.
31. Odinaeva ND, Belyaeva IA, Yatsyk GV. Preventive and therapeutic agents for skin care in preterm infants. Pediatric Pharmacology. 2009;6(6):118–120. (In Russ.) Available at: https://www.pedpharma.ru/jour/article/view/955.
32. Gorski J, Proksch E, Baron JM, Schmid D, Zhang L. Dexpanthenol in Wound Healing after Medical and Cosmetic Interventions (Postprocedure Wound Healing). Pharmaceuticals. 2020;13(7):138. https://doi.org/10.3390/ph13070138.
33. Shahriari-Khalaji M, Hong S, Hu G, Ji Y, Hong FF. Bacterial Nanocellulose-Enhanced Alginate Double-Network Hydrogels Cross-Linked with Six Metal Cations for Antibacterial Wound Dressing. Polymers. 2020;12(11):2683. https://doi.org/10.3390/polym12112683.
34. Tan C, Bhattamisra SK, Chellappan DK, Candasamy M. Actions and Therapeutic Potential of Madecassoside and Other Major Constituents of Centella asiatica: A Review. Appl Sci. 2021;11(18):8475. https://doi.org/10.3390/app11188475.
35. Mahe YF, Perez MJ, Tacheau C, Fanchon C, Martin R, Rousset F, Seite S. A new Vitreoscilla filiformis extract grown on spa water-enriched medium activates endogenous cutaneous antioxidant and antimicrobial defenses through a potential Toll-like receptor 2/protein kinase C, zeta transduction pathway. Clin Cosmet Investig Dermatol. 2013;6:191–196. https://doi.org/10.2147/CCID.S47324.
36. Mahé Y, Martin R. Use of a lipopolysaccharide fraction of Vitreoscilla filiformis as agent for stimulating the synthesis of antimicrobial peptides on the skin. Patent FR-2914189-A1, 2008/10/03. Available at: https://pubchem.ncbi.nlm.nih.gov/patent/FR-2914189-A1.
37. Gueniche A, Liboutet M, Cheilian S, Fagot D, Juchaux F, Breton L. Vitreoscilla filiformis Extract for Topical Skin Care: A Review. Front Cell Infect Microbiol. 2021;11:747663. https://doi.org/10.3389/fcimb.2021.747663.
Review
For citations:
Zakharova IN, Zaytseva OV, Fedenko ES, Pampura AN, Murashkin NN, Pupykina VV. The role of emollients is a plus in diaper dermatitis. Meditsinskiy sovet = Medical Council. 2025;(11):123-132. (In Russ.) https://doi.org/10.21518/ms2025-252
Views:
19
Email this article 