Nappy rash, diaper dermatitis - causes, symptoms, treatment

Nappy rash, diaper dermatitis – what is it?

Nappy rash is one of the most common inflammatory skin diseases in childhood. The friction of the diaper, as well as the damp and warm environment underneath, make the skin more susceptible to external irritants. These factors include irritating components contained in feces and urine. As a result, prolonged contact with the contents of the diaper makes the skin red and burning. Inflammation develops. That's why it's so important to regularly use a diaper rash protection ointment, such as Bepanthen Baby, which will separate your baby's delicate skin from the irritants.

Causes of diaper rash

Under a tightly fastened diaper, things happen that have a bad effect on the baby's skin. Therefore, this sensitive area must be carefully cared for: the baby's bottom must be washed frequently, ventilated as often as possible, and appropriate hygiene and protection products should be used every time the diaper is changed1,2,6.

Did you know?

Up to half of babies experience some form of diaper rash in the first 12 months of life6. Inflammatory lesions in the diaper area with which parents report to the doctor account for 10 to 20% of skin lesions assessed by the pediatrician and occur mainly in children between 7 and 12 months of age1-3.

This is especially true for those children who suffer from diarrhea and are also taking antibiotics for a long time2. The reason for the problem is obvious: there is a lack of air under the diaper, it is humid and warm, and feces and urine constantly irritate the delicate epidermis1. As a result, redness (diaper rash) occurs, and when the protective barrier of the skin is breached, irritants penetrate the skin, causing lesions1–3.

The first symptoms of diaper dermatitis – how to recognize it?

The onset of diaper rash is a slight redness (erythema) in the genital and buttock area. After a few days, it can expand and become more intense, requiring medical consultation1,2. If we ignore the symptom of erythema, the skin lesions will worsen and the risk of developing a secondary bacterial or fungal infection will increase significantly2,3.

How to treat diaper rash?

If, despite following the above rules, the redness has not decreased after three days or has worsened, you should see a pediatrician for a better diagnosis and another treatment1,3. As similar skin reactions can be caused by bacterial or fungal infections, as well as disturbances in the composition of the skin's natural microflora, it is necessary to seek advice from a paediatrician1–3. Your doctor may decide to treat you with an antibiotic, anti-inflammatory or antifungal agent, and possibly introduce a weak corticosteroid1–4.

Important:

- See your pediatrician if, despite intensive hygiene, irritation does not go away after three days3

- see a doctor if you have: pustules, blisters, papules, honey-yellow scabs2;
- Bright red eruptions along with papulopustular rash on the skin folds may indicate yeast superinfection1.

Can diaper rash be prevented?

Preventive measures are the basis for actions aimed at preventing the development of diaper rash.

- We should think of diapers not only as a single-use product, but also as a limited time of use. The younger the child, the more delicate their skin is. Thus, in a newborn, the diaper needs to be changed every hour, in older children every 3-4 hours and whenever it has been heavily soiled. It is important to choose diapers of the right size. Both too small and tightly fastened, as well as those too large are dangerous for the skin, because they promote abrasions and sores 1,2.
- It is very important to cleanse the skin properly. Wet wipes should be an emergency or pre-wash solution rather than a daily hygiene solution. Skin contaminated with feces should always be washed under running water and with gentle cleansers4.
- The washed skin should be thoroughly dried, remembering about the hollows of the skin folds.
- The bottom should be aired as often as possible3!
- Clean and dry skin should be generously protected with a care product – preferably moisturizing and soothing irritated skin. This will create a barrier to protect your baby's sensitive skin1,2,4. According to the latest recommendations, the use of antiseptic products should be avoided in daily preventive activities6. Their use should be reserved for diagnosed fungal and bacterial superinfections in the area of sores.

- If your little one has skin prone to atopy, the right choice of care products is particularly important due to the higher risk of irritation when using certain detergents2,4.

Remember – the best method of fighting the development of diaper rash according to the NHS (National Health Service in Great Britain) is prevention, and the above rules should be applied not only when the skin lesions appear, but throughout the whole diaper wearing period5.

Bibliography

1 Wilmont A., Doboszyńska A. Diaper rash in children. Pediatr Med Rodz 2012; 8: 272–274.

2 Czarnecka-Operacz M., Jenerowicz D. Diaper rash. https://www.mp.pl/pacjent/pediatria/choroby/skora/61801,pieluszkowe-zapalenie-skory (21.09.2017).

3 Horii K.A. Diaper dermatitis – UpToDate. Topic 5795 Version 19.0.

4 Czarnecka-Operacz M. How to care for the skin of the diaper area.
https://www.mp.pl/pacjent/pediatria/pielegnacja/52305,w-jaki-sposob-nalezy-pielegnowac-skore-okolicy-pieluszkowej (07.10.2017).

5 NHS Choices. Nappy rash. http://www.nhs.uk/Conditions/pregnancy-and-baby/Pages/Nappy-rash.aspx (01.01.2023).

6 Atherton et al.: Irritant Diaper Dermatitis: Best Practice Management; SelfCare 2015; 6(S1):1-11

CH-20231116-168