Diaper rash is almost an inevitable part of life for parents of newborns and infants. It is a common problem among children under two years of age. A majority of babies experience it in the first three years of their life. Though not a dangerous condition, it cannot be ignored.
What it looks like
Diaper rash normally appears as a red irritation on the skin on the baby’s bottom or genital area. The rashes may or may not occur within the folds of the skin in the area.
Why it happens
In a majority of cases, diaper rash is the result of friction caused by wet diapers rubbing against the baby’s sensitive skin. Exposure to faeces, urine or cleaning agents can also lead to skin redness. The acid in the urine and stool causes irritation. Rashes caused by these irritants normally appear in the area which comes into contact with the diaper, and does not occur in the folds of the skin.
Certain types of diaper rashes are the result of allergic reactions caused by wipes, the diapers themselves, detergents, soap, lotions or the elastic in the child’s clothing.
Not changing dirty diapers regularly is another major cause of diaper rash, and so is diarrhoea.
Rashes may be caused by fungal or yeast infections (candida) and could be a side-effect of antibiotics.
Certain foods could also cause diaper rash.
Prevention is better than cure
Adequate skin care is the best preventive method. Follow these tips:
- Diapers should be changed regularly.
- Hands should be washed clean with soap and water before handling a fresh diaper. The child, especially his bottom, should be kept clean.
- A barrier cream or ointment like petroleum jelly or zinc oxide should be used to prevent skin irritation. It is necessary to completely dry the baby’s bottom before the ointment is applied.
- If you are using cloth diapers for your baby, study the manufacturer’s cleaning instructions and follow them scrupulously. Detergent should be used in the specified quantity only. And make sure that the diapers are rinsed thoroughly to remove all traces of soap and detergents, as these can irritate the baby’s skin.
- Avoid using fabric softeners as they are a major cause of skin irritation.
- When choosing disposable diapers, select those that are free of dyes and fragrances, as they are potential allergens.
- Be aware that babies may be sensitive to new brands of diapers, so if you are changing from a familiar brand, you need to be alert to the possibility of the baby developing diaper rash.
- Your baby could also be allergic to wipes. Water and a washcloth are safe alternatives.
Plan of action
Despite the best precautions, your baby may still develop a diaper rash. If that happens, try some simple steps to contain the problem and cure it.
Areas affected by rashes should be washed with mild soap and plain water.
Avoid wipes altogether, as the alcohol content in them will irritate the skin further.
Remember also not to scrub the area hard, as this will only aggravate the problem.
After cleaning, pat the area dry with a soft towel. Don’t immediately replace the diaper, let the affected area be exposed to air for some time.
Avoid tight-fitting diapers, as these retain moisture and delay the healing of rashes.
If you think your baby’s problem is because of diet, try to identify the culprit on the menu, and eliminate it.
When to escalate the issue
The diaper rash may become painful and cause extreme discomfort to the child if it persists beyond a week. Professional medical advice should be sought if practical and simple solutions fail to solve the problem.
If the rash worsens and/or spreads to other parts of the body, seek immediate medical attention.
If you cannot identify the cause of the rash, take the baby to a doctor promptly.
If the rash is followed by diarrhoea which persists for more than 48 hours, medical assistance is imperative.
Diagnosis is usually based on physical examination and an understanding of the child’s medical history. Laboratory tests are not usually required, but if the doctor feels that the problem is due to an allergy, a skin test may be done. Based on the findings, a treatment regimen can be worked out.
It is only in rare cases that hospitalisation is required for treating diaper rash.
This too shall pass!
The good news is, diaper rash is a passing problem. Once a child is toilet-trained, and does not need to wear diapers, the problem will automatically disappear.
Dr Raina Nikhil Nahar is a Consultant Cosmetologist and Dermatologist at Nanavati Super Speciality Hospital, Mumbai.