Diaper rash

Diaper rash or diaper dermatitis is one of the most common problems in infancy. The diaper area, tightly covered by plastic pants or plastic-covered diapers, is damp and warm. This environment encourages the growth of bacteria and yeast and increases irritation from urine and stool. It used to be thought that urinary ammonia was a cause of diaper rash, but research has shown that the concentration of ammonia and the strength in a baby's urine are the same in infants with or without diaper rash. It is now thought that the moisture of the urine and stool ("wetness"), as well as enzymes in stool, is the primary factor in skin breakdown and leads to inflammation.

The treatment of diaper rash is most successful if the reason for the diaper dermatitis is found. The baby's skin may be more sensitive to irritants than that of older individuals. In fact, irritant dermatitis from exposure to urine or frequent, loose stools is the most common cause of diaper rash. Not uncommonly, yeast (Candida albicans ) may be present in the diaper area. The use of oral antibiotics (for example, for ear infections) may encourage the overgrowth of this yeast in the diaper area. Occasionally, bacteria may overgrow in the diaper area and require antibiotic treatment. An allergic reaction from a cream or ointment may also cause a rash in the diaper area.

What to expect

Occasionally, bacteria may overgrow in the diaper area and require antibiotic treatment. An allergic reaction from a cream or ointment may also cause a rash in the diaper area.

The diaper area should always be kept as dry as possible. When changing the diaper after urination, the area should be dried gently. Washing the area each time that the baby urinates may be irritating and is not necessary. If commercial baby wipes are not irritating, they may be used after each bowel movement; if the commercial baby wipes are irritating, plain water (or a soap-free cleanser such as Aquanil or Cetaphil) may be used to clean after the bowel movement. Studies comparing cloth diapers to plastic covered disposable diapers have demonstrated that the new thin disposable diapers greatly decrease the incidence of diaper rash.

Treatment

Ointments, such as Triple Paste, Aquaphor, Desitin, Balmex, or A and D Ointment can prevent the skin from coming in contact with irritants such as stool and urine. Your doctor may prescribe a low strength corticosteroid cream/ointment to be applied to the affected areas if an irritant dermatitis is suspected. Yeast infections are usually treated with a prescription antifungal cream.