Infants and children may have normal, dry, very sensitive, or atopic skin. Each skin type responds to environmental triggers differently. Reducing the discomfort and inflammation of very sensitive and atopic skin promotes healing, and improves the skin’s barrier function.
Infants and children may have normal, dry, very sensitive, or atopic skin. Each skin type responds to environmental triggers differently. Reducing the discomfort and inflammation of very sensitive and atopic skin promotes healing, and improves the skin’s barrier function.
In their EV.E.I.L.S program, Mustela has conducted 15 years of research to evaluate the skincare needs of infants and children. This was done in collaboration with a variety of experts in the field of dermatology, and involved both in vitro and clinical studies. The result was an intensive analysis of infant skin physiology, with an examination of epidermal functions, from its cutaneous barrier down to its lowest-lying layers. This enabled the development of a new, patented ingredient, Avocado Perseose. The Mustela product lines for babies and children are now reformulated to include this innovative ingredient.
For the in vitro studies, a patented synthetic skin product was developed, called Stelaskin®. Cultured human epidermal keratinocytes of six different age groups were used as a foundation to reconstruct the in vitro epidermal skin layer. This enabled the study of skin changes over time, including the effects of genetic biomarkers and UV ray exposure.
Skin consists of three layers: epidermis, dermis, and hypodermis. The outermost epidermis protects the inner layers from anything outside of the body. The central dermis consists of blood vessels, sebaceous glands, nerves, and sweat glands, while the deeper hypodermis is primarily an insulation layer of fatty tissue.
There are several ways in which the skin structure of infants differs from that of adults, especially at birth. The stratum corneum of the epidermis lacks central comeodesmosomes which are important for skin integrity and elasticity. The junction between the epidermis and dermis is also flatter, making it more fragile when subjected to tension.
The upper layer of the dermis is very thin, with fewer papillae, and the central collagen is disorganized and less dense. This reduces the elasticity of the skin, and impedes recovery when skin is damaged. In the EV.E.I.L.S program, transepidermal water loss (TEWL) and natural moisturizing factor (NMF) were assessed. Newborns may have an increased TEWL, making it difficult for skin to remain hydrated. Skin is well hydrated at birth, but loses the ability to maintain it over the first six months of life. The NMF rebounds thereafter. In addition, newborn skin has a higher, more alkaline pH during the first week of life. This contributes to skin fragility, and increases the likelihood of infections or rashes. The protective barrier functions are immature at this stage, and skin is more vulnerable to irritants. Also, epidermal stem cells, present during fetal life, decrease after birth. These stem cells, involved in skin barrier construction and maturation, are more susceptible to damage than those of older children.
To be inclusive, a variety of infant skin types were examined: normal, dry, very sensitive, and atopic skin. The role of skin innervation in how infants are affected by touch and various skin problems was also studied.
For each skin type, the following parameters were considered:
Until now, there has been little discussion of sensitive skin in the pediatric population. The medical literature, however, reveals that many adults have very sensitive skin. This condition is characterized by sensations of stinging, burning, pain, pruritus, or tingling in response to stimuli that are otherwise innocuous. These unpleasant sensations cannot be attributed to any specific skin disorder. The affected skin may appear normal or erythematous, and occur anywhere on the body, especially the face. In most cases, healthcare providers must rely on a patient’s self-diagnosis, but a lactic acid stinging test may be helpful. Very sensitive skin is primarily seen in adults, and there has been no evidence of it in infants. It is also unclear whether or not children experience this condition as the adult test/questionnaires are not applicable or appropriate for diagnosis in this age group.
40 to 50 percent of adults have symptoms of very sensitive skin. The prevalence varies by hereditary, environmental, and socio-linguistic factors. Variability of skin care routines can also be involved.
What About Infants And Children?
Because of limited available data regarding very sensitive skin in infants and children, an epidemiological study was conducted in 2010. 483 pediatricians from six countries provided sensitive skin findings among their newborn to five year old patients. Over 8000 children were evaluated.
Although the total number of cases varied by country, 31 percent of these infants and children exhibited signs of very sensitive skin. Clinical parameters were used as indicators of skin sensitivity since most in this age group were unable to report the symptoms typically experienced by adults. Signs of redness, dryness, and scratching were seen as young three months old.
A variety of triggers were found to both cause and exacerbate very sensitive skin symptoms.
Hot ambient temperatures, perspiration, soaps, and hard water were the most common irritants. The presence of these triggering factors varied by country.
Overall, the results revealed that very sensitive skin does occur in the pediatric population. Those with a family history of such sensitivity or atopy are more likely to develop this condition. Some of the children in this study only had sensitivity on the face, but a significant number experienced it on other body locations.
A subsequent French study confirmed these findings. Over 50 percent of mothers felt that their infant or child had sensitive skin. Many of these mothers reported having their own sensitive skin issues. Dryness and itching were consistent problems. Extremes of heat or cold, urine, and stool were the most common irritants.
What We Know About Sensitive Skin In Adults
The exact mechanism of very sensitive skin in adults is unknown. There are several factors, however, that contribute to this skin problem. In addition to environmental irritants, genetics, and skincare, the sensory nervous system appears to play a role. Burning, itching, and tingling sensations result from irritation of keratinocyte nerves, and can be a sign of neurogenic inflammation. Hormonal changes and emotional stress may also trigger symptoms.
This year, the first exploratory study was conducted to discover the mechanism of very sensitive skin in infants and children. 97 participants were evaluated, aged three months and up. Data was collected via a series of surveys that documented skin symptoms and their triggers.
Questionnaires were provided to the parent or child to document symptoms that occurred in response to environmental, chemical, or mechanical triggers.
To maintain data accuracy and objectivity, two subjective skin sensations were considered equivalent to one observed reaction. The study then defined very sensitive skin as that which reacts to two or three objective triggers. In contrast, children with normal skin had either no reaction, or only one reported trigger.
The results of the patients with normal skin (n=54) were compared to those with signs of sensitivity selected via the new questionnaire – reacting to two out of three triggers) (n=43).
Based on the study findings, this skin type is characterized by redness, dryness, and roughness among infants and children. Symptoms are most severe when present on the face.
Among the very sensitive skin children, tingling and scratching were more frequent and intense than in normal skin children, but were transient symptoms.
Looking at hydration and the protective barrier mechanism of normal skin in adults and children, no differences were found in TEWL, NMF, or ceramide levels. Children with very sensitive skin, however, experienced more dryness than children without.
In addition, inflammatory markers such as IL-8, IL-1-delta, and pro-inflammatory lipids were all increased among those with very sensitive skin. This is the first study demonstrating a clear inflammation in very sensitive skin, especially regarding pro-inflammatory lipids.
To correlate with these results, in vitro studies were conducted using the patented synthetic skin product, Stelaskin. Inflammation was simulated by applying lactic acid at six and 48 hours. Then, the interleukin IL1RA/IL1αlevel was quantified.
Mustela soothing moisturizing cream is dedicated to children very sensitive skin and contains specific patented schizandra peptides. It was applied to the inflamed Stelaskin. This resulted in a reduction of the inflammatory marker, and improvement of the Stelaskin condition.
To further show this benefit, the stratum corneum of the Stelaskin was stained with involucrine. This revealed improved stratum corneum integrity in the Stelaskin treated with Mustela soothing moisturizing cream.
We also developed a model of re-innervated Stelaskin, in which human neurons derived from stem cells (IPS) were introduced into Stelaskin To simulate the neurological effects of very sensitive skin, lactic acid was applied to the re-innervated Stelaskin. This triggered a release of a neuromediator called substance P which was used as an indicator of neurogenic inflammation.
Application of schizandra peptides (contained in Mustela soothing moisturizing cream) blocked the release of substance P. This shows that the product’s unique active ingredient can reduce the discomfort of very sensitive skin.
Although they cannot express it, infants and children may experience the symptoms of very sensitive skin. There may be dryness, erythema, reduced hydration, and signs of inflammation.
Mustela soothing moisturizing cream restores the skin’s barrier mechanism, and reduces inflammation. Their very sensitive skin product line is designed to specifically address the skincare needs of infants and children with this skin type.
