Sunflower seed oil for skin barrier repair in newborns
a systematic review and meta-analysis with biophysical parameters
DOI:
https://doi.org/10.66344/jpad.v32i1.1838Abstract
Background The skin barrier in newborns is immature, and moisturizers may help repair the barrier. The recommended skincare products for newborns are those containing fewer ingredients. Hence, natural oil-like sunflower seed oil (SSO), free of chemical ingredients, is a cost-effective option. The aim of this study was thus to assess the efficacy of topical SSO to improve skin barriers in newborns.
Methods Online searching in Pubmed-MEDLINE, Scopus, EBSCO, Cambridge Core, ProQuest, Cochrane library, ClinicalTrials.gov, and Google Scholar databases found five relevant articles included in a systematic review (n=1,272 subjects), from which three articles are used in meta-analysis (n=908 subject).
Results A meta-analysis showed that following a topical application of SSO, transepidermal water loss (TEWL) tended to lower than other moisturizers (standardized mean difference [SMD] −0.11, confidence interval [CI] 95%, −0.23 to 0.11, p=0.07, I2=0%), and it was not comparable to no moisturizer (SMD 0.09, CI 95%, −0.19 to 0.38, p=0.52, I2=0%). The stratum corneum hydration (SCH) was comparable to other moisturizers (SMD 0.03, CI 95%, −0.20 to 0.26, p=0.81, I2=0%), but it was significantly higher than no moisturizer (SMD 0.77, CI 95%, 0.48 to 1.06, p<0.00001, I2=0%). Qualitative analysis showed that SSO may reduce neonatal skin condition score.
Conclusion A meta-analysis showed that topical application of SSO may act as a moisturizer and improve skin hydration, but it may not repair the barrier. SCH indicates that it increased significantly, which means the hydration improved. The TEWL analysis did not show supportive results for SSO compared to either other moisturizers or control; however, the qualitative analysis did show that SSO had a positive effect on the clinical condition.
References
1. El-Atawi K, Elhalik M. Neonatal Skin Care. Pediatr Neonatal Nurs. 2016;2(2):10–2.
2. Mathanda TR, Bhat RM, Hegde P, Anand S. Transepidermal Water Loss in Neonates : Baseline Values Using a Closed-Chamber System. Pediatr Dermatol. 2016;33(1):33–7.
3. Darmstadt GL, Badrawi N, Law PA, Ahmed S, Bashir M, Iskander I, et al. Topically applied sunflower seed oil prevents invasive bacterial infections in preterm infants in Egypt: A randomized, controlled clinical trial. Pediatr Infect Dis J. 2004;23(8):719–25.
4. LeFevre A, Shillcutt SD, Saha SK, Nawshad Uddin Ahmed ASM, Ahmed S, Azad Chowdhury MAK, et al. Cost-effectiveness of skin-barrier-enhancing emollients among preterm infants in Bangladesh. Bull World Health Organ. 2010;88(2):104–12.
5. World Health Organization. Maternal, Newborn, Child and Adolescent Health and Ageing, Data Portal [Internet]. 2020 [cited 2020 Oct 15]. Available from: https://www.who.int/data/maternal-newborn-child-adolescent-ageing/indicator-explorer-new/
6. Summers A, Visscher MO, Khatry SK, Sherchand JB, Leclerq SC, Katz J, et al. Impact of sunflower seed oil versus mustard seed oil on skin barrier function in newborns: a community-based, cluster-randomized trial. BMC Pediatr. 2019;19:512.
7. Bartels NG, Scheufele R, Prosch F, Schink T, Proquitte H, Wauner RR, et al. Effect of Standardized Skin Care Regimens on Neonatal Skin Barrier Function in Different Body Areas. Pediatr Dermatol. 2010;27(1):1–8.
8. Blume-Peytavi U, Hauser M, Stamatas GN, Pathirana D, Bartels NG. Skin Care Practices for Newborns and Infants : Review of the clinical evidence for best practices. Pediatr Dermatol. 2012;29(1):1–14.
9. Hunt R, Chang MW, Shah KN. Neonatal Dermatology. In: Kang S, Amagai M, Bruckner AL, Enk AH, Margolis DJ, McMichael AJ, et al., editors. Fitzpatrick’s Dermatology. 9th ed. New York: McGraw-Hill; 2019. p. 1727–49.
10. Karagounis TK, Gittler JK, Rotemberg V, Morel KD. Use of “natural” oils for moisturization : Review of olive, coconut, and sunflower seed oil. Pediatr Dermatol. 2018;1–7.
11. Purnamawati S, Indrastuti N, Danarti R, Saefudin T. The role of moisturizers in addressing various kinds of dermatitis: A review. Clin Med Res. 2017;15(3-4):75-87.
12. Seiler GJ, Gulya TJ, Crop N. Sunflower : Overview. In: Wrigley C, Corke H, Seetharaman K, Faubion J, editors. Encyclopedia of Food Grains. 2nd ed. Amsterdam: Elsevier Ltd.; 2016. p. 247–53.
13. Baumann L. Cosmeceuticals and Skin Care in Dermatology. In: Kang S, Amagai M, Bruckner AL, Enk AH, Margolis DJ, McMichael AJ, et al., editors. Fitzpatrick’s Dermatology. 9th ed. New York: McGraw-Hill; 2019. p. 3803–19.
14. Berardesca E, Loden M, Serup J, Masson P, Rodrigues LM. The revised EEMCO guidance for the in vivo measurement of water in the skin. Ski Res Technol. 2018;24(3):351–8.
15. Kubo A, Amagai M. Skin Barrier. In: Kang S, Amagai M, Bruckner AL, Enk AH, Margolis DJ, McMichael AJ, et al., editors. Fitzpatrick’s Dermatology. 9th ed. New York: McGraw-Hill; 2019. p. 206–31.
16. Higgins JPT, Thomas J, editors. Cochrane Handbook for Systematic Reviews of Interventions version 510 [Internet]. The Cochrane Collaboration; 2011. Available from: www.training.cochrane.org/handbook
17. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. J Clin Epidemiol. 2009;62(10):1006–12.
18. Higgins JPT, Thomas J. Collecting data - form for RCTs only. In: Higgins JPT, Thomas J, editors. Cochrane Handbook for Systematic Reviews of Interventions Version 510 [Internet]. The Cochrane Collaboration; 2011 [cited 2020 Sep 30]. Available from
https://training.cochrane.org/data-collection-form-rcts
19. Higgins JPT, Altman DG, Gotzsche PC, Juni P, Moher D, Oxman AD, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011;343(2):d5928–d5928.
20. Guyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J, et al. GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol. 2011;64(4):383-94.
21. Kanti V, Grande C, Stroux A, Bührer C, Blume-Peytavi U, Bartels NG. Influence of Sunflower Seed Oil on the Skin Barrier Function of Preterm Infants: A Randomized Controlled Trial. Dermatology. 2014;229:230–9.
22. Caglar S, Yildiz GK, Bakoglu I, Salihoglu O. The Effect of Sunflower Seed and Almond Oil on Preterm Infant Skin: A Randomized Controlled Trial. Adv Ski Wound Care. 2020;33(8):1–6.
23. Cooke A, Cork MJ, Victor S, Campbell M, Danby S, Chittock J, et al. Olive oil, sunflower oil or no oil for baby dry skin or massage: A pilot, assessor-blinded, randomized controlled trial (the oil in baby skincare [observe] study). Acta Derm Venereol. 2016;96(3):323–31.
24. Kanti V, Günther M, Stroux A, Sawatzky S, Henrich W, Abou-Dakn M, et al. Influence of sunflower seed oil or baby lotion on the skin barrier function of newborns: A pilot study. J Cosmet Dermatol. 2017;00:1–8.
25. White-Chu EF, Reddy M. Dry skin in the elderly: Complexities of a common problem. Clin Dermatol. 2011;29(1):37–42.
26. Bhatt DR, White R, Martin G, Van Marter LJ, Finer N, Goldsmith JP, et al. Transitional hypothermia in preterm newborns. J Perinatol. 2007;27:S45–7.
27. Wyllie J, Bruinenberg J, Roehr CC, Rüdiger M, Trevisanuto D, Urlesberger B. European Resuscitation Council Guidelines for Resuscitation 2015. Section 7. Resuscitation and support of transition of babies at birth. Resuscitation [Internet]. 2015;95:249-63. Available from:
http://dx.doi.org/10.1016/j.resuscitation.2015.07.029
28. Jia YS, Lin ZL, Lv H, Li YM, Green R, Lin J. Effect of delivery room temperature on the admission temperature of premature infants: A randomized controlled trial. J Perinatol. 2013;33(4):264–7.
29. Trevisanuto D, Testoni D, de Almeida MFB. Maintaining normothermia: Why and how? Semin Fetal Neonatal Med. 2018;23(5):333–9.
30. Raone B, Raboni R, Rizzo N, Simonazzi G, Patrizi A. Transepidermal water loss in newborns within the first 24 hours of life: Baseline values and comparison with adults. Pediatr Dermatol. 2014;31(2):191–5.
Downloads
Published
Issue
Section
License
Copyright (c) 2022 R. Rizcky Erika Pratami, Asih Budiastuti, Puguh Riyanto, Diah Adriani Malik, Retno Indar Widayati, Muslimin, Hardian
This work is licensed under a Creative Commons Attribution 4.0 International License.
Submission declaration
Authors retain the copyright to their work and grant the 'Journal of Pakistan Association of Dermatologists (JPAD)' the right of first publication under a Creative Commons Attribution 4.0 International (CC BY 4.0) license. This license allows others to share, adapt, and reuse the work for any purpose, including commercial use, as long as appropriate credit is given to the original authors and the journal.
By submitting a manuscript, authors confirm that the work has not been published previously (except as an abstract, lecture, or academic thesis), is not under review elsewhere, and has been approved by all authors and relevant authorities. Once accepted, the article will be openly accessible under the CC BY 4.0 license, ensuring wide dissemination and reuse with proper attribution.
