BABY CARE
last update: 29 June 2020

Diaper rash

The diaper rash is a common skin inflammation present in the area that is covered by diapers. For all the babies that suffer with irritations and redness caused by diapers.

 

What is it?


Diaper rash or Diaper dermatitis is an inflammation of the skin of the area that is covered by diapers (buttocks and genitals).

What types of diaper erythema are there?

The most frequent dermite of the diaper area is simple or common erythema, which results from prolonged contact of urine and feces with the skin, causing maceration and chemical irritation, due to the action of urea and intestinal enzymes there, causing thw breakdown of stratum corneum.
Other causes of diaper erythema are: fungi (e.g., Candida Albicans responsible for Candide dermite skin or Candidiasis) or bacteria that can secondarily infect fragile skin by prolonged contact with urine.
Other less frequent situations, such as Psoriasis and Eczema, may also manifest themselves by erythema (reddish skin tone) of the buttocks.


How do the different types of diaper erythema manifest?

tipos de eritema das fraldas

Diaper erythema is always manifested by a change in skin color that acquires a reddish tone, sometimes with local flaking and appearance of small ulcerations. The baby may be irritated, uncomfortable and cry when urinating or has a dejection, due to the burning feeling provided by urine and feces in contact with the injuried skin.
In the case of candidiasis, the erythema is bright red, with a well-defined edge, along which appear small lesions with the same color. Sometimes it is possible to find other lesions caused by the same fungus in other body regions, where humidity usually accumulates, such as the neck, armpits and other folds of the skin, or even in the oral cavity. Candidiasis of the oral cavity has the appearance of small white spots.
Due to the difficulty that may exist in distinguishing other forms of erythema, the baby should be observed by the doctor when the problem is not resolved after two or three days in which the general measures of treatment of simple erythema have been applied.


What are the factors that can lead to the appearance of diaper rash?

The risk of diaper rash is higher when hygiene conditions are bad or less frequent, for example, when the baby stays for long eriods with the same wet or dirty diaper, or when the baby has diarrhoea, increasing the number of ejections in contact with the skin in a given period of time.


What can be done to prevent the appearance of diaper erythema?

Diaper erythema is a common problem that can be avoided through a few simple measures:

  • Change the diaper frequently, avoiding prolonged contact of urine or faeces with the skin;
  • In diaper changes wash the baby's tail only with water or washing product without rinsing as the (1.) Baby 1ère liniment oleothermal baby hygiene care.  Wipes contain substances that can make skin more sensitive and should be used only when is not possible use water (outside the home, for example) we recommend the (2.) Mustela's Cleansing wipes without perfume. Frequent use of soaps or wipes can change the balance between microorganisms commonly present in the skin and mucous membranes (saprophytic flora), reducing their protective role;
  • After washing, dry well the entire area of the diaper and the most difficult areas on skin where humidity can still be presentn, because the humidity conditions in non-ventilated areas can cause the maceration of the skin, facilitating the growth of fungi;
  • Nowadays it is common to use disposable diapers. Some children may be allergic to certain diaper brands, so another brand should be chosen if sensitivity to the type of diaper used is suspected;
  • When changing the diaper, the baby skin should be protected with a thin layer of cream with zinc oxide as the (3.) Babyses diaper cream or  (4.) Pediatric nappy rash cream by Laboratorios Babé. Talcum powder should not be used as it may be irritating to the skin and can be harmful for baby's breathing, specially if it inhales it at the time of application.

How is diaper erythema treated?

Como se trata eritema da fralda

Simple erythema can be treated by reinforcing the above mentioned hygiene measures, increasing the frequency of diaper changes and, specially, leaving the baby without a diaper whenever possible, because contact with air turns easier the treatment of erythema. You can apply (1.) Uriage Baby 1ère eau thermale 1 st thermal water for baby that will help to appease and soothe the area.
If inflammation worsens, with the appearance of papules and vesicles, or if it does not yield to hygiene measures, the doctor can prescribe an ointment with a corticosteroid. Topical corticosteroids should only be used by medical/doctor indication and for the time indicated, because it depends of the type of medicine chosen and because some skin problems can be increased with this treatment.
In dermatitis caused by fungi, doctor will indicate an antifungal ointment and if there is a secondary infection by bacteria it will be prescribed an ointment containing an antibiotic.
As soon as the lesions and skin irritation disappear, the treatment can be suspended, maintaining the general hygienic measures and the use of a zinc oxide barrier cream can help complete the treatment, as mentioned above. We also suggest (2.) Nutraisdin af repairing ointment with miconazole containing 20% zinc oxide or (3.) Bioderma Abcderm change intensif water paste that contains a high percentage of zinc oxide in the formulation.

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