Diaper Rash

What Is Diaper Rash?

Picture of Diaper Rash

Diaper rash appears on the skin under a diaper. It usually happens in infants and children younger than 2 years, but the rash can also be seen in people who are incontinent or paralyzed.

Almost every baby will get diaper rash at least once during the first 3 years of life, with most of these babies 9-12 months old. This is the time when the baby is still sitting most of the time and is also eating solid foods, which may change the acidity of the bowel movements.

Diaper rash is also known as:

Diaper Rash Causes

  • Friction: Most diaper rash is caused by friction that happens when sensitive baby skin is rubbed by wet diapers. This results in a red, shiny rash on exposed areas.
  • Irritation: The skin under the diaper gets red from irritants like poop, urine, or cleaning agents. Irritation can be caused by the diaper or by the acid in urine and bowel movements. This rash appears red in the area where the diaper has rubbed and is normally not seen in the folds of the skin.
  • Candidal infection: The rash of a candidal infection, also known as fungal or yeast infection, usually has a bright, beefy red appearance and is very common after the use of antibiotics. Candida is a fungal microorganism that is typically found in warm, moist places like the mouth. In fact, Candida is the same organism that causes thrush.
  • Allergic reaction: The rash may be a reaction to diaper wipes, diapers, laundry detergent, soap, lotion, or the elastic in plastic pants.
  • Seborrhea: This is an oily, yellow-colored rash that may also be seen in other areas of the body, like the face, head, and neck.

Although less common, diaper rash can be caused by bacteria like staph.

Diaper Rash Symptoms

Identifying a diaper rash is usually easy. The rash is on the skin underneath the diaper.

The skin is red and irritated. It may appear all over your baby's bottom or genital area, or only in certain places. It may or may not involve the folds of the skin.

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It’s usually not necessary to call the doctor for a simple diaper rash. Keeping the diaper area clean and dry should prevent most diaper rashes. But even the best prevention is sometimes not enough.

Call your doctor if you see any of these conditions:

  • The rash doesn’t get better despite treatment with over-the-counter medicines in 4-7 days.
  • The rash is getting much worse or has spread to other parts of the body.
  • The rash appears also to have a bacterial infection, with symptoms such as a pus-like drainage or yellowish-colored crusting, or if your baby has a fever with the rash. This is called impetigo and needs to be treated with antibiotics.
  • You aren’t certain what may be causing the rash.
  • You suspect the rash could be from an allergy. The doctor can help you pinpoint the possible allergen.
  • The rash comes with diarrhea that continues for more than 48 hours.

It’s very rare to need to go to the hospital for diaper rash. But should your child appear to be in serious pain, or if you notice rapid spread of the rash with fever, you should seek medical help.

Diaper Rash Diagnosis

Diagnosis is typically based on a history and physical examination of the rash. Lab testing usually isn’t needed. If the rash appears to be caused by an allergic response, your doctor may do skin testing to find out what caused the allergy.

Diaper Rash Treatment and Home Remedies

Proper skin care is one of the most important treatments for diaper rash. These things may help ease or shorten the duration of diaper rash:

  • Diapers should be changed more often than normal.
  • Skin should be washed with a very mild soap and air-dried or lightly patted dry.
  • The skin should be cleaned, but avoid any rough scrubbing, which could irritate the skin more. After cleaning, the skin should be exposed to air, leaving the diaper off for several hours if possible. Avoiding wipes during this time is helpful, as the alcohol in wipes may be irritating. Consider using plain water to clean the skin.
  • If you use cloth diapers, avoid using plastic pants during this time.
  • Certain foods may seem to worsen the rash. If this is the case, avoid these foods until the rash has cleared.
  • If the rash is caused by contact or allergic dermatitis, stop using any new soaps or detergents that may be causing the rash.
  • If the rash appears to be caused by a candidal infection, it may be treated with topical, over-the-counter antifungal creams.
  • Topical steroids can be used for diaper rash caused by allergic, atopic, or seborrheic causes but should not be used for fungal infections.
  • Zinc oxide may also be effective, especially as a barrier.

Medical treatment

  • If the child (or adult) appears to have a candidal infection, the doctor may recommend antifungal creams or medicines.
  • If the child has impetigo (a bacterial infection), antibiotics may be prescribed.
  • Your doctor may recommend a short course of mild topical steroid cream or ointment if the rash does not appear to be a fungal infection.

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Diaper Rash Prevention

Prevention is the most effective way to treat diaper rash.

  • Diapers today are highly absorbent and can wick away excess moisture from the skin. But it’s still a good idea to change diapers every few hours to prevent urine or feces from coming into contact with skin.
  • Before putting on a new diaper, be sure the skin is dry and clean.
  • When putting the diaper on, make sure tape doesn’t stick to the skin, as this could irritate the skin.
  • Good hand-washing is a must to help prevent infections of all kinds.

Diaper Rash Outlook

Diaper rash usually goes away on its own. And a child will stop having diaper rash once potty training is over and the child no longer wears a diaper.

WebMD Medical Reference Reviewed by Hansa D. Bhargava, MD on July 16, 2020

Sources

SOURCE:

eMedicineHealth: “Diaper Rash.”

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