Managing Diaper Rash in Babies

Diaper rash, also referred to as diaper dermatitis, occurs on the skin in areas covered by a diaper. It is one of the most common skin conditions seen in infants and young children.

Diaper rash affects between 7 and 35 percent of babies at some point. The rash often appears as red and inflamed skin caused by the irritants found in urine and faeces, medically termed irritant dermatitis. In more severe cases, the rash can spread to other parts of the body. If this occurs, it is essential to consult a doctor for appropriate care.

Types of Diaper Rash

Diaper-Related Rash

Diaper-related rashes can arise from irritation, yeast infections, or allergic reactions. They are more common in children who have diarrhoea or those recently on antibiotics.

Irritant Dermatitis: This is the most prevalent type of diaper rash, caused by exposure to urine and faeces. It typically affects the buttocks, lower abdomen, genitals, and upper thighs, but not the skin folds. Symptoms can range from mild redness to raised, painful, or peeling areas.
Yeast Infection: When irritant dermatitis remains untreated for several days, it can lead to a yeast infection (Candida). This type of rash is characterised by dark red skin, sometimes with pustules that rupture and flake. It typically affects the skin folds and the genital area.
Allergic Reactions: While less common, allergic reactions to the materials in a diaper or baby wipes can also cause diaper rash. This type of rash typically appears as red, raised, itchy skin where the diaper or wipes come into contact with the skin.

Non-Diaper-Related Rash

Some skin conditions can develop in the diaper area without being caused by the diaper itself:

Seborrheic Dermatitis: This condition results in red, greasy patches of yellow, scaly skin, often found in skin folds between the thighs and body. It can also affect the scalp (known as cradle cap), face, neck, and other areas.
Atopic Dermatitis (Eczema): Although eczema usually does not appear in the diaper area, it may occasionally cause symptoms there, including scratch marks or scabs from frequent scratching.
Scabies: Caused by mites burrowing under the skin, scabies leads to red, itchy rashes that can appear on the abdomen, genitals, hands, and feet. It is highly contagious and can spread among family members.
Bacterial Infections: Impetigo, a bacterial skin infection, can develop in the diaper area as well as other parts of the body. It is characterised by yellow fluid-filled areas or crusted lesions.
Psoriasis: Psoriasis can cause red, scaly patches of skin, though in the diaper area, the silver scales typically seen in psoriasis may not be present.

Treating Diaper Rash

Caring for your baby’s skin during a diaper rash outbreak is essential. Here are some effective treatments:

Diaper-free periods	Limit or discontinue diaper use to reduce contact between the skin and irritants. Allow the baby’s skin to be exposed to air by giving them diaper-free time. Use waterproof pads or barriers under the baby to reduce the risk of soiling. Change diapers often—approximately every two to three hours and right after bowel movements.
Skin barrier ointments and pastes	Products containing zinc oxide or petrolatum help form a protective barrier on the skin. Apply a thin layer during each diaper change, using petroleum jelly on top to prevent sticking. Avoid products with added preservatives, fragrances, or other irritants.
Antifungal treatments	If a yeast infection is present, an antifungal cream, ointment, or powder may be prescribed by a doctor. Apply the antifungal treatment two or three times a day under a barrier ointment until the rash resolves.
Steroid ointment	For severe inflammation, a mild over-the-counter steroid ointment (like 1% hydrocortisone) can help. Apply twice daily for no more than one week, as prolonged use can irritate sensitive skin.
Antibiotics	If the rash is complicated by a bacterial infection, your doctor may prescribe an antibiotic ointment or, in more severe cases, an oral antibiotic.

Preventing Diaper Rash

Prevention begins with good skin care practices:

Ensure your baby’s skin is kept clean and dry.
Change diapers frequently, especially after bowel movements.
Give your baby some diaper-free time when possible.
Gently cleanse the diaper area with warm water and a soft cloth, avoiding harsh soaps.
Avoid scented wipes or wipes containing alcohol, which can irritate sensitive skin.

When to Consult a Doctor

It is essential to seek medical advice if:

The diaper rash does not improve with treatment or spreads to other parts of the body.
Your baby has a fever or appears uncomfortable.
You are concerned about the severity or persistence of the rash.

Book an Appointment at Gleneagles Hospitals

Should you have any concerns regarding your baby’s diaper rash or other skin conditions, get in touch with us to find out more about our Paediatric services at your nearest Gleneagles Hospital.

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