With wet diapers continually holding moisture and chemicals against the skin, it is no wonder that many babies are destined to encounter diaper rash. While some diaper rashes may not be preventable, much can be done to minimize the problem.
What Causes Diaper Rash?
The leading factor is generally the moisture that, when constantly held against the baby’s bottom, breaks down the skin’s protective barriers. This causes cracking of the skin, allowing chemicals and microorganisms in urine and stools to reach the deeper layers of skin.
Diaper Dermatitis
The most common form of diaper rash is identified medically as chemical or diaper dermatitis. It usually is caused by contact with ammonia, a chemical abundantly present in soiled diapers. Diaper dermatitis initially appears as a bright red rash that can progress, if not treated, to painful open sores.
This dermatitis also can be caused by the dyes used in some diapers or the soaps and chemicals in moistened wipes intended for use in infant hygiene. These wipes also can damage the skin’s natural protective oils.
Indirect Causes
Gastrointestinal illness, such as diarrhea, can increase the frequency and wetness of bowel movements, leading to increased skin irritation.
In a roundabout way, frequent bacterial illnesses, such as ear and throat infections, can make an infant increasingly prone to fungal diaper rashes. Bacteria usually compete with fungi for growing room on the baby’s moist parts. The antibiotics prescribed for infectious diseases can kill bacteria but not the fungi, which then may thrive in the absence of competition.
Thrush, a common problem in children, is an oral yeast infection that can pass yeast fungi through the stomach and intestinal tract into diapers, constantly re-infecting an infant’s moist skin.
Do Some Children Have Diaper Rashes More Often Than Others?
Some children seem unusually susceptible to diaper rash, possibly because they are not as quick to wake up or express distress about having a diaper that needs to be changed.
Can Anything Be Done to Prevent Diaper Rash?
Disposable diapers are supposed to reduce the occurrence of diaper rashes. These include diapers with linings designed to transport moisture away from the skin to outer layers of material. Other diapers contain gelatinized fibers that are intended to absorb moisture.
What Can Be Done to Treat Diaper Rash?
- Good skin care is mandatory to prevent outbreaks or clear them up before they become painful.
- The key is applying a barrier (ointments such as A & D, Desitin or Vaseline) to supplement the skin’s natural protections.
- The ointment should be waterproof to keep moisture away from the skin and should neutralize irritating chemicals. If there is suspicion that moistened baby wipes may have contributed to a baby’s diaper rash, it may be a good idea to use a clean wash cloth and water instead of wipes.
- Call your pediatrician immediately if the child is under 3 months and has a fever, or if pimples, blisters, open sores or a bright red appearance are present.
- For an older child with these symptoms, or if there is no response to home care within three days, call your physician during office hours.
This information was provided by the Division of Dermatology and the Answer Line at St. Louis Children’s Hospital. For questions, please contact the pediatric nuses of the Answer Line at 314.454.KIDS (5437) or 800.678.KIDS.