Diaper rash is a generalized term indicating any skin irritation (regardless of cause) that develops in the diaper-covered region. Synonyms include diaper dermatitis (dermatitis = inflammation of the skin), napkin (or “nappy”) dermatitis, and ammonia dermatitis. While there are several broad categories of causes of diaper rash, contact irritation is the most common culprit. While diaper rash is generally thought to affect infants and toddlers, any individual wearing a diaper (for example, an incontinent adult) is a candidate to develop this dermatitis.
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Causes
There are several categories of causes for this dermatitis. First and foremost is “irritant” or “contact” dermatitis. Skin involvement may vary from mild redness (similar in character to a sunburn) to erosion of the top layers of skin. A characteristic differential point of contract diaper dermatitis from other causes of diaper rash is that it rarely involves the skin fold regions — therefore, it spares areas not in contact with urine/stool.
Skin infections compose the next most common category of diaper rash. Bacteria (staph and strep) and yeast/fungal (Candida) are common causes of diaper rash. Generally both of these types of infections tend to result from a disruption of skin integrity and overwhelming the natural defense mechanisms of skin in this diaper region. Staph and strep bacterial infections are commonly termed impetigo. Classic descriptions of impetigo include small (1-2 mm) tiny blisters (vesicles) and pustules that tend to easily rupture leaving multiple erosions in a sea of generalized skin irritation. Candida diaper dermatitis also has several distinguishing patterns. The rash is characterized by zones of bright red skin with a series of discrete 2-4 mm “satellite” lesions at the borders of the confluent irritated skin. In contrast to contact dermatitis, Candida is generally only found in the skin folds creases and often around the anal region. Infectious causes of diaper dermatitis can generally be diagnosed by visual inspection alone. If confusion exists, laboratory studies of swabs of the involved areas may be obtained.
Allergic reactions are a less common cause of diaper rash. Commonly proposed allergens are fragrances and components of the diaper and wipes. These regions often have well-defined zones of redness with superficial vesicles and erosions. If the diagnosis of allergic skin reaction is suspect, skin-patch testing may be done to identify the offending agent. This is rarely necessary.
In addition to the common place causes of diaper rash, there are also a few very unusual causes of this problem. Unusual infections, metabolic and nutritional deficiency states, and immunodeficiency states and malignancies can all be implicated. Unfortunately, child abuse (hot-water immersion, extreme neglect to infant hygiene) can also feature a diaper rash.
Symptoms
Identifying a diaper rash is usually fairly easy. The rash is located on skin underneath the diaper area.
The skin is red and irritated. It may appear all over your baby’s bottom or genital area, or only in certain places. It may or may not involve the folds of the skin.
Prescription Treatments
The typical treatment for diaper rash includes keeping your baby’s bottom as clean and dry as possible.
You can also try:
- changing diapers at the sign of wetness
- cleaning the area with a gentle washcloth
- allowing the skin to air-dry
- applying a diaper cream that contains zinc oxide
But if these treatments don’t work as well, your baby’s doctor may prescribe targeted, topical ointments. Your child’s doctor will examine the area to determine if it appears fungal or bacterial in nature. If needed, your child’s doctor may take a skin sample to determine the exact cause.
Examples of prescription treatments that may help to get rid of persistent diaper rash include:
- hydrocortisone cream
- antifungal cream
- topical antibiotics
If the infection is bacterial in nature, a doctor may also prescribe oral antibiotics. But you should never apply over-the-counter hydrocortisone or topical antibiotics to your baby’s diaper rash. Use prescription medications or get approval from your doctor before using over-the-counter treatments.
You also want to avoid products that could be harmful or potentially toxic to babies, which includes ingredients like:
- benzocaine
- camphor
- salicylates
Using medicated ointments that aren’t right for your baby’s diaper rash can do more harm than help.
Remedies
Here are some natural remedies for diaper rash that should help your little one smile again in no time.
Vinegar
Stale urine is extremely alkaline in nature and can burn a baby’s soft skin like an acid. To balance out the high pH, vinegar is one of the best ingredients.
Baking Soda
Baking soda has healing properties that can help treat diaper rash.
Petroleum Jelly
Many pediatricians recommend applying a thin layer of protective coating on the baby’s soft skin every time you change a diaper. Petroleum jelly is perfect for this purpose. It will help protect the diaper area from the irritating effects of urine and feces.
Coconut Oil
Coconut oil has antifungal and antimicrobial properties, and hence can be used to treat diaper rash. It can also have a soothing and healing effect on the baby’s soft skin.
Breast Milk
Are you believing this one? Yep. Literally applying breast milk to your baby’s rash can help it heal. All you do is rub in a few drops and let it air dry before you put another diaper on your baby.
Oatmeal
Yep. Oatmeal. Put it in a blender and mix on the highest setting until it turns into a fine powder. Mix it in a tub of water until it has a silky feel, then let your child soak in the bath for 15-20 minutes.
Yogurt
Make sure you are using sugar-free yogurt, and apply a thick layer to baby’s diaper rash. Wipe it clean with each diaper change, and apply a new layer until it is gone.
