Diaper Dermatitis

"It is very important to follow the recommendations to prevent the appearance of these injuries that are very annoying for the child".

DR. ANA CATALÁN LAMBÁN
SPECIALIST. PEDIATRICS DEPARTMENT

Diaper dermatitis is a rash that appears in the diaper area, affecting the lower abdomen, genitals, buttocks and upper thighs, especially exposed to irritants.

It is a common problem in the child in the first year of life, although it can also occur in older children or adults with incontinence or paralysis from various causes, who need to use diapers.

The combination of a series of factors causes a continuous aggression on the skin that ends up producing an alteration of the skin barrier, with red areas in the areas of greatest contact with the diaper, which soon erode and are superinfected by bacteria or, more frequently, by a fungus called Candida albicans.

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What are the symptoms of diaper rash?

The clinical presentation is characteristic, varying according to the cause, by erythema, slight edema, papular lesions, eczematous or ulceration.

In the last years, with the use of disposable diapers, the incidence of this dermatitis has diminished notably.

The most common symptoms are:

  • Itching and redness.
  • Inflammation.
  • Discomfort.
  • Overinfection of the area.

Does your child have any of these symptoms?

You may have a diaper rash

What are the causes of diaper rash?

The first cause of diaper rash is excess moisture and friction that leads to skin maceration in the area. This involves prolonged contact with urine and feces, high surface temperature, fecal enzymes, powerful detergents, antiseptics, bacteria and fungi. As a result, the pH of the skin increases, activating some enzymes, the fecal lipase and protease, irritating the skin.

Another factor that can influence the appearance of these lesions is food. It has been shown that breastfed babies had a lower fecal pH and therefore the irritative action is also lower, decreasing the incidence of diaper rash. 

How do you prevent diaper rash?

The use of disposable diapers has contributed greatly to reducing this pathology. The diaper should be big enough and the rubbing should be kept to a minimum.

It should be changed frequently, not leaving a dirty diaper for a long time.

The skin can be protected with protective ointments containing zinc oxide (as a barrier) and moisturizing and emollient substances. In the case of an established dermatitis it is advisable to remove the diaper and leave the exposed area outdoors for as long as possible.

How is diaper dermatitis diagnosed?

The diagnosis is made through physical examination. Sometimes it is complicated for the pediatrician, since diaper rash can be associated with other rashes in the area:

  • Seborrheic dermatitis.
  • Atopic dermatitis.
  • Allergic contact dermatitis.
  • Psoriasis.

How is diaper rash treated?

Proper care and management of the skin in the diaper area is very important to prevent or decrease episodes of diaper rash.

  • The most important thing is to keep the skin as dry and airy as possible.
  • It is very important to clean the skin of the area, using only warm water or a mild soap, with neutral or acid pH, with moisturizing properties, every time you change the diaper.
  • Whenever possible, the use of disposable diapers is recommended, since they have advantages over traditional cotton diapers in absorbing moisture and avoiding the mixing of urine and feces, thus keeping the area as dry as possible.
  • The diaper should be changed frequently, at least 5 times a day. It is important to let the area dry outdoors for a few minutes before putting on the diaper.
  • It is convenient to use emollient products and lubricants or mineral oils, not antibiotics or corticoids, unless your pediatrician indicates otherwise.
  • The use of vaseline or pastes, such as Lassar paste, is beneficial. If the skin is unharmed, talc or soft powders can be used. If not, it should be discontinued because of its irritating properties.
  • If the dermatitis persists, change the type of diapers, soap or wipes to clean the baby. If a superinfection with a fungus is added, your pediatrician will indicate a cream with topical imidazole derivatives.
  • In more severe cases, low-potency steroids (hydrocortisone 1%) may be used, in treatments limited to no more than one week. Do not use high-potency steroids.

Where do we treat it?

IN NAVARRE AND MADRID

The Department of Pediatrics
of the Clínica Universidad de Navarra

All our specialists work exclusively and, in addition, since we have all the technology in the same center, we offer the performance of tests and diagnosis in less than 72 hours.

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