Diaper rash (irritant diaper dermatitis) occurs when an infant's sensitive skin is exposed to urine and stool, coupled with the diaper rubbing and chafing the skin, a tight-fitting diaper, or a diaper being left on too long. A diarrheal illness can bring on or worsen the condition.
Who's At Risk
Diaper rash may occur in anyone who wears diapers. It is an extremely common condition in infants.
Signs and Symptoms
Diaper rash is usually limited to any area that is covered by a diaper. The area of skin covered by the diaper will appear red and irritated, with the exception of the skin's creases, which are generally not affected by diaper rash. Redness may be especially severe where the skin meets the edges of the diaper.
Although disposable diapers may be superabsorbent and may not necessitate as frequent diaper changes as cloth diapers, changing any diaper often will help keep the area clean and dry. When cleaning the diaper area, try using diaper wipes that have no fragrances or extra additives or even use simply water and clean washcloths. Applying a barrier cream, such as one with zinc oxide in it, to the diaper area will help reduce friction and skin contact with urine and stool. If possible, allow your baby to have "naked time," where he or she is free from the diaper, to reduce the amount of time the skin is in contact with diapers.
The above self-care measures should always be followed to help prevent diaper rash from occurring.
When to Seek Medical Care
See your baby's doctor for evaluation of diaper rash that does not improve with self-care measures, is getting worse, or involves the skin creases or any area that is not covered by the diaper.
Treatments Your Physician May Prescribe
The doctor may suggest the following:
- Mild topical corticosteroids to treat inflamed areas of skin. Be careful to prevent thinning of the skin (atrophy) from using steroids in skin folds and occluded areas by carefully following the instructions given with the corticosteroid.
- Tacrolimus ointment, a non-steroid ointment, may be prescribed if diaper rash does not improve with other treatments. However, this medication is not approved for use with children under the age of 2 years.
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Freedberg, Irwin M., ed. Fitzpatrick's Dermatology in General Medicine
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