Diaper rash……accounts for 7 to 16 % of paediatric dermatology cases worldwide.
What is Diaper Rash ?
Diaper dermatitis as we call it is a primary irritant contact dermatitis. this is caused due to maceration of the skin, friction & contact with Faeces & urine associated with poor hygiene. The ph of the skin increases leading to a break in the skin barrier & contact with acidic enzymes contained in normal faeces deteriorates the condition. Friction & maceration in the diapers is a common occurrence in growing children.
How does Diaper rash look ?
A glaringly obvious red skin ! Small boils red or whitish in colour, some amount of peeling is seen especially in prominent contact areas like the thighs, abdomen & genitals. What is distinctive is that the skin folds are Normal !
It is important in all cases of diaper rash to show a dermatologist?
i if the rash does not subside in 72 Hrs after application of barrier creams or diaper rash creams – yes . Our job is to rule out the other skin conditions that can confuse the issue…….the commonest being……
….. Infantile Eczema,
….. Candidiasis ( fungal),
….. Miliaria ( prickly heat),
….. Psoriasis & Seborrheic dermatitis.
Firstly let me stress that Diaper rash does NOT indicate a neglegient or improper child care ! Most children grow out of this rash. Disposable Diapers are very much a social necessity & as to whether these or cloth diapers are superior is Debatable. One has to adapt as per ones own life style & individually as per the childs predispositions. Either way FREQUENT DIAPER CHANGES are of prime importance. 3 hrs maximum in cases of disposables & wet ones in cases of cottons are recommended. At every diaper change gentle cleansing of the area with water & application of a barrier cream ( Vasogen, Mustela diaper rash cream, Johnsons diaper protection jelly, mothercare diaper creams, Sebamed etc etc ) is useful. Every Baby care Product company worth its salt has a Diaper Rash Cream on its product Line ! Mild cases of Diaper rash improve by these ennumerated methods. When there is superimposed Bacterial or fungal infection then it is necessary to include usage of Antibiotic creams Or Antifungal creams. Whether to use a cream or ointment is as per the doctors discretion. When the case is severe systemic antibiotic therapy is useful.
A word of caution………Ampicilin is seen to increase chances of superimposed Candidial infection. When the rash is severe enough to cause sleeplessness & crankiness in a child usage of steroidal creams are a must to releive the discomfort but BEWARE these creams are to be used under strict medical supervision only !
Talc…….cornstarch powders or Baby powders are a powerful weapon against diaper rash & should be used as such . They reduce friction, maceration & keep the baby feeling dry & fresh. Babies have their own psyche , never forget that !