Skin Sciences

Protect Children from Sun Exposure

Exposure to the sun's damaging rays is a major factor in the development of skin cancer and skin aging. We strongly recommend the use of sunscreen daily, even during winter, but especially during summer. The best sunscreen protection will have an SPF number of at least 15. I It should be applied liberally to the skin at least once every hour for maximum protection.

• American Academy of Pediatrics
• Society for Pediatric Dermatology
• American Academy of Dermatology

Unlike the full-term baby, the premature infant’s skin is not fully formed. It is thinner, easily torn and, for very premature babies, like a full body wound. As a result, the premature infant is at risk for high water loss, electrolyte imbalance, thermal instability and increased exposure to environmental irritants and infectious agents. We study ways to improve the skin maturation process. We are working with neonatal intensive care units and the Ohio Perinatal Quality Collaborative to minimize skin trauma and associated infections.

• Cincinnati Children’s Perinatal Institute
• Ohio Perinatal Quality Collaborative website

Diaper dermatitis is not present at birth, but it is very common among infants and toddlers. Skin breakdown in the diaper area is the result of several factors, including increased hydration, contact with skin irritants (urine, feces, enzymes), friction, skin acidity, gestational age, use of antibiotics and diarrhea.

Irritant dermatitis, or skin irritation, is the redness and dryness or scaling that occurs with exposure to the environment, e.g., cold dry winter conditions, water, alcohol and topical treatments such as soaps, shampoos, cleaning solutions and other materials. These factors cause damage to the upper portion of the skin and can allow the irritants to penetrate more easily. Dryness occurs because the normal moisturization processes are disrupted.

Irritant hand dermatitis is a condition that often occurs in healthcare workers since they perform repetitive hand hygiene procedures. We have identified factors that are responsible for increased susceptibility to irritation in this group. We demonstrated that high frequency lotion application helps to reverse the damage. Reduction in irritation and improvement in skin condition are expected to increase hand hygiene compliance.

Wound care constitutes the work of patient services and clinical divisions within Cincinnati Children’s. Ailments vary greatly in severity and complexity. We are working with groups from patient services, surgery, neonatology and hematology / oncology to develop and implement multimodal skin imaging methods for use in clinical settings. The methods provide detailed, quantitative information of size, shape, color, temperature and perfusion and describe the underlying features to guide treatment planning. An important goal of this work is to effectively quantify skin condition in dark-skinned patients for whom skin pigmentation masks the visual features of wounds.

• The wound and ostomy nurse site in patient services
• Hemangioma and Vascular Malformation Clinic
• Wound Center
• Surgery

Pediatric burn care is provided by the staff of Shriners Hospitals for Children − Cincinnati. We are collaborating with J. Kevin Bailey, MD, on a project to compare the effects of pulse-dye laser therapy and compression with compression alone for the restoration of disfiguring burn scars. We are using high-resolution color imaging, three-dimensional surface scanning and measures of tissue biomechanical properties to quantify color, color uniformity, scar height and elasticity. This effort is aimed at developing objective methods that become the standard of care for burns and wounds.

• Shriners Hospital For Children - Cincinnati
• UC Department of Surgery - Burn Center

Inflammatory conditions such as wounds, burns, wound grafts, laser resurfacing, chemical peels and acne can cause hyperpigmentation or darkening of the skin color. Skin darkening, as discrete spots, occurs with repeated sun exposure. The pigmented areas are often in great contrast to the color of the surrounding skin. We further developed a skin technology that is designed to reduce skin darkening due to wounds, burns, acne and chronic sun exposure following a donation of patents. Cincinnati Children’s has licensed the technology, known as deoxyarbutin, making it available to treat these conditions in patients.

Vitiligo is an acquired disease whereby the normal process for making skin pigmentation, or color, is destroyed causing white spots to appear. It is an autoimmune disease involving both genetic and environmental factors. Our investigators (including Raymond Boissy) have identified key mechanisms and genes involved in the disease process including the role of oxidative stress. These discoveries form the basis for treatment strategies. The mission of the National Vitiligo Foundation, led by Boissy, is to advocates for patients, promote research and raise public awareness.

• National Vitiligo Foundation

Pediatric patients are at risk for the development of pressure ulcers due to poor perfusion, decreased mobility, poor nutrition, excess moisture and necessary devices such as tracheostomies, G-tubes, braces and casts. We have participated in the Pressure Ulcer Prevention Collaborative at Cincinnati Children’s to conduct research, provide skin education and assist in the development and implementation of assessments to prevent pressure ulcers in the pediatric population.