Diaper rash (diaper dermatitis) is the inflammation of the perineal and perianal skin. The region is also known as the diaper area. It is so common that infants will have it at least once. It is often due to irritation by chemicals within the diapers, infection, allergen (atopy). It is usually mild and self-limited. Treatment includes antifungal medications if Candida albicans is the causative agent. However, interventions include skincare, good hygiene, and shying away from chemical irritants.
Prolonged contact with urine, faeces, detergents, or moisture predisposes an infant to diaper rash. Candida albicans, a yeast, is the most implicated causative agent after the above irritants. But, in a few cases, infectious diaper dermatitis can be due to bacteria like Staphylococcus aureus and Streptococcus pyogenes. They may be originating from the umbilical cord stump.
Diaper rash presents with redness and irritation in the diaper area. The rash begins as faint raised pink spots that can enlarge without treatment. Rarely, the skin may peel off: skin folds become raw, predisposing the baby to superimposed bacterial infections. The infant may cry due to pain during urination or bowel emptying. Infants usually don’t have fevers.
We diagnose diaper dermatitis by history and physical examination. Rarely do we do investigations unless we are taking scrapings to look for candida species.
Skin creams and ointments, as well as frequent diaper changes, often do the magic. If urine is the source of the rash, apply a cream containing zinc oxide on every diaper change to offer relief. Before using a new diaper, clean the skin area with lukewarm water and pat it dry.
In case the rash persists, change the diaper brand: your baby’s skin might be reacting to a chemical in a few brands of diapers. Recent studies have shown that baby wipes do not worsen diaper rash due to the improved technology in their manufacturing. Nevertheless, only use quality-proven baby wipes.
If diaper dermatitis is due to candida infection, you may call your doctor for an ointment containing nystatin or clotrimazole and apply. If the rash is suspicious for a bacterial infection, antibiotics creams will suffice upon a doctor’s prescription. The doctor will often examine your child for any other diseases – specifically from the ears.
What should you do to keep a diaper rash at bay?
- Prevent a diaper rash by ensuring that your baby’s diaper area is dry all the time. Allow the skin to receive fresh air: you cannot keep the infant in a diaper 24/7.
- Buy the right diaper size and change them frequently.
- Use lukewarm water with a soft washcloth for cleaning the genital region of the baby after they urinate. A small bath can suffice after a bowel opening.
- In case of a diaper rash, apply either zinc oxide or antifungal ointment on every diaper change.
- If the rash persists or worsens, immediately call your doctor. Do not delay. Call the doctor if the child refuses to feed or develops vomiting and diarrhoea.
- Only use over-the-counter antibiotic creams upon a prescription from your doctor.
- Once you notice the rash, start treatment: do not wait until you see the doctor. Treatment involves removing the irritant, changing diapers, and keeping the child’s skin dry.
For more information, read this article.