Diaper Rash: Symptoms, Causes and Treatment

Diaper rash is a very uncomfortable condition characterized by irritation of the genital area. Fortunately, treatment is usually simple, done from home, and has a quick recovery.

Newborn and nursing babies have thinner and more delicate skin than an adult’s. For this reason, they’re more susceptible to friction skin conditions such as diaper rash. Are you interested in learning more about this pathology? Keep reading and we’ll tell you.

Diaper rash is a type of irritative dermatitis characterized by inflammation and redness of the diaper area. This is associated with wet diapers that are changed infrequently. In addition, several factors of maceration, friction, and contact with urine, feces or other substances are recognized.

Studies estimate that between 7% and 35% of babies suffer from this type of dermatitis at some time during breastfeeding. Similarly, it’s more common in children between 6 and 12 months of age, with an incidence 3 to 4 times higher in cases of diarrhea.

Symptoms

Diaper rash usually alarms parents and causes great discomfort in children, which is why it’s a frequent reason for consultation in pediatrics. This condition usually appears as red and tender spots in the areas with the greatest contact with the diaper, such as the genitals, buttocks and thighs.

In general, the groin folds aren’t affected as they have less contact with the diaper, urine, and feces. However, dermatitis can progress to more serious forms and be accompanied by the following symptoms:

• Scaly areas at the level of the external genitalia
• A rash that grows larger, covering the groin folds
• Shiny, scant discharge that covers the affected skin
• Vesicles, bullae, and superficial bumps
• Superficial ulceration in severe cases

Similarly, this entity can present as contact dermatitis in the areas of the diaper that lack absorbent material. It manifests as a linear erosion or redness on the sides of the infant’s thighs. In chronic cases, warty lesions and large bumps may appear.

Causes of diaper rash

Today, diaper rash is considered a condition with a multifactorial cause. In this sense, there are various irritative factors that can act on the skin, causing damage to the epidermis and promoting the classic symptoms of the disease.

The most common cause of diaper rash is infrequent diaper changes. Studies suggest that this promotes moisture, maceration, and overhydration of the skin, increasing its sensitivity to friction and altering its barrier function. Other common causes of diaper rash include the following:

• Prolonged exposure to feces and urine
• Lack of hygiene and skin care
• Small, tight-fitting diapers
• Use of chemical products, such as antiseptics, detergents and perfumes
• Diarrhea
• Atopic dermatitis
• Seborrheic dermatitis
• Use of broad-spectrum antibiotics

Complications

The main complication of diaper rash is superinfection by fungi or bacteria. Infection with Candida albicans, a yeast fungus that usually inhabits the oral and genital mucosa, is common. This manifests as an intense purplish-red rash accompanied by papules and pustules.

On the other hand, infantile gluteal granuloma is another complication of diaper rash. It’s associated with the use of potent topical corticosteroids. It produces violaceous nodules of less than 3 centimeters (around an inch). Also, whitish spots and scarring are other adverse effects of this dermatitis.

Treatment of diaper rash

Treatment of diaper rash is aimed at correcting the underlying cause and alleviating symptoms in the child. In this sense, gentle hygiene of the diaper area should be sought, avoiding contact with chemical products and reviewing any other associated symptom such as diarrhea.

In mild cases, it’s advisable to keep the affected area exposed to the air and make frequent diaper changes. Studies recommend the use of creams and ointments based on zinc oxide or petroleum jelly as a barrier method.

On the other hand, in moderate or severe diaper rash, the use of low-potency topical corticosteroids such as 1% hydrocortisone is usually recommended. These work by reducing and eliminating both inflammation and redness. They should be applied for a maximum of 2 weeks or until the rash has disappeared.

In diaper rash complicated by candidiasis, the use of topical antifungal medications is recommended. Such is the case with nystatin, clotrimazole, and miconazole. Therapy is usually combined with a mild corticosteroid to help resolve symptoms.

The use of topical antibiotics is only recommended in cases of proven bacterial infection, because they can act as irritants and astringent, worsening the condition. Its use is exclusively for medical indication and continuous supervision.

Prevention

Diaper rash is a condition that can be prevented by following different guidelines in the care and hygiene of newborns. Among the recommendations to avoid this condition are the following:

• Change the diaper frequently, at least 2 to 3 times a day
• Keep the nappy off the area for 5 to 10 minutes at each diaper change
• Clean the skin with water without rubbing it excessively
• Use alcohol-free hygiene towels
• Dry the diaper area very well
• Use barrier creams with petroleum jelly or zinc oxide
• Use diapers with high absorption capacity

A common problem in toddlers and newborns

Diaper rash is an irritant contact dermatitis that affects most infants while breastfeeding. This is a condition that can be avoided through proper child hygiene and frequent diaper changes. The classic manifestation are tender, red spots in the diaper area that cover the genitals, buttocks, and thighs.

On seeing diaper rash symptoms, it’s best to seek medical attention as soon as possible. Some warning signs include bleeding, oozing, and fever. This condition is usually resolved with simple home treatments under the guidance of a healthcare professional.