Bath: Baby soaps or neutral pH soaps can be used for this purpose. Bathing with soap once or twice a week, and using only warm water in other baths is recommended. As a result; skin dry, irritation, and pH variations will be minimized. For premature babies, bathing without soap at all is recommended for the first week.
Moisturizers, Baby oils: These products should be recommended only if the skin is very dry and if fissures occur. Also in this case, perfume- and dye-free, Vaseline- or lanolin-based moisturizers can be preferred. Humectants such as lactic acid, urea, and glycerol, can be used for patients with ichthyosis particularly, but their use in the newborn should be avoided as much as possible. The body surface/body weight ratio of the newborn is 2.4 times higher than an adult. Therefore, it is possible to say that the absorption of preparations which contain 10% urea in the newborn will cause an effect which is equal to that of a preparation with 24% urea in adults. Such moisturizers not only cause intoxication but they also have other side effects such as changing the skin pH, and impacting colonization. Baby oils contain vegetable oil, lanoline derivatives, alcohol and esters. However, they are not recommended for everyday use as they may have occlusive effects.
Shampoos: The purpose of using shampoo for babies is to clean the scalp, remove sebum, keratin fragments and the dust. For older children, bright, soft hair that can be shaped easily, can also be the purpose. The cleaning effect of the shampoos is through ensuring solubility and rinsing with hydrophilic groups and bonding to greasy substances with surfactants which have an hydro carbonated end. The surfactants used in shampoos can be classified according to their ion charges. Anionic surfactants are frequently used; lauryl sulfate is such a surfactant with a strong cleaning and foaming character. Cationic surfactants, for example stearates and their derivatives provide a good look to the hair; however, they are not used in baby shampoos as they are irritant for eyes. Amphoteric compounds such as imidazoline derivatives and betaine contain both positive and negative charges they are tolerated very well and they are frequently used in baby shampoos. Non-ionic surfactants are also frequently used in baby products. Now, alkyl ether sulfates which are newly developed surfactants with less irritation potential are also used (2).
The shampoos’ pH should be close to lacrimal pH, and its composition should be isotonic with teardrop. Generally, skin reaction does not occur with products which do not cause eye irritation (2). The main substances of all shampoos are water, cleaning surfactants and foam providing surfactants. Cleaning surfactants are medium-long chain oil acids such as lauryl sulfates, while foam providing surfactants are short chain oil acids such as cocamide diethanolamine. Stabilizers are also included in shampoos to ensure viscosity. As a result, the shampoo becomes easier to apply on hair and the risk of penetration into eye decreases. Shampoos are made resistant to the microbial contamination to which they are susceptible due to their high water ratios by adding preservatives (such as quaternium 15, formaldehyde, methylparaben etc.) Chelators such as EDTA prevent sedimentation of heavy metals, and deterioration of the oil content. Perfumes, colorants, and antioxidants can also be added. However, the substances which give a bright or matte look to the products used in adult shampoos are not used in baby shampoos due to their irritative effects; therefore baby shampoos have a crystal appearance.
Normal baby shampoos and olive oil are recommended for seborrheic dermatitis seen in the scalp of the newborn, medical shampoos are not recommended. In babies, the medical shampoos other than 2% ketoconazole shampoo that may be recommended for seborrheic dermatitis may have toxic effects. Since early puberty symptoms may develop with shampoos that contain estrogen or placenta, they should not be used for babies and children. Considering the entire shampoo quantity used for babies in one year, side effects are rare. The reported most common side effects are burning eyes and dry-matte appearance of hair. Shampoos rarely cause skin reactions as they are diluted for use, and rinsed in a short time. However, contact urticaria or irritant dermatitis may occur in the event of inadequate rinsing. Reportedly, if the baby is seated in the bathtub and allowed to play in the water for rinsing the shampoo; contact dermatitis, vulvovaginitis and secondary infections may develop due to long term contact of mucosas with surfactants, aromatizers and other substances. Hair creams contain cationic polymers and cellulose (quaterniums). They have an effect by replacing the natural grease that the shampoos capture from the hair surface. They provide easy combing and bright appearance to hair, but they are not recommended to be used for children under five years. Most hair creams have long-chain oil acids such as cetylic alcohol, lanolin alcohol and stearyl alcohol.