When the summer heat and humidity cause cheeks to turn red and sweaty, sometimes little bottoms turn red, as well. Diaper rash is so common that it is estimated that diaper wearing children ages 4 months to 15 months suffer at least one episode every 2 months. It becomes more common as children begin to eat solid foods.
Moisture, chafing, and prolonged contact with urine or stool are among the common culprits for diaper rash. Occasionally, infants may suffer a rash due to an allergic reaction to chemicals found in disposable diapers or wipes. Antibiotics that cause loose stools or GI illnesses that result in diarrhea are other frequent causes of diaper rash. In the summer, heat and humidity, longer changing intervals due to busy travel, time in swim diapers and the like may result in an increased frequency of rashes. Although the choice of cloth or disposable diapers depends on many factors, research suggests that rashes are less common when disposable diapers are used. For cloth diapers, consider the use of a ‘stay dry’ liner.
Often times the first signs of diaper rash are a mild redness or an infant that is fussy when the diaper is changed. Once the skin is inflamed and irritated, it becomes an easy target for bacteria and yeast to begin to multiply. If these infections take hold, you will notice small bumps, pimple-type lesions or sometimes open sores.
As with any ailment, prevention might be better than a cure! There are several steps you can take to ensure that your child won’t suffer this summer. Frequent and timely changes are the mainstay of prevention. A dry bottom is much less likely to suffer a rash. If possible, allow the skin to be open to air for brief periods throughout the day. When changing soiled diapers, using water to clean the area is best. A mild soap may be necessary for particularly messy changes; however it isn’t routinely needed for each change. Commercial baby wipes, even those made for sensitive skin, may contain irritating perfumes or chemicals.
If, despite your careful attention to prevention, your infant suffers redness and irritation, there are many things you can do to heal it quickly. Continue to change your infant promptly and often. Using water will be less irritating than wipes. Consider the use of a squeeze bottle to apply a gentle cleansing jet of water rather than rubbing irritated skin. Pat the tender skin dry, do not rub. Allow the skin to sit open to air in order to fully dry. Barrier (diaper) creams that contain zinc oxide or petrolatum can be good for soothing and helping skin to heal. Thicker creams generally work best (e.g 40% zinc oxide). Apply a very thick layer of barrier cream as a skin protectant; if you can see the skin underneath the layer of diaper cream, apply more. Remember when changing soiled diapers, it is best to wipe of just stool and barrier cream, it is not necessary to completely remove the diaper cream. Scrubbing of the skin will only cause further irritation. The use of a colloidal oatmeal bath is an excellent tool to soothe, as well. Another home remedy of use is painting the irritated area with Maalox solution and allowing it to dry. The compounds in the medicine will have a soothing effect on the skin. You may then put your barrier cream over top of the dried Maalox.
If the area is bright red and bumpy, this is often a sign that yeast are present. Yeast love warm, moist areas, thus they often thrive in diaper areas. If you suspect a yeast infection, continue the care of irritated skin as above. Prior to applying your diaper cream, use a thin layer of clotrimazole ointment or cream. This is available over the counter under brand names such as Lotrimin™. Be sure to check the label to ensure ‘clotrimazole’ is the active ingredient. Use this as your first layer four times daily. Place your thick barrier cream directly over top of the clotrimazole layer. Yeast in the diaper area may need to be treated for a week to ten days prior to resolution. Contact our office if the rash fails to improve within 3-4 days of beginning treatment, however.
If you notice pimple or pus filled lesions in the diaper area, that may be a sign of a bacterial infection which may require a prescription to improve. Schedule an office visit for help. If a rash appears blistered or bleeding, that is another indicator that a visit to our office may be needed. Of course, any rash that continues to worsen despite your treatment at home also needs to be seen.