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Diaper Rash


DefinitionDiaper Rash
A form of contact dermatitis that causes skin irritation in the diaper area of infants, generally involves skin around the genitals, rectum and abdomen - in the area covered by diapers.

Signs & Symptoms

  • Moist, painful, red, spotty and itchy (sometimes) skin in the diaper area. The skin may be cracked and fissured.
  • In male infants, a red, raw and occasionally bloody area may appear around the meatus (the opening at the tip of the penis). 

Causes

  • Excessive ammonia (a natural product of urine) on the wet diaper and skin caused by bacterial action. (Urine does not naturally contain ammonia).
  • Monilial fungal infection - the same fungus that causes thrush.
  • Allergy to soap, detergent, fabric softener, lotion, powder or other chemicals. 

Risk Increases With

  • Infrequent diaper changes.
  • Improper laundering of diapers.
  • Family history of skin allergies.
  • Hot, humid weather.

Prevention

  • Change diapers frequently.
  • Don't use waterproof diapers at night.
  • Keep diapers clean. After washing, rinse them twice to remove detergents and other chemicals.

Diagnostic Measures

  • Observation of symptoms.
  • Medical history and physical examination by a doctor.
  • Urinalysis to rule out urinary-tract infection, which may complicate healing.

Possible Complications

Secondary bacterial infection in the rash area.

Probable Outcome

Usually curable with treatment. Recurrence is common.

TREATMENT

General Measures

  • Expose the buttocks to air as much as possible.
  • Don't use waterproof pants during treatment--either in the day or at night. They keep skin wet and subject to rash or infection.
  • Change diapers frequently--even at night if the rash is extensive.
  • Don't use soap or boric acid to wash the rash area. Cleanse with cotton dipped in mineral oil.
  • Discontinue using baby lotion, powder, ointment or baby oil unless prescribed by your doctor.
  • Apply small amounts of non-prescription petroleum jelly, lanolin-based ointment or zinc oxide ointment to the rash at the earliest sign of diaper rash, and 2 or 3 times a day thereafter.
  • Add 1 cup of vinegar to the waterproof panties when it is half-full of rinse water. This neutralizes detergent residue.

Medication

Your doctor may prescribe medicated anti-inflammatory ointments or creams.

Diet

No special diet. Avoid foods that cause diarrhea.

Contact Your Doctor

The following occurs during treatment:

  • Fever.
  • Pustules in the rash area.
  • Male infant has a weak urinary stream.
  • Female infant develops adhesions of the vaginal lips.
  • New, unexplained symptoms develop.