Infant epidermal skin physiology: adaptation after birth
J.W. Fluhr
Department of Dermatology, Charité University Clinic, Charité Platz 1, D-10117 Berlin, Germany
Search for more papers by this authorR. Darlenski
Department of Dermatology and Venereology, Tokuda Hospital, Sofia, Bulgaria
Search for more papers by this authorN. Lachmann
Innovation R&D Direction, Laboratoires Expanscience, Epernon, France
Search for more papers by this authorC. Baudouin
Innovation R&D Direction, Laboratoires Expanscience, Epernon, France
Search for more papers by this authorP. Msika
Innovation R&D Direction, Laboratoires Expanscience, Epernon, France
Search for more papers by this authorJ.-P. Hachem
Dermatology Research, Vrije Universiteit Brussel, Brussels, Belgium
Search for more papers by this authorJ.W. Fluhr
Department of Dermatology, Charité University Clinic, Charité Platz 1, D-10117 Berlin, Germany
Search for more papers by this authorR. Darlenski
Department of Dermatology and Venereology, Tokuda Hospital, Sofia, Bulgaria
Search for more papers by this authorN. Lachmann
Innovation R&D Direction, Laboratoires Expanscience, Epernon, France
Search for more papers by this authorC. Baudouin
Innovation R&D Direction, Laboratoires Expanscience, Epernon, France
Search for more papers by this authorP. Msika
Innovation R&D Direction, Laboratoires Expanscience, Epernon, France
Search for more papers by this authorJ.-P. Hachem
Dermatology Research, Vrije Universiteit Brussel, Brussels, Belgium
Search for more papers by this authorFunding sources The present study was sponsored by Expanscience and performed by bioskin, Hamburg, Germany.
Conflicts of interest J.W.F. was an employee of bioskin, a dermatology contract research organization, at the time the study was performed. No products were evaluated; the purpose was to understand infant skin and was not of commercial interest.
Summary
Background Functional and structural skin adaptation is a dynamic process which starts immediately after birth in humans and in mammalian skin in general. This adjustment to the extrauterine dry environment is accomplished in the first year of postnatal life of humans.
Objectives To assess the dynamic changes in vivo after birth in the molecular composition and skin physiology parameters compared with older children and adults.
Methods The molecular composition of the stratum corneum (SC) and the water profile were investigated noninvasively by in vivo Raman confocal microscopy as a function of depth. Functional parameters including transepidermal water loss (characterizing epidermal permeability barrier), capacitance (as an indirect parameter for SC hydration) and skin surface pH were assessed noninvasively. The measurements were performed in 108 subjects divided into six age groups: full-term newborns (1–15 days), babies aged 5–6 weeks, babies aged 6 ± 1 months, children aged 1–2 years, children aged 4–5 years and adults aged 20–35 years.
Results We showed that skin acidification is still under development during the first weeks of life. While the basal epidermal barrier is competent immediately after birth, the SC is less hydrated in the first 2 weeks of postnatal life. Similar continuous decreasing water content towards the surface for all age groups was observed, whereas this gradient was lower for the newborns. Dynamic changes in the amounts of the natural moisturizing factor constituents were revealed in the period of infancy.
Conclusions We demonstrated the relation of formation of an acidic pH as well as underlying mechanisms in the induction of a fully hydrated SC over the first weeks of human life as a dynamic functional adaptation.
References
- 1 Giusti F, Martella A, Bertoni L et al. Skin barrier, hydration, and pH of the skin of infants under 2 years of age. Pediatr Dermatol 2001; 18: 93–6.
- 2 Stamatas GN, Nikolovski J, Luedtke MA et al. Infant skin microstructure assessed in vivo differs from adult skin in organization and at the cellular level. Pediatr Dermatol 2010; 27: 125–31.
- 3 Nikolovski J, Stamatas GN, Kollias N et al. Barrier function and water-holding and transport properties of infant stratum corneum are different from adult and continue to develop through the first year of life. J Invest Dermatol 2008; 128: 1728–36.
- 4 Fluhr JW, Mao-Qiang M, Brown BE et al. Functional consequences of a neutral pH in neonatal rat stratum corneum. J Invest Dermatol 2004; 123: 140–51.
- 5 Egawa M, Tagami H. Comparison of the depth profiles of water and water-binding substances in the stratum corneum determined in vivo by Raman spectroscopy between the cheek and volar forearm skin: effects of age, seasonal changes and artificial forced hydration. Br J Dermatol 2008; 158: 251–60.
- 6 Caspers PJ, Lucassen GW, Puppels GJ. Combined in vivo confocal Raman spectroscopy and confocal microscopy of human skin. Biophys J 2003; 85: 572–80.
- 7 Darvin ME, Fluhr JW, Caspers P et al. In vivo distribution of carotenoids in different anatomical locations of human skin: comparative assessment with two different Raman spectroscopy methods. Exp Dermatol 2009; 18: 1060–3.
- 8 Caspers PJ, Lucassen GW, Carter EA et al. In vivo confocal Raman microspectroscopy of the skin: noninvasive determination of molecular concentration profiles. J Invest Dermatol 2001; 116: 434–42.
- 9 Lademann J, Caspers PJ, van der Pol A et al. In vivo Raman spectroscopy detects increased epidermal antioxidative potential with topically applied carotenoids. Laser Phys Lett 2009; 6: 76–9.
- 10 Crowther JM, Sieg A, Blenkiron P et al. Measuring the effects of topical moisturizers on changes in stratum corneum thickness, water gradients and hydration in vivo. Br J Dermatol 2008; 159: 567–77.
- 11 Stamatas GN, Nikolovski J, Mack MC et al. Infant skin physiology and development during the first years of life: a review of recent findings based on in vivo studies. Int J Cosmet Sci 2011; 33: 17–24.
- 12 Behne MJ, Meyer JW, Hanson KM et al. NHE1 regulates the stratum corneum permeability barrier homeostasis. Microenvironment acidification assessed with fluorescence lifetime imaging. J Biol Chem 2002; 277: 47399–406.
- 13 Hoeger PH, Enzmann CC. Skin physiology of the neonate and young infant: a prospective study of functional skin parameters during early infancy. Pediatr Dermatol 2002; 19: 256–62.
- 14 Visscher MO, Chatterjee R, Munson KA et al. Changes in diapered and nondiapered infant skin over the first month of life. Pediatr Dermatol 2000; 17: 45–51.
- 15 Yosipovitch G, Maayan-Metzger A, Merlob P et al. Skin barrier properties in different body areas in neonates. Pediatrics 2000; 106: 105–8.
- 16 Chiou YB, Blume-Peytavi U. Stratum corneum maturation. A review of neonatal skin function. Skin Pharmacol Physiol 2004; 17: 57–66.
- 17 Fluhr JW, Darlenski R, Taieb A et al. Functional skin adaptation in infancy – almost complete but not fully competent. Exp Dermatol 2010; 19: 483–92.
- 18 Schmid-Wendtner MH, Korting HC. The pH of the skin surface and its impact on the barrier function. Skin Pharmacol Physiol 2006; 19: 296–302.
- 19 Fluhr JW, Elias PM. Stratum corneum pH: formation and function of the ‘acid mantle’. Exog Dermatol 2002; 1: 163–75.
- 20 Fluhr JW, Behne MJ, Brown BE et al. Stratum corneum acidification in neonatal skin: secretory phospholipase A2 and the sodium/hydrogen antiporter-1 acidify neonatal rat stratum corneum. J Invest Dermatol 2004; 122: 320–9.
- 21 Fluhr JW, Kao J, Jain M et al. Generation of free fatty acids from phospholipids regulates stratum corneum acidification and integrity. J Invest Dermatol 2001; 117: 44–51.
- 22 Mao-Qiang M, Jain M, Feingold KR et al. Secretory phospholipase A2 activity is required for permeability barrier homeostasis. J Invest Dermatol 1996; 106: 57–63.
- 23 Behne MJ, Barry NP, Hanson KM et al. Neonatal development of the stratum corneum pH gradient: localization and mechanisms leading to emergence of optimal barrier function. J Invest Dermatol 2003; 120: 998–1006.
- 24 Schwarz W, Langer K, Schell H, Schönberger A. Distribution of urocanic acid in human stratum corneum. Photodermatology 1986; 3: 239–40.
- 25 Krien PM, Kermici M. Evidence for the existence of a self-regulated enzymatic process within the human stratum corneum – an unexpected role for urocanic acid. J Invest Dermatol 2000; 115: 414–20.
- 26 Fluhr JW, Elias PM, Man MQ et al. Is the filaggrin–histidine–urocanic acid pathway essential for stratum corneum acidification? J Invest Dermatol 2010; 130: 2141–4.
- 27 Ament W, Huizenga JR, Mook GA et al. Lactate and ammonia concentration in blood and sweat during incremental cycle ergometer exercise. Int J Sports Med 1997; 18: 35–9.
- 28 Thueson DO, Chan EK, Oechsli LM et al. The roles of pH and concentration in lactic acid-induced stimulation of epidermal turnover. Dermatol Surg 1998; 24: 641–5.
- 29 Bibel DJ, Miller SJ, Brown BE et al. Antimicrobial activity of stratum corneum lipids from normal and essential fatty acid-deficient mice. J Invest Dermatol 1989; 92: 632–8.
- 30 Puhvel SM, Reisner RM, Sakamoto M. Analysis of lipid composition of isolated human sebaceous gland homogenates after incubation with cutaneous bacteria. Thin-layer chromatography. J Invest Dermatol 1975; 64: 406–11.
- 31 Foster KG, Hey EN, Katz G. The response of the sweat glands of the newborn baby to thermal stimuli and to intradermal acetylcholine. J Physiol 1969; 203: 13–29.
- 32 Shankle WR, Azen SP, Landing BH. Comparisons of eccrine sweat gland anatomy in genetic, chromosomal, and other diseases, and a suggested procedure for use of sweat gland measurements in differential diagnosis. Teratology 1982; 25: 239–45.
- 33 Rogiers V. EEMCO guidance for the assessment of transepidermal water loss in cosmetic sciences. Skin Pharmacol Appl Skin Physiol 2001; 14: 117–28.
- 34 Fluhr JW, Feingold KR, Elias PM. Transepidermal water loss reflects permeability barrier status: validation in human and rodent in vivo and ex vivo models. Exp Dermatol 2006; 15: 483–92.
- 35 Rutter N, Hull D. Water loss from the skin of term and preterm babies. Arch Dis Child 1979; 54: 858–68.
- 36 Kikuchi K, Kobayashi H, O’Goshi K et al. Impairment of skin barrier function is not inherent in atopic dermatitis patients: a prospective study conducted in newborns. Pediatr Dermatol 2006; 23: 109–13.
- 37 Skov L, Halkjaer LB, Agner T et al. Neonatal colonization with Staphylococcus aureus is not associated with development of atopic dermatitis. Br J Dermatol 2009; 160: 1286–91.
- 38 Evans NJ, Rutter N. Development of the epidermis in the newborn. Biol Neonate 1986; 49: 74–80.
- 39 Fluhr JW, Pfisterer S, Gloor M. Direct comparison of skin physiology in children and adults with bioengineering methods. Pediatr Dermatol 2000; 17: 436–9.
- 40 Pinnagoda J, Tupker RA, Agner T et al. Guidelines for transepidermal water loss (TEWL) measurement. A report from the Standardization Group of the European Society of Contact Dermatitis. Contact Dermatitis 1990; 22: 164–78.
- 41 Rawlings AV, Matts PJ. Stratum corneum moisturization at the molecular level: an update in relation to the dry skin cycle. J Invest Dermatol 2005; 124: 1099–110.
- 42 Feingold KR. The outer frontier: the importance of lipid metabolism in the skin. J Lipid Res 2009; 50 (Suppl.): S417–22.
- 43 Scott IR, Harding CR. Filaggrin breakdown to water binding compounds during development of the rat stratum corneum is controlled by the water activity of the environment. Dev Biol 1986; 115: 84–92.
- 44 Hachem JP, Man MQ, Crumrine D et al. Sustained serine proteases activity by prolonged increase in pH leads to degradation of lipid processing enzymes and profound alterations of barrier function and stratum corneum integrity. J Invest Dermatol 2005; 125: 510–20.
- 45 Briot A, Deraison C, Lacroix M et al. Kallikrein 5 induces atopic dermatitis-like lesions through PAR2-mediated thymic stromal lymphopoietin expression in Netherton syndrome. J Exp Med 2009; 206: 1135–47.
- 46 Korting HC, Hubner K, Greiner K et al. Differences in the skin surface pH and bacterial microflora due to the long-term application of synthetic detergent preparations of pH 5·5 and pH 7·0. Results of a crossover trial in healthy volunteers. Acta Derm Venereol (Stockh) 1990; 70: 429–31.
- 47 Gfatter R, Hackl P, Braun F. Effects of soap and detergents on skin surface pH, stratum corneum hydration and fat content in infants. Dermatology 1997; 195: 258–62.
- 48 Holbrook KA, Odland GF. Regional differences in the thickness (cell layers) of the human stratum corneum: an ultrastructural analysis. J Invest Dermatol 1974; 62: 415–22.
- 49 Rawlings AV, Scott IR, Harding CR et al. Stratum corneum moisturization at the molecular level. J Invest Dermatol 1994; 103: 731–41.
- 50 Robinson M, Visscher M, Laruffa A, Wickett R. Natural moisturizing factors (NMF) in the stratum corneum (SC). I. Effects of lipid extraction and soaking. J Cosmet Sci 2010; 61: 13–22.
- 51 Nakagawa N, Sakai S, Matsumoto M et al. Relationship between NMF (lactate and potassium) content and the physical properties of the stratum corneum in healthy subjects. J Invest Dermatol 2004; 122: 755–63.
- 52 Warner RR, Myers MC, Taylor DA. Electron probe analysis of human skin: element concentration profiles. J Invest Dermatol 1988; 90: 78–85.