The two most common causes of diaper rash are:
- Chemical irritation (stool/diarrhea and urine) – This rash is usually most prominent in the area where the buttocks contact the diaper. The skin can be just reddened or severely broken down to look like a rug burn and even ulcerated.
- Yeast – This rash is usually most prominent on or around the genitalia. The skin usually is covered with slightly raised red dots that blend into several large splotches with “scalloped” borders and surrounding “satellite” red dots or tiny pustules.
Treatment for these rashes include:
- Drying the skin
- Change the diaper as soon as the diaper is soiled or wet.
- Dry the skin with a blow drier on a low cool setting prior to dressing the skin.
- Leave the diaper off and allow the skin to “air out” for as much as is practical (5-10 minutes will suffice).
- Stopping Trauma and chemical irritation
- Gently rub stool or urine from the skin with warm water over a sink or tub instead of using wipeys.
- If wipeys are used, rinse out all fragrance and chemicals prior to use by gently holding them under running water for a few seconds then wringing out the excess water. You can also use a moistened tissue or soft paper towel to gently remove more stubborn stool.
- Placing a barrier
- Keep a thick barrier in place when the diaper is on to prevent contact with stool and urine while the sensitive, underlying skin heals.
- We recommend using Desitin Original Ointment with 40% zinc oxide, or Vaseline Petroleum Jelly. Most other leading diaper rash brands are generally as effective.
- When large amounts of diarrhea are an issue, we may write a prescription for 20% cholestyramine compounded in Aquaphor. The cholestyramine binds to the bile acids in the stool to protect the skin.
- For a yeast infection, clotrimazole cream (over-the-counter) works well, or we can prescribe Nystatin cream to be applied before the barrier agent with each diaper change.
Please contact the office if any of the following occur:
- The rash does not improve within a week
- The rash worsens
- Crusty yellow discharge forms
- Peeling occurs
- Tenderness spreads
- The number of pustules increases
- The child develops a fever
- Any other worrisome symptom develops