A mother cradles a naked newborn baby and smiles down lovingly at the infant.
Structural differences make the newborn skin softer and more fragile.

How newborn skin differs

What words come to mind when you think of the texture of newborn skin? Soft? Smooth? Perfect?

We all love the feel of a newborn baby’s skin. Have you ever wondered why it feels so different to adult skin?

There are distinct differences between the skin of a preterm and term baby and that of an adult. This is due to differences in the structure of the layers of the skin. For example, the term baby’s stratum corneum (the outermost layer) is 30% thinner than in adults. In terms of skincare, what do you think are the implications of this?

A diagram shows the layers of human skin ©Shutterstock

The neonatal dermis (the thick layer of tissue below the epidermis) also contains fewer collagen and elastin fibres and structural proteins. This affects the strength of the skin, making it more fragile than adult skin. In a preterm baby, this layer is exceptionally fragile. Also, the section between the epidermis and the dermis is weaker in preterm than term skin, which can even cause the skin layers to separate from each other easily (Kain & Mannix, 2018).

Vernix

Have you heard of vernix before? The correct term is ‘vernix caseosa’ (‘vernix’ = to varnish; ‘caseous’ = cheesy nature). It is a white, creamy, naturally occurring substance that covers the skin of the fetus during the last trimester of pregnancy. Remember, the baby has been swimming in amniotic fluid for 40 weeks and just like our skin, it can wrinkle. Think of vernix as water proofing!

Vernix © V. Kain (used with permission)

In the picture above you can see the thick vernix on this newborn’s face and brow, particularly around the nose, mouth and skin creases.

Don’t be in a rush to wash it off. When allowed to remain on the skin after birth, vernix provides protection for newborn skin and helps the skin adapt to life outside the womb, during the first week after birth. Vernix is made up of water (81%), lipid [fats] (9%), and proteins (10%) (Singh & Archana, 2008).

When we think about organ systems of the body, we often overlook the skin. However, the skin is a complex organ and it performs important functions. For example, it provides UV protection, a physical barrier against pathogens invading our body, temperature regulation and supports our sensory perception (Oranges, Dini & Romanelli, 2015).

Your task

To learn more about neonatal skin, please read Skin Physiology of the Neonate and Infant: Clinical Implications and post your thoughts and questions in the comments link below.

References

Kain, V. & Mannix, T. (2018). Neonatal Nursing in Australia and New Zealand, 1st Edition. Australia: Elsevier

Oranges, T., Dini, V., & Romanelli, M. (2015). Skin Physiology of the Neonate and Infant: Clinical Implications

Singh, G. & Archana, G. (2008). Unravelling the mystery of vernix caseosa. Indian Journal of Dermatology, 53(2), 54–60.

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This article is from the free online course:

Assessment of the Newborn

Griffith University