Diaper rashDiaper rash is a generalized term indicating any skin irritation (regardless of cause) that develops in the diaper-covered region. Synonyms include diaper dermatitis (dermatitis = inflammation of the skin), napkin (or "nappy") dermatitis, and ammonia dermatitis. While there are several broad categories of causes of diaper rash, contact irritation is the most common culprit. While diaper rash is generally thought to affect infants and toddlers, any individual wearing a diaper (for example, an incontinent adult) is a candidate to develop this dermatitis.
Is diaper rash a sign of neglectful care?No, not at all. Parents often incorrectly feel that the rash is a visual representation of poor caretaking skills. However, parents need to understand that the basic causes for this common kind of skin irritation are still under active debate in the field of dermatology and that neglectful parenting is not among the possible factors. While the rash may develop as early as the first week of life, the most frequent time period is between 9-12 months of age. Studies have indicated that, at any point in time, between 7%-35% of children in this age range are experiencing such a skin rash.
What causes diaper rash?Diaper rash can be traced to a number of sources, including:
- Irritation from stool and urine. Prolonged exposure to urine or stool can irritate a baby's sensitive skin. Your baby may be more prone to diaper rash if he or she is experiencing frequent bowel movements or diarrhea because feces are more irritating than urine. A characteristic differential point of contract diaper dermatitis from other causes of diaper rash is that it rarely involves the skin fold regions -- therefore, it spares areas not in contact with urine/stool.
- Chafing or rubbing. Tightfitting diapers or clothing that rubs against the skin can lead to a rash.
- Irritation from a new product. Your baby's skin may react to baby wipes, a new brand of disposable diapers, or a detergent, bleach or fabric softener used to launder cloth diapers. Other substances that can add to the problem include ingredients found in some baby lotions, powders and oils.
- Bacterial or yeast (fungal) infection. What begins as a simple skin infection may spread to the surrounding region. The area covered by a diaper — buttocks, thighs and genitals — is especially vulnerable because it's warm and moist, making a perfect breeding ground for bacteria and yeast. These rashes can be found within the creases of the skin, and there may be red dots scattered around the creases.
- Introduction of new foods. As babies start to eat solid foods, the content of their stool changes. This increases the likelihood of diaper rash. Changes in your baby's diet can also increase the frequency of stools, which can lead to diaper rash. If your baby is breast-fed, he or she may develop diaper rash in response to something the mother has eaten.
- Sensitive skin. Babies with skin conditions, such as atopic dermatitis or seborrheic dermatitis (eczema), may be more likely to develop diaper rash. However, the irritated skin of atopic dermatitis and eczema primarily affects areas other than the diaper area.
- Use of antibiotics. Antibiotics kill bacteria — the good kinds as well as the bad. When a baby takes antibiotics, bacteria that keep yeast growth in check may be depleted, resulting in diaper rash due to yeast infection. Antibiotic use also increases the risk of diarrhea. Breast-fed babies whose mothers take antibiotics are also at increased risk of diaper rash.
What are diaper rash symptoms and signs?A diaper rash is a change in the skin enclosed by a child's diaper. Most commonly, the involved skin is red and may or may not have erosion of the superficial skin layers. Pustules or small blisters may be present. If the irritated skin is sensitive, diaper changing may be mildly uncomfortable to the child.
You may notice your baby seems more uncomfortable than usual, especially during diaper changes. A baby with a diaper rash often fusses or cries when the diaper area is washed or touched.
When to see a doctor?If your baby's skin doesn't improve after a few days of home treatment, talk with your doctor. Sometimes, you'll need a prescription medication to treat diaper rash.
Have your child examined if the rash:
- Is severe or unusual
- Gets worse despite home treatment
- Bleeds, itches or oozes
- Causes burning or pain with urination or a bowel movement
- Is accompanied by a fever
What you can do in the meantime?
- In the time leading up to your appointment, avoid products that seem to trigger your baby's rash. Wash your baby's bottom with water after each diaper change. Avoid soaps and wipes that contain alcohol or fragrance.
- Give your baby as much diaper-free time as possible, so that his or her skin can have a chance to stay dry and start healing. When you do use diapers, change them frequently and apply a diaper rash cream, lotion, paste or ointment to act as a barrier between your baby's skin and a dirty diaper