Dia­per der­ma­ti­tis

Diaper dermatitis
Diaper dermatitis

There are several expressions for “diaper dermatitis”, such as napkin dermatitis, nappy dermatitis, nappy rash, diaper rash. The condition indicates any skin irritation that occurs in the diaper-covered region. It is often related to wet or infrequently changed nappies, chafing and skin sensitivity. While diaper rash is generally thought to affect babies and toddlers, any person wearing a diaper (e.g. an incontinent adult) can develop this skin irritation.

Symptoms of diaper dermatitis

Symptoms in the babies’ diaper area (thighs, buttocks, genitals):

  • Bright red, tender-looking rash that gets bigger
  • Blisters, ulcers, pimples, bumps, sores with pus
  • Boys: Red, scaly areas on the scrotum and penis
  • Girls: Red, scaly areas on the labia and vagina
  • Older infants: They might scratch after the removal of the diaper

Changes in the babies’ disposition might be:

  • Uncomfortable feeling, particularly when the  diaper is changed
  • Crying when the diaper area is touched or washed
  • Fever
  • Burning or pain with urination or a bowel movement
Diaper dermatitis is also known as napkin dermatitis, nappy dermatitis, nappy rash or diaper rash
Diaper dermatitis is also known as napkin dermatitis, nappy dermatitis, nappy rash or diaper rash

Causes and origin of diaper dermatitis

Diaper dermatitis is common in children between 4 and 15 months old. The condition is caused by infection with a yeast (fungus) called Candida. Candida grows best in warm, wet places, e.g. under a diaper.

Diaper rash often occurs in babies who are:

  • Not kept dry and clean
  • Getting antibiotics
  • Breast fed by mothers taking antibiotics
  • Breast fed by mothers eating foods the baby doesn’t tolerate well
  • Introduced to new (solid) foods which results in
    • Changing of the stool’s content  
    • More frequent stools

Other causes of diaper rash might be:

  • Acids in the stool (e.g. when the child has diarrhea)
  • Ammonia (produced when bacteria break down urine)
  • Very tight diapers that rub the skin
  • Allergic reaction to soaps and laundry detergents

Consequences of diaper dermatitis

Diaper rashes rarely spread beyond the edge of the diaper. Sometimes the thighs can also be affected. However, nappy dermatitis usually responds well to treatment. If it occurs more often, a doctor should be seen.
In rare cases, it might be necessary to determine if the rash is really caused by diaper dermatitis or by another illness, such as allergy, psoriasis or neurodermatitis.

Prevention and therapy of diaper dermatitis

If the baby's skin doesn't improve after a few days of home treatment, a doctor’s visit is needed. Sometimes, the physician prescribes medication to treat diaper rash.
But the best treatment for diaper dermatitis is to keep the diaper area dry and clean. This also helps avoid a new nappy rash. To prevent the condition, the baby should be laid down on a towel without a diaper as often as possible. The more time the child keeps out of a diaper, the better.

More suggestions:

  • Change  the diapers often
  • Change the diaper right after the baby urinates or passes stool
  • Gently clean the diaper area by using water and a soft cloth or cotton ball with every diaper change
  • Don’t scrub the area
  • Don’t use wipes with alcohol or perfume
  • Don’t use talcum powder (bad for the lungs of the baby)
  • Use a squirt bottle of water if the area is very sensitive
  • Air-dry the area or pat it dry
  • Put diapers on loosely
  • Use absorbent diapers
  • Cloth diapers:
    • After washing, rinse several times to remove all soap
    • Don’t use fabric softeners
    • Don’t put rubber or plastic pants over the diaper (not enough air)
  • Wash your hands before and after changing diapers
  • Ask the doctor what kind of powders or ointments are most effective
  • Zinc oxide products help keep moisture away from the skin (but it has to be applied to clean, dry skin)