DIAPER RASH

General Information

DEFINITION--A form of contact dermatitis that causes skin irritation in the diaper area of infants.

BODY PARTS INVOLVED--Skin around the genitals, rectum and abdomen in the area covered by diapers.

SEX OR AGE MOST AFFECTED--Infants and young children who wear 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--Diaper rash results from skin irritation produced by substances in the urine or stool.

RISK INCREASES WITH

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

HOW TO PREVENT

• Change diapers frequently.
• Don't use waterproof diapers at night.
• Keep diapers clean. After washing, rinse them twice to remove detergents and other chemicals.
• Leave diaper off for 10-30 minutes between diaper changes for air exposure.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Urinalysis to rule out urinary-tract infection, which may complicate healing (sometimes).

APPROPRIATE HEALTH CARE

• Home care after diagnosis.
• Doctor's treatment, if home treatment fails to cure the rash.

POSSIBLE COMPLICATIONS--Secondary bacterial infection in the rash area.

PROBABLE OUTCOME--Usually curable with treatment. Recurrence is common.

How To Treat

GENERAL MEASURES--

• Expose the buttocks to air as much as possible.
• 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 for you.
• Don't use packaged wipes that contain alcohol. They can cause overdrying of the skin making it susceptible to irritants.
• 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.
• Use boiling water to launder cloth diapers or use an antiseptic product manufactured for the purpose. Avoid fabric softeners as they may cause the rash.
• If you use disposable diapers, switching to cloth diapers for period of time may help.

MEDICATION--Your doctor may prescribe medicated anti-inflammatory ointments or creams, such as hydrocortisone, or antifungal cream such as miconazole, to apply to the skin.

ACTIVITY--No restrictions.

DIET--No special diet. Avoid foods that can make stools irritating (breads, pasta, tomatoes and acidic fruit).

Call Your Doctor If

• Home treatment doesn't cure the rash in 1 week.
• 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.