What patients and families need to know
Key Points about Diaper Dermatitis (Diaper Rash)
- Diaper dermatitis (diaper rash) is inflammation of the skin under a diaper.
- It's most often because of irritation from urine and feces.
- Different types of diaper rash have different symptoms. When irritated from urine and feces, the skin is usually red in color.
- Treatment includes diaper-free periods, cream and ointment.
- It's important to keep the diaper area clean and dry, change diapers often and avoid irritants such as soap or scented wipes.
Diaper dermatitis (diaper rash) is inflammation of the skin in the diaper area. It is a very common condition in babies and toddlers.
In most cases, diaper dermatitis is a type of contact dermatitis. That means the skin is inflamed from contact with certain substances. In diaper dermatitis, urine and feces irritate the skin.
Other common causes of diaper rash include:
- Candida. This is a yeast infection in the diaper area. Candida infection may occur if contact dermatitis is not treated within a few days.
- Seborrhea. This is a common, long-term skin condition. The cause of seborrhea is not known. It usually affects the diaper area and other parts of the body.
Other less common causes of dermatitis in the diaper area include:
- Bacteria. Staph or strep bacteria can cause it.
- Allergies. It can be caused by an allergic reaction to dye in disposable diapers, or detergent used to wash cloth diapers.
Any baby or toddler can develop diaper dermatitis. Things that increase the risk include:
- You don't change your child's diapers often enough
- Your child has diarrhea or frequent bowel movements
- Your child is taking antibiotics. Or you are taking antibiotics and you are breastfeeding.
The symptoms of diaper dermatitis vary depending on the cause. And symptoms can occur a bit differently in each child. They can include:
- Contact diaper dermatitis. Skin that is irritated from urine and feces will look red and shiny. The skin on the buttocks, thighs, belly (abdomen) and waist may be affected. The skin creases or folds are usually not affected.
- Candida diaper dermatitis. The skin is a deep red color with patches outside of the diaper area. A baby may also have a yeast infection in the mouth (thrush). The creases or folds of the thighs and in the diaper area are usually affected.
- Seborrheic diaper dermatitis. The skin is red with yellow, oily patches. It also affects the skin folds. It also usually affects the face, scalp or neck at the same time.
The symptoms of diaper rash can be like other health conditions. Make sure your child sees his or her health care provider for a diagnosis.
The health care provider will ask about your child’s symptoms and health history. He or she will give your child a physical exam. Your child's healthcare provider may advise lab tests, but they are usually not needed.
Proper skin care is very important to prevent diaper rash. This includes:
- Keeping the skin under a diaper clean and dry
- Changing diapers often
- Letting the skin under a diaper to air dry at times
- Letting your child to go without a diaper when possible
- Gently cleaning the diaper area with a soft cloth and warm water
- Limiting the use of soap or other strong products on the skin
- Not using scented wipes or wipes with alcohol
Treatment will depend on your child’s symptoms, age and general health. It will also depend on the cause, and how severe the condition is. Treatment may include:
- Periods of time without wearing diapers
- Frequent diaper changes
- Ointment put on the diaper area to protect the skin
- Antifungal cream or ointment for a Candida infection
- Corticosteroid cream for more severe dermatitis
- Antibiotic medicine for a bacterial infection
Call the health care provider if your child has:
- Symptoms that don’t get better in 2 to 3 days
- Symptoms that get worse
- Blisters or pus-filled sores
Interim Chief, Dermatology
The Division of Dermatology at Children's National Hospital 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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