Diaper Rash

Diaper rash or diaper dermatitis is a general term used to describe skin lesions in the diaper area. It is regarded as a classic example of irritant contact dermatitis, a skin inflammation caused by nonspecific injury to the skin.

The diaper area may become red and scaly, with rashes appearing as papules or vesicles which can be patchy or confluent. The rashes are prominent in the convex area of the buttocks with sparing of the skin folds. This inflammatory reaction of the skin develops when exposed to prolonged wetness, friction, maceration and an alteration of the skin’s pH due to prolonged contact with urine, feces and retained soaps and topical skin preparations.

Exposure to such irritants leads to the destruction of the outermost layer of the skin (stratum corneum). This layer of the skin acts as a barrier against bacteria and other microbes reduces water loss and protects the deeper layers of the skin from injury. Compared to adults, this layer of the skin is thinner in infants making it more susceptible to infection.

Diaper dermatitis is often relieved by simple measures. The damaging effect of over-hydration of the skin and the macerating effect of urine and feces can be prevented by frequent changing of the diapers and washing the baby’s genitals meticulously. The use of disposable diapers with a super absorbent material may keep the area dry, although there is no significant difference in the rate of diaper rash among babies who wear disposable diapers and reusable cloth wearers.

Topical application of petroleum jelly or zinc oxide paste that serves as a protective barrier agent may keep the area dry by sealing the moisture in the skin. Thorough air-drying of the area before putting the diapers on and dabbing moisture-absorbing powders such as starch and talc may be the most practical prevention for diaper rash. When the above mentioned treatment measures are still ineffective, application of a 0.5-1% hydrocortisone cream after each diaper change may afford relief of the rash.

However, steroid creams should not be used for a long time and the physician’s instructions should be strictly followed. A combination anti-fungal-corticosteroid cream is usually prescribed by the physician for infected diaper dermatitis.

Diaper Rash Explained