Update on the Use of Topical Agents in Neonates

Topical agents include anything that touches the infant's skin. The skin is crucial to the way the infant perceives and responds to the care environment and, therefore, in neurodevelopment. Psychological stress negatively affects the barrier. The full-term infant has well-developed epidermal barrier despite spending 9 months being submerged in water. Vernix caseosa is a natural topical agent that facilitates stratum corneum barrier development through protective and adaptive mechanisms. Its properties include hydration, wound healing, antiinfection, and acid mantle development. The ontogeny of neonatal skin development and vernix biology provide the basis for assisting barrier maturation in premature infants, treating compromised skin and selecting topical agents. The published research on the effects of topical products on premature and damaged neonatal skin is very limited, especially for adequately sized randomized controlled clinical trials. Health care providers have keen interest and the skills to identify improved treatments through outcomes-based research.