A diaper rash is an area of inflamed skin found in the diaper area in infants and young children. It is usually caused by skin irritation from prolonged contact with urine and feces.
A diaper rash can sometimes lead to a bacterial or fungal infection. Diapers, whether reusable or disposable, create a hot moist environment that traps diaper contents (e.g., urine and feces) against the skin, which causes irritation and can promote infection.
Most babies will have a diaper rash at some point. Although the number of severe diaper rash cases has decreased over time, diaper rash is just as common now as it was 30 years ago.
Diaper rash may be caused by a number of factors, including:
Diaper rashes often appear as redness on the skin, with shiny patches and some pimply spots. The rash is usually found in the diaper area, which includes the buttocks, upper thighs, and genitalia. The affected skin may also be warm to the touch. The folds or creases of the skin are usually unaffected.
An infant or young child with a diaper rash may be more irritable and may complain or cry during diaper changes, especially when the skin in the diaper area is being cleaned or touched. An infection is usually indicated by red bumps that are present in the skin folds or creases. Blisters, pus, or red and severely swollen areas can also be signs of infection. "Satellite" red areas beyond the main rash are common with Candida yeast infection rashes.
The symptoms and location of the rash are usually the only necessary factors required to diagnose a diaper rash. Other information such as medication use and chemical exposure can help the doctor identify factors that may be making the rash worse.
In general, a mild case of diaper rash should clear up after a few days of proper treatment. It’s important to understand that diaper rashes are very common and do not indicate poor child care.
Currently, the main treatment for diaper rash is to use a barrier cream or ointment containing ingredients such as zinc oxide* and petroleum jelly, which act both as a physical barrier between the skin and the irritant and as an absorbent to soak up moisture. Thicker barrier creams and ointments are usually recommended for treating a diaper rash. Some may contain vitamins A and D to promote healing.
Many common non-prescription diaper rash products contain zinc oxide. In general, the more zinc oxide a product contains, the thicker the product will be. Zinc oxide in concentrations up to 40% is suitable for treating a diaper rash. Lower concentrations (i.e., below 15%) can be used daily to prevent diaper rash.
Avoid using products with ingredients that may irritate the skin, such as certain fragrances or lanolin. Your child’s doctor may recommend a topical antifungal product (such as clotrimazole, miconazole, or nystatin) to treat an infection on the skin caused by yeast (i.e., Candida). Avoid using topical steroid products (such as hydrocortisone) unless otherwise directed by your child’s physician. Other measures you can take to help treat your child’s diaper rash include:
With an effective treatment, your child’s diaper rash should clear up after several days. If it doesn’t, or if your child has a fever or worsening symptoms (e.g., blistering, becoming inconsolable, or appearing lethargic), seek medical attention as soon as possible.
The following tips can be used to help prevent or reduce the chances of a diaper rash:
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