Introduction: The use of certain topical oils for the prevention or treatment of baby dry skin or massage may affect skin barrier function. Adverse effects may contribute to the development of childhood atopic eczema. Prevalence of atopic eczema has increased substantially since the 1940s, which could be linked to environmental factors, including increased use of oils and other baby skincare products.
Purpose: Maternity service health professionals commonly recommend topical olive oil or sunflower oil to new parents for their newborn baby’s skin. Study aims included providing proof of concept that topical oils have some effect on baby skin barrier function, and data to inform optimal trial design.
Materials and Methods: A pilot, assessor-blinded, RCT was conducted. 115 healthy, full-term babies aged <72 hours were recruited at a large hospital in North West England between September 2013 and June 2014. Babies were randomly assigned to using topical olive oil, topical sunflower oil or no oil, twice a day for 4 weeks, stratified by family history of atopic eczema. Change in spectral profile of lipid lamellae, transepidermal water loss, stratum corneum hydration, skin surface pH and clinical observations were measured on the forearm, abdomen and thigh, within 72 hours, and at 4 weeks post-birth. Mothers completed weekly questionnaires to record skincare practices and medical treatments.
Results: Recruitment rate was 11.1%, with completion of 80%. Protocol adherence was 79-93%, 83-94% and 100% for olive oil, sunflower oil and no oil groups respectively. At 4 weeks lipid lamellae in both oil groups was significantly less ordered compared to the no oil group, suggesting that both oils impede development of lipid lamellae structures of the skin barrier from birth. Both oil groups had significantly improved hydration, with no significant differences for other parameters across groups.
Conclusions: Proof of concept was achieved. Novel baseline data and information on trial parameters and processes to guide future study design were obtained. Observational and mechanistic studies are recommended to examine the link between using topical oils from birth and the development of atopic eczema, prior to conducting a definitive RCT. This pilot study was not powered to detect clinical significance, but, findings suggest caution when recommending topical oils for term newborn skin.
1The University of Manchester, United Kingdom; 2The University of Sheffield, United Kingdom; 3Sidra Medical and Research Center, Doha Qatar