TrustCare Kids: Diaper Rash

Babies are a lot to handle, and it can be especially stressful when they have an ailment of some sort and it appears to be painful. One example of such an ailment is diaper rash, a very common condition that happens to almost all babies at some point during their infancy. The good news is that treating and preventing diaper rash has never been easier.

What is Diaper Rash?

Doctors refer to diaper rash as irritant diaper dermatitis, and it is generally defined as any skin rash in the diaper area that can be caused by various conditions. Typically, though, when people talk about diaper rash, they’re talking about contact dermatitis triggered by a soiled diaper that has been worn too long. Yet even though it’s called “diaper rash,” it typically isn’t the diaper itself that causes the rash; rather, it is the combination of the bacteria present in urine and feces that has an impact on the skin.

The top layer of human skin is called the stratum corneum, and, in adults, this layer has many sublayers that are constantly shed and replaced from below. Among the skin cells that make up these layers are lipids that help make the skin a barrier that repels water from without and retains water from within. In addition to repelling water, this topmost layer of skin protects deeper layers from injury and microbial invasion. In infants, however, this layer of skin is much thinner and more susceptible to damage.

This highly sensitive skin in a baby’s diaper area is likewise prone to irritation. When the skin in this area is exposed to prolonged moisture, along with urine and feces, the pH level of the skin increases and the stratum corneum begins to break down. The result of this process is patches of red, scaly skin that are tender and especially sensitive. In more severe cases, a secondary infection may occur and cause the skin to be red, puffy, and surrounded by blisters. In cases where the irritated skin becomes infected, the infant can experience pain and discomfort.

What Causes Diaper Rash?

Prolonged exposure to a soiled diaper is the primary mechanism of diaper rash, but it isn’t the only possible cause or contributing factor. Because babies’ skin is so delicate, there are a variety of potential irritants that could play a role. Below are some common factors that might lead to inflammation:

• Feces and Urine: As noted above, one of the most common causes of diaper rash across the board is simply a soiled diaper being worn too long. As fastidious as a parent might be, even a relatively short exposure time could still be irritating to some babies.
• Diarrhea: Since enzymes and microorganisms contained in feces are a much greater source of irritation than urine, an infant may be more prone to diaper rash during bouts of diarrhea.
• Chafing: Diapers that fit too tightly can cause chafing or rubbing that can irritate the skin in the diaper area. While this irritation is usually very mild, even a little inflammation can make the skin more prone to further irritation from urine and feces.
• New Product: Parents use any number of diapers, wipes, detergents, lotions, and other products in caring for their babies, and some of these products can have fragrances or chemicals that can have an inflammatory effect, either individually or in conjunction with each other.
• Infection: It is also possible for an infection in a different area of the infant’s body to become infected by a bacterial or fungal agent; this infection can then spread to the diaper area, where the moist warmth makes it fertile breeding ground for microorganisms. This kind of rash is most noticeable in skin creases.
• New Foods: Most babies start to eat solid foods at around 6 months old, and these new foods can cause changes in stool content and the frequency of bowel movements. Some potential irritants can even be passed to a breastfed infant, depending on what the mother has been eating.
• Sensitive Skin: Some babies simply have more sensitive skin than others, and they are more likely to get diaper rash. Some babies also have other skin conditions that might make them more prone to irritation in general.
• Antibiotics: Antibiotics are sometimes prescribed for babies with bacterial infections, but antibiotics can eliminate helpful bacteria in the process of eliminating the harmful kinds. This includes bacteria that normally regulates yeast growth; as a result, the baby can get a yeast infection that presents in the diaper area.
• Age: Though any child who wears a diaper can potentially get diaper rash, it is most common in infants who are around 9-12 months old. This is partly because babies are still relatively immobile at this age and are therefore more likely to be sitting most of the time.

Diaper Rash Treatment and Prevention

The treatment options and preventative measures for diaper rash have a lot of overlap and involve returning the diaper to a clean and dry state and then helping it stay that way. As parents know, however, this is sometimes easier said than done. Below are some tips for making diaper rash less likely:

• Change Diapers Often: While it may seem obvious, it’s important to change a wet or dirty diaper promptly. This is especially true when feces may be present as it is the greater risk.
• Clean Thoroughly: It can be tempting to rush a diaper change since it isn’t a very pleasant job, but you can help prevent a rash from developing by thoroughly but gently cleaning the baby’s bottom with mild soap and warm water, baby wipes, or cotton balls after each diaper change. Also make sure to pat or air dry afterwards; avoid rubbing when possible.
• Stay Loose: If a diaper is overtightened, it will prevent any air flow from reaching the baby’s diaper area. This allows a moist environment to persist that makes diaper rash much more likely. Tight diapers can also cause chafing.
• Ointments, Creams, or Lotions: In some cases where diaper rash is a recurring problem, you may turn to over-the-counter ointments, hydrocortisone creams, or lotions. Zinc oxide (Desitin) and petroleum jelly (Vaseline) are classic substances that effectively create a protective barrier on the skin. If the rash is due to a yeast (candida) infection, antifungal cream is the best option.
• Wash Your Hands: If you don’t wash your hands thoroughly after changing a diaper, you may unwittingly spread bacteria or fungus to other parts of the baby’s body or to yourself or other people.

TrustCare Kids Can Help!

It can be a very distressing time for parents when their children are hurting, and so seeing the puffy red skin of diaper rash may be a cause for alarm. Fortunately, it usually goes away on its own and isn’t a major health concern. If your child has diaper rash and you’re not sure what to do, TrustCare Kids is here to help! We offer walk-in visits at convenient hours, seven days a week, so we can help your little one get great pediatric care and feel better as quickly as possible.

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This post has been medically reviewed by Dr. Catherine Phillippi, pediatrician at TrustCare Kids. She earned her medical degree from the University of Mississippi School of Medicine in 1999 and completed her pediatric training at the University of Arkansas for Medical Sciences/Arkansas Children’s Hospital.