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Treating Diaper Rash
The term diaper rash is used to describe a number of different skin conditions that can affect your little one. Diaper rash can appear at any time, but it is most common as your child is introduced to solid food. When your child's diet becomes more diverse, their stool can become more irritating to their sensitive skin. Diaper rash also tends to occur where urine accumulates in the diaper, in the front for boys and towards the bottom for girls. This is due to ammonia in urine, which can irritate the skin. The good news is that most cases of diaper rash can be effectively treated at home.
Types of Diaper Rash
Chafing Dermatitis - This is the most common form of diaper rash and the most transient. It is caused by friction from the diaper and will probably cause little discomfort, as long as it is not irritated by another infection.
Allergic Reaction - Your baby's sensitive skin can be irritated by an allergic reaction. Many times soaps marked as gentle may not be. Stick to those soaps recommended for babies that are free of perfumes and dyes. Areas of skin that come into contact with dyed areas of the diaper may also be irritated by allergens in the dye.
Candidal Dermatitis - Unlike chafing dermatitis, this rash begins in the protected folds of the skin and is caused by yeast (the same type that causes thrush). This rash is bright red and uncomfortable. Unfortunately, most diaper rashes that last more than 72 hours will often become infected with candidal dermatitis. Sometimes, raised, yellow, fluid-filled pustules can accompany this rash.
Other Rashes
Sometimes, skin can be irritated in the diaper area, but not be caused by the diaper. These rashes include seborrheic dermatitis, atopic dermatitis, and impetigo.
Seborrheic Dermatitis - This is a skin condition that can begin on the scalp (cradle cap) and spread down, but it can also begin in the diaper area and spread up. It is also commonly located in the skin folds and causes patches of bright red or greasy, yellow scales on the skin.
Atopic Dermatitis - Also known as eczema, this rash will probably appear on other areas of the body first, but can spread to the diaper area.
Impetigo - Impetigo is a bacterial infection that can develop in the diaper area, but it can show up on other areas of the body as well. The bacteria that causes it, streptococcus or staphylococcus, is normally found on the skin. It only becomes a problem when there is a break in the skin. Impetigo that is found in the diaper area can cause large blisters that can burst and leave yellow-crusted lesions that can be both itchy and painful. Impetigo can cover your child's buttocks and thighs and spread to other parts of their body. Though many forms of diaper rash can be treated with home remedies, you should contact your pediatrician should your child develop these symptoms.
Prevention is Key
Preventing diaper rash isn't always possible, but there are steps that you can take to reduce the chance that your child will develop diaper rash.
- Keep the diaper area clean and dry.
- Change diapers often, even in the middle of the night if your child wakes up.
- As you introduce new fluids into your child's diet (i.e. juice), be sure not to lose track of how much they are drinking during the day. The more they drink, the more wet diapers they will produce. Excessively wet diapers will probably lead to diaper rash.
- If the soaps or wipes you are using seem to be irritating your child's skin, ask your pediatrician which soaps they recommend. Wipes that contain alcohol can be particularly drying to your baby's sensitive skin.
Treatment
Air - One of the most effective treatments for diaper rash is to reduce skin contact with diapers. Diaper-free periods will reduce the amount of contact the skin has with urine and feces and will reduce the amount of friction on their skin when they move. During diaper-free time, draping a receiving blanket over a waterproof pad will provide a safe play space.
Ointments and Pastes - These creams provide a barrier between the skin and the irritant and should be applied at every diaper change whenever diaper rash is present. Be sure your baby's skin is completely dry before applying these ointments. These products (i.e. Desitin, Balmex, etc.) will also prevent urine and feces from touching your baby's skin. When you are airing your baby's bottom out, however, these ointments aren't necessary.
Powders - Powders like corn starch can absorb extra moisture and reduce the amount of friction between your baby's skin and their diaper. However, you should check with your pediatrician before using because many pediatricians do not recommend powders due to the concern that your child could accidentally inhale them.
Prescription Treatment - If your child is diagnosed with a yeast infection, your pediatrician will probably prescribe an antifungal treatment like nystatin or clotrimazole. Antifungal treatments are usually available as a cream, ointment, or powder that will need to be applied 2 to 3 times a day. Your pediatrician may prescribe an antibiotic ointment or cream if your child develops an infection. Over-the-counter antibiotic creams should be avoided because they may further irritate your baby's skin. Steroid ointments may be prescribed if your baby's skin is severely inflamed.
When to contact your Pediatrician
If your efforts to treat the diaper rash at home have yielded no results after a couple of days, or if the rash is worsening, you should contact your healthcare provider. Other symptoms, such as bloody stool, signs of infection or fever should also be a signal to give your doctor's office a call. Lab testing is not usually required, but your doctor will probably want to see the rash and will want to know what treatments you have already tried at home. If you have used any ointment, it may be helpful to bring it with you to the appointment. If your doctor determines that it is a bacterial infection, an antibiotic may be needed to treat the rash.
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