There are many
different types of diaper rash or diaper
irritation.
Friction rash:
This is the most common form of
diaper rash, and affects almost all
babies at some time. It is most
common on areas where friction is
most pronounced, such as the inner
thighs, or under the elastic of
diapers that are too tight. It comes
and goes quickly, and responds well
to frequent diaper changes, airing
out, and protective barriers.
Irritant rash:
This type of diaper rash is most
conspicuous on the exposed areas,
such as the round part of the
buttocks. It usually doesn’t occur
in skin folds and creases. It's
generally the result of contact with
stool enzymes or irritants such as
harsh soaps, baby wipes, detergents,
or topical medicines.
Allergic rash:
This may occur in combination with
an irritant rash or by itself. It is
also more common on exposed areas.
The skin may look like it’s been
exposed to poison ivy.
Heat rash
(caused by the blockage of the pores
that lead to the sweat glands) is
most common in very young children
but can occur at any age. When the
weather is hot or humid, the infant
sweats, but because of the blockage
of the sweat glands, this sweat is
held within the skin and forms
little red bumps, or occasionally
small blisters in young infants.
Prickly heat
causes rash or blotches during hot
weather or in a hot environment (the
same as heat rash).
Intertrigo:
Moist heat causes this common type
of diaper rash that occurs deep in
the skin folds. The involved skin
looks thin, as if it has lost
several layers.
Seborrhea rash:
A salmon-colored, greasy rash with
yellowish scales characterizes this
diaper rash that is also worse in
the skin folds.
Psoriasis: This
stubborn diaper rash doesn't
necessarily look distinctive. Other
signs of psoriasis usually accompany
the diaper rash, though, such as
pitting of the nails or dark red
areas with sharp borders and fine
silvery scales on the trunk, face,
or scalp.
What causes diaper
rash?
Skin wetness is the
common denominator underlying the
various causes of diaper rash. Urinary
wetness increases skin friction, raises
the skin pH, makes the skin less
cohesive, and makes it more permeable.
These effects combine to intensify the
action of stool enzymes or other
irritants that then inflame the skin. In
all the above diaper rashes, the
outermost layer of skin has been
damaged. With this protective layer
compromised, it is easy for
microorganisms such as yeast or bacteria
to invade the inflamed skin. This makes
the rash worse and less responsive to
usual treatments.
Yeast is by far the
most common type of organism found in a
diaper rash. The organism is quite
prevalent and thrives in warm, moist
skin. Yeast involvement should be
suspected in any diaper rash that has
not improved dramatically with 72 hours
of appropriate therapy. Current or
recent antibiotic use makes a yeast
infection even more likely, since this
reduces the amount of the skin's 'good'
bacteria that fight infection.
Classically a yeast rash is beefy red
with sharp raised borders and white
scales. Smaller lesions surround the
main rash. Even without the classic
pattern, however, yeast is often
present.
What are the signs
and symptoms?
The skin might
be red.
The diaper rash
is usually on the stomach, genitals,
and inside the skin folds of the
thighs and bottom.
The diaper rash
may be warmer than other skin.
Your baby may
seem uncomfortable, especially when
you are changing her diaper or
washing her diaper area.
More severe
cases of diaper rash may have
painful, open sores.
How common is
diaper rash?
Diaper rash is very
common. All infants develop a diaper
rash at some time or another; some even
arrive home from the hospital with a
slight rash. Still, diaper rash may be
more common after solid foods are added
to your baby's diet or when your baby is
taking antibiotics. Other factors that
can lead to diaper rash include
continuously wet or infrequently changed
diapers, diarrhea and the use of plastic
pants to cover a diaper.
Many babies
between the ages of 4 months and 15
months get diaper rash.
Diaper rash
is most common between the ages of 8
to 10 months.
Diaper rash
is more common in babies who have
many stools, especially if the
diaper is not changed overnight.
Diaper rash
is more common in babies who have
started to eat solid foods.
Diaper rash
is more common in babies who are
taking antibiotics.
Diaper rash
is more common in babies who are
nursing from mothers who are taking
antibiotics.
Babies with
a sensitive skin condition, such as
eczema, are more likely to get
diaper rash.
Is diaper rash
contagious?
Diaper rash is
usually not contagious.
How is diaper rash
treated?
It may be
helpful to remove the diaper and let
your baby's skin be open to the air.
Set your baby on a few cloth diapers
or on a blanket over a plastic
sheet. Use the time to play.
If you use
disposable baby wipes and your baby
has a rash, you may need to switch
to another brand or stop use all
together. Plain water is best.
Some products
can irritate young skin. If you use
harsh detergent, bleach, or fabric
softener, you may need to change
brands or stop using the product.
Use a thick
ointment or balm on your baby's
bottom. It helps protect the skin.
Apply after each changing.
Avoid using
adult products on your baby's skin.
You may want to
try using a different brand of
diapers if you think they are
irritating your baby's skin and
contributing to diaper rash.
Avoid using
talcum powder. If inhaled, it could
irritate your baby's lungs.
Avoid using
cornstarch. It may help bacteria
grow in your baby's diaper area.
Can diaper rash be
prevented?
Keep the diaper
area dry and clean. Change your
baby's diaper often. Babies usually
have 6-8 wet diapers every 24 hours.
Avoid using
disposable baby wipes. They can
irritate or dry out the skin. Wash
your baby with each changing using
plain water. Pat the skin to clean
it. Do not rub.
Avoid using
harsh soap. Gentle soap is best.
Using soap once a day is enough.
Gently pat the
diaper area dry after washing it. Do
not rub it or use a hair dryer.
Avoid dressing
your child in plastic pants. They do
not let the diaper area get enough
air.
Avoid using
tight fitting diapers that could rub
against the skin.
Use mild
detergents to wash diapers.
Avoid using
fabric softeners or antistatic
sheets when washing diapers.
How long does
diaper rash last?
Mild cases of
diaper rash may clear up in 3 to 4
days without any treatment.
Some cases of
diaper rash take several days to
improve, even with treatment.
The diaper rash
can last for weeks.
When do I seek
medical help for diaper rash?
Diaper rash is
easily treated in most cases and
improves within several days after
starting home treatment. If standard
treatments such as frequent diaper
changes and over-the-counter ointments
don't bring improvement after a few
days, consult your doctor. In some cases
diaper rash can lead to secondary
infections that may require prescription
medications. Have your child examined if
the diaper rash is severe, worsens
despite home treatment or occurs along
with any of the following:
Fever
Blisters or
boils
Bleeding
Crusty areas
Bright red
spots that together form a solid red
area with a scalloped border
