May 7, 2003 For nine months before birth, infants soak in a watery, urine-filled environment. Just hours after birth, however, they have near-perfect skin. How is it that nature enables infants to develop ideal skin in such seemingly unsuitable surroundings?
A new study by researchers at the Skin Sciences Institute of Cincinnati Children’s Hospital Medical Center shows that the answer may be vernix -- the white, cheesy substance that coats infants for weeks before they are born, then is wiped off and discarded immediately after birth. If they’re right, the healthcare implications for newborns and adults could be remarkable.
The study, to be presented May 6 at the annual meeting of the Pediatric Academic Societies in Seattle, shows that newborn skin with vernix left intact “is more hydrated, less scaly, and undergoes a more rapid decrease in pH than with vernix removed,” says Marty Visscher, PhD, executive director of the Skin Sciences Institute and the study’s main author. “These beneficial effects of vernix suggest that it should be left intact at birth.”
Vernix is a complex mixture of lipids (fats), proteins and water. Babies born at 32 to 33 weeks are covered with the material. Those who are born full term have already lost a good portion of it. The researchers studied full-term infants, half of whom had vernix wiped off and half left intact on the surface of the skin. Skin hydration, moisture accumulation rate, skin pH and visual dryness were measured at one, four and 24 hours after birth.
Skin Sciences Institute researchers have been studying vernix for several years and found that it is not only a moisturizer but also a wound healer, cleanser, anti-infective and antioxidant. Cincinnati Children’s has obtained four patents on vernix technology and hopes to formulate a synthetic equivalent that could be used in a variety of ways: as a film on products ranging from diapers to wound dressings; as a replacement for vernix in low-birthweight, premature infants who are born before vernix develops at about 27 weeks; as a cream or lotion for topical needs; and as a delivery system for other medications.
“We view the production of vernix as analogous to infant formula as a substitute for milk,” says Dr. Visscher. “Nature has figured out how to make it. Long term, we hope to be able to mass produce a synthetic equivalent. There is nothing out there now to take care of these preterm babies, and the list of other applications for vernix is endless.”
The Skin Sciences Institute views infant skin as ideal skin and focuses on the skin as a primary care interface – a biological spacesuit that separates outer from inner space. “Skin is the largest organ in the body, yet it’s often treated as insignificant,” says Stephen Hoath, MD, a neonatologist, medical director of the Skin Sciences Institute and co-author of the study. “You can’t deliver medical care in the home or hospital without paying attention to this interface, and it has a disproportionate impact on patient satisfaction. People assume you can transplant a liver, but if you can’t pull leads off without hurting them, you’re not providing good care.”
The Skin Sciences Institute has established collaborative relationships with major companies involved in skin care as well as skin barrier structure and function, including the Procter & Gamble Co., the Andrew Jergens Company, Kao Corporation, GOJO Industries, Coloplast Corporation, Kenabo, Becton Dickinson, Vyteris, NOVA Technology Corporation, 3M, and W. L. Gore Industries.
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