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Diaper Rash

Alternate Names

  • diaper dermatitis

Definition

Diaper rash is a rash in the area of the body covered by a diaper.

What is going on in the body?

Most infants develop a diaper rash at one time or another. Diaper rash is a very common condition in infants because their skin is very sensitive. A diaper rash is most often due to a reaction of the infant's skin to moisture and irritants.

Risks

What are the causes and risks of the condition?

There are many causes of a diaper rash. Most diaper rashes are due to prolonged contact with wetness, bacteria from bowel movements, and chemicals in the urine. Diaper rash may also develop if an infant is on antibiotics and develops a yeast infection of the skin. Infants with a history of skin disorders, such as eczema, or cradle cap, may be more likely to develop a diaper rash.
Diaper rash does not usually present a health risk. However, if it is not properly treated, a bacterial infection may develop in the affected skin. A bacterial infection can lead to more serious problems such as:
  • an infection in the blood, which can be life threatening.
  • scarring of the tube, called the urethra, which carries urine out of the body. This is quite rare.

Prevention

What can be done to prevent the condition?

Diaper rash is difficult to prevent. However, the following steps may decrease skin irritation in the diaper area:
  • frequent diaper changing to decrease contact between the skin and urine or stools.
  • cleaning of the diaper area with water and drying of the skin with each diaper change.
  • loosely fastening the diaper to allow for more air circulation.
  • giving yogurt to infants on antibiotics, if they are old enough. An ingredient (called probiotics) in yogurt may help prevent yeast infections.

Diagnosed

How is the condition diagnosed?

To diagnose a diaper rash a healthcare professional will take a history and examine the rash. A rash caused by an irritant is tends be a spotty, pinkish-red rash that is itchy. If the rash is caused from a yeast infection, the rash often has bright red spots that form a solid area. In this case, the rash is often surrounded by red dots. This rash typically covers a large area.

Long Term Effects

What are the long-term effects of the condition?

Diaper rashes usually have no long-term effects. It is possible that chronic rashes or those that become severely infected could lead to scarring.

Other Risks

What are the risks to others?

Diaper rash presents no health risks to others and is not contagious.

Treatments

What are the treatments for the condition?

Prevention is the first measure for diaper rashes. When a diaper rash develops, treatment may include:
  • frequent diaper changing.
  • leaving the infant's bottom exposed to air as much as possible each day.
  • rinsing the skin with warm water. If the rash causes raw skin, warm water soaks in a tub can be used a few times a day. A few tablespoons of baking soda added to the water may decrease itching and promote healing.
  • changing the diaper during the night until the rash heals.
  • applying an ointment, such as zinc oxide paste. This ointment, when applied to the affected areas, helps to keep stool and urine off the skin until it heals.
  • applying an antifungal cream, such as nystatin (i.e., Mycostatin, Pedi-Dri, Nyamyc) or clotrimazole (Lotrimin, Mycelex), for rashes due to yeast infections.
If the skin is quite inflamed, it may also help to apply a mild hydrocortisone ointment. The baby's healthcare professional should evaluate a rash before this is done. Stronger cortisone preparations should be avoided. These may cause thinning of the skin of the genital area, which is very sensitive to cortisone.
If bacterial infection of the skin occurs, it should be treated with a topical antibiotic. One should be cautious when using wipes with alcohol in them, as they may irritate the skin further.
The caregiver may also need to provide extra comforting to a fussy infant.

Side Effects

What are the side effects of the treatments?

There are usually no side effects to changing a diaper and cleaning the infant's skin frequently. If powder is used, the caregiver should be careful to use a small amount and limit the powder to the diaper area. This is because an infant can easily inhale powder dust.
There are possible side effects to ointments and cortisone creams including further rash. Strong hydrocortisone creams can cause thinning and scarring of the genital area. If an antibiotic is used, there may be side effects from the antibiotic. These include stomach upset and allergic reaction. A healthcare professional should be contacted if side effects develop.

After Treatment

What happens after treatment for the condition?

After a diaper rash is treated and goes away, there is no further treatment needed. If an infant has a diaper rash that persists despite treatment, the baby's healthcare professional should be consulted.

Monitor

How is the condition monitored?

The parents can often monitor the rash at home to make sure it is getting better. If a rash does not improve, the caregiver should consult a healthcare professional for further evaluation and monitoring.

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