Diaper Rash

What is diaper rash?

Diaper rash is a skin inflammation (dermatitis) that shows up on babies’ buttocks, thighs and genitals.

What are the symptoms of diaper rash?

The inflammation is bright red and patchy. While it usually affects babies, diaper rash can occur in anyone who wears diapers regularly. Diaper rash can cause babies to become uncomfortable and fussy especially during diaper changes and washing. In severe cases, the affected area can bleed, ooze or itch and cause pain during urination or bowel movements. Sometimes babies run fevers. If any of these symptoms occur or if the diaper rash doesn’t improve with a few days of home treatment, consult your pediatrician.

What are the causes of diaper rash?

The usual causes are wet or infrequently changed diapers. Urine and feces left in the diaper can chafe and irritate the skin. The rash also can be related to skin sensitivity, particularly if the diaper fits too tightly.

Diaper rash can also develop as a result of switching detergents, disposable diaper brands, baby lotions, powders and oils. Because skin covered by the diaper is warm and moist, it is breeding ground for bacteria and yeast that may cause infection. Signs of infection include rashes or red dots in the creases of your baby’s skin.

Diaper rash can also occur when you introduce new foods. This can change the frequency of stools. Breast-fed babies can develop diaper rash in response to food the mother has eaten. Babies with skin allergies or eczema may be more prone than others to diaper rash, even though the diaper area isn’t where these skin irritations usually occur. Diaper rash can also develop as a result of antibiotic use (even if the drug was taken by a mother who is breast feeding).

How is diaper rash diagnosed?

Diaper rash usually is evident to parents as well as physicians. Your child’s pediatrician is likely to question you to narrow down the possible causes – changes in products you use on the baby, how often diapers are changed, introduction of new foods, antibiotic use etc.

What is the conventional treatment for diaper rash?

Keeping your baby’s skin clean and dry is the best treatment. The American Academy of Pediatrics recommends rinsing the baby’s skin with warm water during each diaper change and washing with a mild soap (the AAP recommends Dove) only after stools. Avoid diaper wipes because they leave a film of bacteria on the skin. The AAP also advises exposing the baby’s bottom to air as much as possible by attaching the diaper loosely at the waist and by taking the diaper off and placing the baby on a towel during naps. Bright red rashes that don’t clear up after three days suggest yeast infections. The AAP recommends treating these by applying Lotrimin cream (available without a prescription) three times a day. Here are other suggestions from the AAP:

• Raw skin: Soak the baby’s bottom in warm water for 10 minutes 3 times a day. Add 2 tablespoons of baking soda to the tub of warm water.  Then apply Lotrimin cream.
• Sore or Scab on End of the Penis: These symptoms signal a bacterial infection that can cause painful urination. To treat the sore or scab apply an antibiotic ointment such as Polysporin (no prescription needed) 3 times per day.
• Diarrhea Rash: If your child has diarrhea and a severe rash around the anus, use a protective ointment such as petroleum jelly, A&D or Desitin. Otherwise these products aren’t needed. Caution: Wash off the skin before applying.

If those approaches don’t help within 3 days, see your doctor who may prescribe a mild hydrocortisone cream, antibiotic cream, an antifungal medication (oral or for application to the skin). Be sure to contact your doctor day or night if your baby is running a fever, looks or acts very sick, has symptoms that appear to be more severe and unusual than a diaper rash, and if you think he or she has an immediate need for medical care.

To discourage diaper rash, do not use plastic pants over the diaper – they will only hold in moisture and make matters worse. When buying over-the-counter diaper rash creams or ointments, ask your pediatrician or pharmacist for a recommendation. Use only products designed for babies, not those containing baking soda, boric acid, camphor, phenol, benzocaine, diphenhydramine, or salicylates, all of which can be toxic for babies.

What therapies does Dr. Weil recommend for diaper rash?

In addition to frequent diaper changes and keeping your baby’s skin clean and dry, you can use the herb calendula (pot marigold), available as lotions or creams for diaper rash (as well as for other types of skin irritation that occur in adults). Look for products with at least 10% extract of marigold, listed under its official name Calendula officinalis.