Diaper Rash (or irritant diaper dermatitis) is the condition characterized by redness and scaling on the area where the diaper is touching the skin. This condition is a type of contact dermatitis. The diaper is not the main cause of irritation but the materials trapped inside the diaper are, such as urine and feces. Diaper rash can result to bacterial and fungal involvement leading to severe rashes that can spread to skin folds. These severe rashes can be described as beefy red erythema with pustules around the border.
• Wetness – Diaper rash develops when skin is exposed to long periods of wetness that increases the PH of the skin therefore causing irritation. This is mostly caused by urine and feces that result into breakdown of stratum corneum, or the outermost layer of the skin. The stratum corneum is the layer of the skin responsible for reducing water loss, repelling water, repelling invasion of microorganisms and protecting deeper layers of the skin from injury. In the case of babies, their stratum corneum is thinner making them more susceptible to irritation caused by wetness.
• Urine – Aside from wetness, urine has properties that can cause diaper rash. When urea breaks down in the presence of fecal matter, it increases the PH of the skin because ammonia is released. Although ammonia is only a mild irritant, its presence activates fecal enzymes such as protease and lipase. These two enzymes increase skin hydration and permeability to bile salts present in feces, which act as irritants.
• Disposable VS Cloth Diapers – Babies wearing super absorbent disposable diapers are less likely to acquire diaper rash than babies wearing cloth diapers. But one has to be cautious because disposable diapers have central gels that contain chemicals. These chemicals have been claimed to cause contact dermatitis. Whether a baby is using cloth diaper or disposable ones, parents need to make sure that those diapers are changed frequently, even if they are not soiled, to avoid rashes.
• Diet – Diet has also an effect in causing diaper rash. The type of diet affects the number of fecal enzymes. The less fecal enzymes, the less likely will there be an irritation. Breast-fed babies have a lower incidence of diaper rash because of their high PH and low enzymatic activity.
• Aggravation – Secondary infections such as bacterial and fungal infections may cause the rashes to aggravate.
To prevent diaper rash, parents should check their baby’s diapers regularly and changed them on time. See to it that the baby’s bottom is cleaned and dry thoroughly to prevent moisture from urine, feces and sweat. When drying the baby’s bottom, parents should not rub the area as this can cause irritation. Instead of rubbing the skin, they should only pat the area dry. One should avoid using plastic pants, diapers with plastic edges, alcohol and other fragrances because they aggravate skin irritation.
An effective treatment is to discontinue the use of diapers. This allows the affected area to be exposed to air. Moisture absorbing powders, oil based protectants, zinc oxide ointment and sealants are also effective in sealing the skin from maceration. Anti fungal cream and corticosteroids such as hydrocortisone cream is used to alleviate the rash.