Diaper Dermatitis
I. Definition:
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.
II. Causes:
- We all have a natural protective film of oil on
our skin. If this oil is removed the skin becomes red, irritated, cracked and inflamed.
When a persons skin is exposed to urine or feces for prolonged periods, the natural skin
oil is removed causing diaper dermatitis.
- After the skin becomes red and inflamed, the skin
becomes predisposed to infection. Both bacteria and yeast can infect the inflamed cracked
skin making the diaper rash worse.
- Antibiotic treatment for unrelated conditions can
cause yeast overgrowth making diaper dermatitis worse.
III. Prevention:
- The best treatment for diaper
dermatitis is to prevent it from starting. This is easiest 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.
- 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.
IV. Treatment:
- 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.
- Lotrimin cream can be used for diaper rash and can
be purchased without a prescription. Do not use a medication named Lotrisone, even if
given to you by your doctor. This medication 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. This is best sorted out by your doctor. If your doctor finds
infection or an allergy, other medications will be prescribed.
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