Induction of epidermal damage by tape stripping to evaluate skin mildness of cleansing regimens for the premature epidermal barrier.

Abstract

Previous works indicate a compromised skin model may be a possible surrogate for premature, undeveloped skin. This study was performed to investigate the use of a current model as a surrogate test design. Serial tape stripping on the volar forearms of adult female volunteers (n=36) was used to "thin" the stratum corneum. The forearm sites received intensive applications of different wiping options that exaggerated the exposures to cleansers that might be experienced by an infant in a neonatal intensive care unit. The recovery of skin barrier function during the wiping regimen, measured by transepidermal water loss (TEWL), was used as the primary indicator of the mildness of the cleansing options. Measurements of TEWL were made prior to the first wash on days 1-4, on day 5 and on day 8. Erythema was graded as a secondary endpoint. There was an early and sustained distinction in rates of skin barrier recovery between the washcloth and water treatment, and the two wipes treatments (P<0.05). Areas submitted to the wipes treatments showed recovery rates similar to that of the tape-stripped untreated site, indicating that the use of disposable wipes led to minimal perturbation of the recovery process. By contrast, cleansing with a cotton washcloth and water markedly perturbed the repair process compared with all other conditions (P<0.05). This model shows promise as a possible surrogate model for assessing the mildness of skin cleansing products for the care of premature infants.