Diaper rash is the most common skin disorder of infants and toddlers, occurring in 1 out of 4 infants .A survey of suburban infants revealed that 25% had some form of diaper dermatitis, and 4% had severe rash issues. The greatest frequency occurs in infants between 9 and 12 months of age.
The most common cause of nappy rash in babies is irritation. Constant moisture and rubbing can cause damage to the skin. This is further irritated by bacteria, yeasts (e.g. candida or thrush), detergents, urineand faeces .
Nappy rash is made worse by loose faeces (diarrhoea),not changing the nappy often,plastic pants.Most children grow out of nappy rash when they are toilet trained.Reportedly highest during winter months, perhaps due to less frequent diaper changing.
Most episodes of diaper dermatitis are self-limited with a duration of 3 days or less. Severe cases of diaper dermatitis are usually caused by chronic irritants or secondary infection with candida or bacteria.
Signs and symptoms :
There may be red patches on your baby’s bottom, or the whole area may be red. The skin may look sore and feel hot to touch, and there may be spots, pimples or blisters.It can be sore or itchy when the area is wiped.Your baby may be unsettled or irritable.
Preventions and Cure:
The following help is minimizing rashes in the diaper area:
1.Change wet or soiled nappies as soon as possible. Young babies need changing as many as 10 or 12 times a day; older babies at least six to eight times.
Clean the whole nappy area thoroughly, wiping from front to back. Use plain water or baby wipes.
2.Lie your baby on a towel and leave the nappy off for as long and as often as you can in order to let fresh air get to the skin.
3. Remove any irritating agent or allergen from the diaper environment; hypoallergenic or cloth diapers may be less irritating.
4. Exposing the skin to air periodically will help keep it dry.
5. Protective creams and ointments such as zinc oxide (B4nappi), petroleum (Vaseline), mineral oils, baby oils, lanolin, or vitamins A and D (A&D ointment) may protect the skin from moisture and help heal the infant’s skin.
6. For severe rashes, steroids creams(2.5% hydrocortisone ointment)may be used sparingly. Since the diaper area is always under occlusion, the steroid effects will be augmented, and baby skin in the groin area is already very sensitive.
7.Fungal infection requires topical treatment with nystatin or clotrimazole creams.
8. Bacterial infections may be treated with topical mupirocin; caution is advised with bacitracin and neomycin preparations as the incidence of allergic contact dermatitis is very high. Oral antibiotics may be indicated in severe cases.
9. Powders (talc,baby powder,cornstarch,magnesium stearate, zinc stearate, and baking soda) can be used to absorb moisture and reduce friction but should be applied carefully so accidental inhalation does not occur.