Causes and Concerns of Diaper rash

Diaper rash is a common problem that is easy to deal with. It can have a multitude of causes such as fungus infection, urinary tract infection, or allergy to soaps and lotions or to disposable diapers. The culprit is usually moisture. Infants urinate many times a day and have frequent bowel movements. Other rashes that occur in the diaper area include Seborrheic dermatitis and Atopic dermatitis.

The wearing of diapers causes a significant increase in skin wetness and pH. Prolonged wetness leads to maceration (softening) of the stratum corneum, the outer, protective layer of the skin, which is associated with extensive disruption of intercellular lipid lamellae. Weakening of its physical integrity makes the stratum corneum more susceptible to damage by (1) friction from the surface of the diaper, and (2) local irritants.

The interaction between fecal enzyme activity and IDD explains the observation that infant diet and diaper rash are linked, since fecal enzymes are in turn affected by diet. Breast-fed babies, for example, have a lower incidence of diaper rash, possibly because their stools have lower pH and lower enzymatic activity (Hockenberry, 2003). Diaper rash is also most likely to be diagnosed in infants 8–12 months old, perhaps in response to an increase in eating solid foods and dietary changes around that age that affect fecal composition.

Whether the high concentration of ammonia (found in urine) or bacteria and their chemical byproducts (found in stool) is a contributing factor for routine diaper rash is still under study. Some information indicates that these elements may foster the progression from a simple diaper rash to a more severe case. Diaper rash usually can be cleared up by checking your baby’s diaper often and changing it as soon as it’s wet or soiled, and by using a zinc oxide cream or ointment to soothe skin and protect it from moisture.

Diaper rash can alarm parents and annoy babies, but fortunately most cases disappear after a few days with simple home treatments. Diaper rashes can occur intermittently, anytime while your child wears diapers, but they’re more common in babies during their first 15 months, especially between 8 and 10 months of age. However, although steroids are commonly prescribed to treat eczema, eczema is not very common in the diaper area, so it is likely something else causing his rash. Eczema more typically causes a red, itchy rash on a child’s cheeks, arms, and legs. Still, if you really think that it is eczema, you can ask your doctor if you can use a mild potency steroid, like those sold over-the-counter, for a few days.

Thrush is a type of oral yeast infection. Some babies with thrush develop a yeast infection in their diaper area too. 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. Small satellite lesions surround the main rash. Even without the classic pattern, however, yeast is often present.

To prevent diaper rash, it’s important to change your baby’s soiled or wet diapers as soon as possible, occasionally soak your baby’s bottom between diaper changes with warm water or allow your baby’s skin to dry completely before you put on another diaper. Keep in mind that these conditions usually have other symptoms besides a simple diaper rash and most are not very common.