Diaper dermatitis or diaper rash is an irritation of the skin
covering the groin, lower stomach, upper thighs and buttocks. The term
diaper rash includes a variety of disorders of the skin that occur in
infants, young children and incontinent or paralyzed individuals. This
condition is seen more commonly in infants and early childhood prior
to 2 years of age. Diaper dermatitis usually occurs between one and
two months of age and may continue until the child no longer wears
diapers. Diaper dermatitis may become irritated or difficult to treat
if the area becomes infected or the patient becomes allergic to one of
the medications applied to the area.
Diaper dermatitis starts with irritation from prolonged contact
with urine and feces. After the skin becomes red and inflamed,
bacteria and yeast grow on the raw areas. This will inflame the
already irritated skin, making the diaper rash worse. Antibiotic
treatment for throat and ear infections can cause yeast overgrowth
making diaper dermatitis worse.
The best treatment for diaper dermatitis is to prevent it from
starting. This is most easily done by using absorbent disposable
diapers. These do not allow urine to come into contact with the skin.
Modern absorbent disposable diapers can hold large amounts of urine
and keep it away from the skin. For all practical purposes these
diapers only need to be changed when they become soiled with feces or
they get so heavy that they are down near the child's ankles. It is
the mixture of urine and feces that causes the rash.
If you plan to use reusable diapers, they must be changed each time
after they become wet or every one to two hours. When using disposable
diapers, it is important to prevent tape from adhering to the infant's
skin. The adhesive can lead to skin break down. Contrary to popular
belief, powder is not needed to keep the baby dry or to prevent diaper
rash - in fact it may cause diaper rash to become inflamed
particularly in the creases of the legs. Desitin (and other zinc oxide
containing pastes), applied at bedtime are often helpful. This helps
prevent a rash from starting if there is a nighttime bowel movement.
Keep the diaper area as dry as possible by using absorbent
disposable diapers or by frequent changes of conventional diapers.
Triple paste is an ointment that can be applied to the diapered area
with every diaper change. A pharmacist usually makes this up by
prescription. Lotrimin AF or Micatin creams can be used for diaper
rash and can be purchased without a prescription. Avoid the use of
Neosporin ointment, and especially avoid the medication named
Lotrisone, even if given to you by your doctor (as well as most
prescription cortisone containing creams). These medications can do
irreversible harm if applied to the groin area of a child. Often
diaper rash is worsened by infection or an allergy to a medication.
Your doctor best sorts this out. If your doctor finds infection or an
allergy, other medications will be prescribed.