If you have a newborn, there’s a chance you’ll be treating a bout of diaper rash at some point. Diaper rash is found most commonly among children younger than 2 years of age, with most cases found in children under the age of 1 year.
According to Associate Professor Dr Choo Yao Mun, a consultant paediatrician from UM Specialist Centre (UMSC), diaper rash, which is also called diaper dermatitis (DD), is a skin inflammation condition confined to the area covered by the diaper. It is normally categorized as red and raw looking skin in the nappy area and can be spotty in appearance.
As shared by Dr. Choo, some of the reasons of diaper rash include the following causes:
- Excessive skin hydration from water in urine and stool due to inadequate nappy change frequency.
- Skin trauma by friction between nappy and skin. Diapers that rub against the skin or fit too tightly can cause irritation.
- Presence of irritants; ammonia produced from urine or faeces, soap, and detergent leftover on the skin, fragrance present in nappy wipes and baby powders, etc.
- Fungal infection e.g. Candida albicans which is a fungus that grows in warm, moist places. Rashes caused by this are usually bright red with smaller red spots around the edges.
- Use of antibiotics
As a consequence of serious diaper rash, some babies experience severe skin infection that can lead to fever and painful ulcerated skin conditions. “While most cases of diaper rash fall under the mild category and can be treated easily if left untreated, however, it can lead to a severe skin infection caused by bacteria like Staphylococcus and Streptococcus as well as fungal infections like Candida,” adds Dr. Choo.
A healing environment
An important method for the treatment of DD is to establish a healing environment for the skin. This is accomplished by protecting the skin from further exposure to irritants and by minimizing the exposure to moisture. Harsh cleansing products and procedures should be avoided and barrier creams and zinc creams could be used to further protect the skin. If those measures fail, topical corticosteroids or antimicrobials may be used for more severe cases.
Dr. Choo warns that to prevent serious infection, parents should seek medical help when:
- Pimples or small ulcers form.
- The rash bleeds or oozes fluid.
- The child runs a fever.
- The rash spreads to other areas, such as the arms, face, or scalp.
- The rash gets worse despite home treatment.
- If your baby is unwell.
In offering practical solutions to prevent diaper rash from occurring especially at night Professor Choo suggests a simple “ABCDE” approach in both the prevention and treatment of diaper rash.
Air
Leave the nappy off as much as possible and expose the diaper area frequently to air for as long as possible; allow diaper-free time.
Barrier
Use barrier creams and another topical cream. Products that contain zinc oxide and petrolatum are the most commonly used for the prevention and treatment of diaper rash.
Cleansing
Using baby wipes on your baby’s skin is as effective as using cotton wool and water. It is best to use wipes that are free from fragrance or alcohol, though.
Diapering
Change the nappy as often as you can, or as soon as it is wet or soiled. In terms of diapering, the availability of disposable diapers which are fast-absorbing is designed to effectively draw wetness away from the baby’s skin, minimising the exposure to urine and feces. Use diapers that have a comfortable stretchy waistband that can be adjusted to fit a baby comfortably.
Education
Parents should wash their hands before and after every diaper change to prevent the transfer of germs. Diaper rash is a preventable condition and all parents should learn common ways to reduce the likelihood of developing this condition.
Your choice of diapers matter
It’s important to choose the right kind of diapers for your baby. On a positive note, since the introduction of hypoallergenic, fast-absorbing disposable diapers, the incidence and severity of irritant and allergic contact dermatitis have decreased. “Fast absorbing diapers help by absorbing the moisture that would otherwise stay on the baby’s skin reducing overhydration, friction, and contact with urine and stools, an easy solution for both happy parents and babies.
With Associate Professor Dr Choo Yao Mun,
Consultant Paediatrician,
UM Specialist Centre (UMSC).
