Diaper Rash

Definition

A diaper rash is a skin irritation in your baby’s diaper area. The rash can be on the abdomen and 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

© 2008 Nucleus Medical Art, Inc.

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

A risk factor is something that can increase your chance of getting a disease or condition. Risk factors for diaper rash include:

  • Frequent stools
  • Infrequent changing of baby’s diaper
  • Treatment of babies or nursing mothers with antibiotics
  • Starting on solid foods
  • Age: 8 to 10 months old
  • Sensitive skin

Symptoms

The main symptoms of diaper rash are bumps or redness and scaly patches on the skin that has been in contact with a soiled diaper. Erosions and vesicular lesions (like blisters) may also be present. This includes the abdomen, genitals, and the folds of the buttocks and thighs. In addition, your baby may be more fussy and irritable when the diaper is changed.

Diagnosis

Most parents can recognize a diaper rash when they see it. A diaper rash doesn’t normally require a visit to the pediatrician. If the rash is not attended to, it can become infected. It can look very bright red with red bumps and blisters. If your baby has open sores, a fever, or isn’t sleeping or eating well, call your pediatrician.

Treatment

Diaper rashes usually clear up in three or four days with the following treatment:

  • Change diapers frequently.
  • Use plain water instead of baby wipes to rinse your baby’s skin in the diaper area.
  • Pat dry gently; do not rub or you could irritate the rash.
  • Apply a protective ointment containing zinc oxide to the diaper area.
  • Expose your baby’s skin to the air as much as possible.
  • Do not use creams containing boric acid, camphor, phenol, methyl salicylate, or a compound of benzoin tincture.
  • Do not use talcum or cornstarch powders.

See your pediatrician if:

  • Open sores, boils, or pus develop
  • 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
  • Your pediatrician may suggest use of a mild hydrocortisone cream or, especially if the rash appears very red, a cream like miconazole, which is effective for treating yeast infection. While these creams are available without prescription, your pediatrician may prefer you contact him or her before starting treatment.

Prevention

To help prevent diaper rash:

  • Change your baby’s diaper frequently.
  • Use plain water to rinse your baby’s diaper area after changing.
  • Dry the diaper area well after changing and let it 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.

RESOURCES:

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

American Academy of Pediatrics
http://www.aap.org

CANADIAN RESOURCES:

About Kids Health
http://www.aboutkidshealth.ca

Sick Kids
http://www.sickkids.ca/

References:

American Academy of Family Physicians website. Available at: http://www.aafp.org/online/en/home.html .

American Academy of Pediatrics website. Available at: http://www.aap.org .

The Children’s Hospital of Philadelphia Book of Pregnancy and Child Care . John Wiley and Sons; 1999.

Kleigman RM, Jensen HB, Behrman RE, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, PA: Saunders Elsevier; 2007.

The Mayo Foundation for Medical Education and Research website. Available at: http://www.mayo.edu/ .



Last reviewed November 2007 by Kari L. Kassir, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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