Vernix, derived from the same root as varnish, is the whitish-gray
covering on newborn skin and is composed of degenerated fetal epidermis
and sebaceous secretions.
Prevalence Seen in all infants.
The vernix caseosa is thought to play a protective role for the
newborn skin with both water-barrier and antimicrobial properties.
Type of Lesion Adherent cheesy
material which dries and desquamates after birth (Fig. 1-1).
Vernix caseosa White, cheesy
vernix caseosa on a newborn baby, just a few seconds old. (Courtesy
of Dr. Mark Waltzman.)
The vernix caseosa is generally very distinctive but must be
differentiated from other membranous coverings such as collodion
baby and harlequin fetus. Both of these are much thicker, more rigid,
and more dry.
In an otherwise healthy newborn, the vernix caseosa will fall
off in 1 to 2 weeks.
No treatment is necessary. Much of the vernix caseosa is usually
wiped from the skin at birth. The rest of the vernix is shed over
the first few weeks of life.
Current newborn skin care recommendations are as follows:
1. Full immersion baths are not recommended until
the umbilical stump is fully healed and detached.
2. At birth, blood and meconium can be gently removed with warm
water and cotton balls.
3. Umbilical cord care and/or circumcision varies from
hospital to hospital. Several methods include a local application
of alcohol (alcohol wipes), topical antibiotic (bacitracin, Polysporin,
or neosporin), or silver sulfadiazine cream (Silvadene) to the area(s)
with each diaper change. The umbilical cord typically falls off
in 7 to 14 days.
4. Until the umbilical and/or circumcision sites are
healed, spot cleaning the baby with cotton balls and warm water
is recommended. After the open sites have healed, the baby can be
gently immersed in lukewarm water and rinsed from head to toe.
5. Avoiding perfumed soaps and bubble baths is best. Fragrance-free,
soap-free cleansers are the least irritating. Such cleansers should
be used only on dirty areas and rinsed off immediately.
6. After bathing, newborn skin should be patted dry (not rubbed).
The vernix caseosa may still be present and adherent for several
weeks. Topical moisturizers are usually not recommended.
A physiologic red–blue reticulated mottling of the skin
of newborn infants. It is seen as ...