Diaper Dermatitis

What is diaper dermatitis?

Diaper dermatitis, commonly known as a diaper rash, is a term used to describe different skin rashes in the diaper area. The rash is usually red and scaling, but rarely ulcerated. It is most commonly seen in infants between the ages of 9 to 12 months, can also begin in the first 2 months of life.

What causes diaper dermatitis?

Possible causes of diaper rash include the following:

  • Irritation - from urine and feces trapped in the diaper
  • Candida diaper dermatitis - dermatitis caused by a yeast infection in the diaper area, often preceded by diaper dermatitis
  • Seborrheic diaper dermatitis - a common, chronic skin condition that can affect the diaper area as well as other locations on the body

Other less common causes of dermatitis in the diaper area include the following:

  • Impetigo - dermatitis caused by a bacterial infection
  • Perianal streptococcal disease - dermatitis caused by a streptococcus
  • Allergic dermatitis - a type of dermatitis that is rare in the first 2 years of life, but that can be caused by soaps and detergents, or the diaper

What are the symptoms of diaper dermatitis?

The symptoms of diaper dermatitis vary depending on the cause of the rash, and may be different from child to child. The following are common characteristics of diaper rash:

  • Candida diaper dermatitis - this rash usually begins in the creases or folds of the thighs and in the diaper area, and then spreads. This is usually a deep, red, shiny rash with red, satellite lesions, and it may be associated with thrush, a yeast infection in the baby's mouth.
  • Seborrheic diaper dermatitis - this rash also affects the skin folds in the groin area and is usually pink. Infants can also have this rash on their face, scalp, or neck at the same time.
  • Contact diaper dermatitis - this rash is mostly seen on the buttocks and may extend to the thighs, stomach, and waist area, but does not generally involve folds in the area. The rash is usually red and shiny.

The symptoms of diaper dermatitis may resemble other skin conditions. Always consult a physician for the correct diagnosis.

How is diaper dermatitis diagnosed?

Diaper dermatitis is usually diagnosed based on the location and appearance of the rash during physical examination of the child. In addition, the physician may do skin scraping to aid in the diagnosis.

What is the treatment for diaper rash?

The treatment for diaper dermatitis varies, depending on the cause of the rash. Specific treatment for diaper dermatitis will also be determined by the physician based on:

  • The child's age, overall health, and medical history
  • Extent of the disease
  • The child's tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the disease
  • Child or parent’s opinion or preference

Treatment may include:

  • Removal of the diaper for a few days
  • Medicated diaper cream (as prescribed by the child's physician)
  • Anti-inflammatory creams
  • Moisture-resistant diaper creams

Proper skin care is also very important in preventing diaper dermatitis. This includes:

  • Keeping the diaper area clean and dry
  • Changing diapers frequently
  • Allowing the diaper area to air dry from time to time
  • Limiting the use of soap and other harsh cleaners in the diaper area
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Dermatology

The Division of Dermatology at Children's National Health System continues to expand services as more families seek our expertise in the diagnosis and treatment of disorders of the skin, hair, and nails.

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