During the past decade, infants born as early as 22-24 weeks' gestation have been admitted to neonatal intensive care units in increasing numbers. This has facilitated a need for greater understanding of skin physiology and structure, as well as of influences of the surrounding environment on maturation. This article aims to elaborate the physiology of skin for infants born ≤24 weeks' gestation and the effects of common clinical practices to prevent and treat iatrogenic wounds. We summarize the evidence, where available, and describe clinical experience.