Therapeutics in Dermatology
A reference textbook in dermatology
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Infant diaper dermatitis

23 May 2013, by MARUANI A. & LORETTE G.

The most common form of diaper rash is irritant diaper dermatitis which arises most frequently in the first 18 months of life. It is caused by prolonged contact between the skin and irritants such as feces and/or urine.

It is characterized by redness and scaly patches mainly seen on the convex surfaces of the diaper area and is particularly common during teething or when the baby has a temperature. Other forms exist, presenting as small raised bumps (papules) and erosions in the diaper area.

Treatment is based on taking hygiene precautions and local care: diapers must be changed frequently (more than 6 times a day), gentle cleansing products used (soap-free detergents and cleansing oils, for example), anything that could irritate the baby’s skin should be avoided (baby wipes, for example), disposable diapers preferred over cloth (several cases of severe irritant diaper dermatitis have been reported with reusable diapers) and a barrier cream should be used.

 Diaper dermatitis can be the result of a variety of causes; the growth of yeasts can be one such cause. This type of diaper dermatitis is encouraged by maceration and tends to affect the skin folds which become red and shiny. Diaper rash caused by proliferation of yeasts is treated with topical anti-fungal agents.

Lastly, there are other causes of diaper dermatitis: eczema of the diaper area (if the baby is allergic to one of the constituents in the diaper, for example, in which case a different type of diaper should be used) psoriasis or, much more rarely, dermatitis that is a facet of a systemic disease.

Generally speaking, a medical opinion should be sought for any atypical diaper rash or rash that does not clear up after two weeks of appropriate local care.

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