Background: In adults the influence of cleansing preparations on the pH, fat content and hydration of the skin is well documented. Studies in newborn and small infants have not been reported.
Objective: Our study aimed at examining whether similar effects can be ascertained in infants.
Methods: Infants without skin disease, aged 2 weeks to 16 months, entered an open, controlled and randomized study. Ten infants each had skin washed with tap water (control group), liquid detergent (pH 5.5), compact detergent (pH 5.5) or alkaline soap (pH 9.5). The pH, fat content and hydration were measured before and 10 min after cleansing. Findings were statistically evaluated by parametric covariance analysis.
Results: The skin pH increased from an average of 6.60 after cleansing in all groups. The smallest increase (+0.19) was observed in the control group, the largest (+0.45) after washing with alkaline soap. After treatment with liquid or compact detergent, the increase of the pH was only 0.09 higher than for the control group. In comparison to the compact and liquid detergents, the alkaline soap group had a significantly higher increase in pH. The fat content (mean starting value: 4.34 micrograms/cm2) decreased after washing in all groups; the smallest effect was observed in the control group (decrease of 0.93 micrograms/cm2), the highest for the alkaline soap group (decrease of 4.81 micrograms/cm2). In comparison to the compact and liquid detergents, the alkaline soap group had a higher decrease in fat content. This difference was significant for compact detergents. No statistically significant differences were observed for hydration before versus after washing.
Conclusion: Each cleansing agent, even normal tap water, influences the skin surface. The increase of the skin pH irritates the physiological protective 'acid mantle', changes the composition of the cutaneous bacterial flora and the activity of enzymes in the upper epidermis, which have an acid pH optimum. The dissolution of fat from the skin surface may influence the hydration status leading to a dry and squamous skin.