Diaper Rash

Definition

A diaper rash is a skin irritation under your baby’s diaper. The rash can be on the abdomen, genitals, and in the folds of the buttocks and thighs. Most babies develop a diaper rash at some time during infancy.
Thigh Folds on Baby
Baby
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Causes

A diaper rash develops when your baby’s skin is irritated. Irritation can be caused by:
  • Leaving dirty diapers on for too long
  • Too much moisture next to the skin
  • Diapers or plastic pants that are too tight
  • Allergic reaction to diaper material or detergent
  • Yeast or bacterial infection
  • Rubbing or chafing of the skin
  • Diarrhea

Risk Factors

Factors that may increase your baby's chance of diaper rash include:
  • Frequent stools
  • Infrequent changing of baby’s diaper
  • Treatment of babies or nursing mothers with antibiotics
  • Lactose intolerance
  • Sensitive skin
  • Poorly fitting diapers or plastic pants

Symptoms

The main symptoms of diaper rash are bumps, redness, and scaly patches on the skin under the diaper. There may also be blister-like spots or sores on the skin. Your baby may also be more fussy and irritable when the diaper is changed.If the rash is not cared for, then it can become infected. It can become bright red with red bumps and blisters.Symptoms of an infected rash may include:
  • Open sores, boils, or pus
  • Your baby is not sleeping or eating normally
  • Your baby develops a fever
  • The rash becomes worse or does not improve in 2 or 3 days
Contact your doctor if your child has signs of an infected rash.

Diagnosis

Most parents can recognize a diaper rash when they see it. A mild diaper rash doesn’t normally require a visit to the pediatrician.

Treatment

Diaper rashes usually clear up in 3-4 days with the following treatment:
  • Change diapers frequently.
  • Use water and a clean washcloth or baby wipes to rinse your baby’s skin.
  • Pat dry gently. Rubbing can irritate the rash.
  • Apply a thick layer of protective ointment to the diaper area. Examples include petroleum jelly, bag balm, or zinc oxide ointment.
  • Expose your baby’s skin to the air as much as possible.
  • Do not use creams that have boric acid, camphor, phenol, methyl salicylate, or a compound of benzoin tincture.
  • Do not use talcum or cornstarch powders.
If the rash is severe, see your child's doctor. The doctor may suggest using a mild hydrocortisone cream to calm the skin if it is irritated. If the rash is yeast-related, then the doctor may recommend a medicated cream. Antibiotic ointments may be used for mild bacterial infections. These creams are available without prescription, but your pediatrician may want to discuss these options before starting treatment.Severe infections may require oral antibiotics.

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Prevention

To help reduce your child's chance of diaper rash:
  • Change your baby’s diaper frequently.
  • Use water and a clean washcloth or baby wipes to rinse your baby’s skin.
  • Dry the diaper area well after changing. Let the area air out.
  • Allow your baby to go without a diaper when possible.
  • Avoid using fabric softeners on cloth diapers.
  • Use cloth diapers or super-absorbent disposable diapers to prevent irritation.
  • Talk to your baby's doctor about giving your baby probiotics when your baby is taking antibiotics.

RESOURCES

Family Doctor—American Academy of Family Physicians
http://www.familydoctor.org

Healthy Children—American Academy of Pediatrics
http://www.healthychildren.org

CANADIAN RESOURCES

About Kids Health—The Hospital for Sick Children
http://www.aboutkidshealth.ca

Caring for Kids—Canadian Paediatric Society
http://www.caringforkids.cps.ca

References

Diaper rash. American Academy of Family PhysiciansFamily Doctor website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/diaper-rash.html. Updated March 2010. Accessed May 13, 2013.

Diaper rash. American Academy of PediatricsHealthy Children website. Available at: http://www.healthychildren.org/English/ages-stages/baby/diapers-clothing/Pages/Diaper-Rash.aspx. Updated November 8, 2012. Accessed May 13, 2013.

Diaper rash. Children's Health Network website. Available at: http://www.childrenshealthnetwork.org/CRS/CRS/pa%5Fdiaperra%5Fhhg.htm. Updated November 8, 2010. Accessed May 13, 2013.

Diaper rash. Nemours Kid's Health website. Available at: http://kidshealth.org/parent/infections/fungal/diaper%5Frash.html. Updated May 2011. Accessed May 13, 2013.

Kleigman RM, Jensen HB, et al. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, PA: Saunders Elsevier; 2007.

7/28/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Blume-Peytavi U, Hauser M, et al. Prevention of diaper dermatitis in infants—A literature review. Pediatr Dermatol. 2014 Jul(4):413-429.

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