Diaper dermatitis is common among babies. Appropriate behavioral measures can help prevent diaper rash.
What is diaper dermatitis?
Diaper dermatitis is a condition of the skin that is inflammatory. The name diaper dermatitis is composed of the Greek words for skin (derma) and for inflammation (-itis). Diaper dermatitis predominantly occurs in babies and young children who are still wearing diapers. The symptoms of diaper dermatitis include painful or itchy redness of the skin in the area covered by the diaper. It is also possible for diaper dermatitis to cause the formation of blisters or pustules that can ooze. In addition to babies and toddlers, diaper dermatitis can also affect adults in comparatively small numbers who wear diapers for incontinence. In early infancy, diaper dermatitis is a very common condition; according to statistics, almost every baby is affected at least once by a more or less severe manifestation of diaper dermatitis.
Causes
Various causes interact in the development of diaper dermatitis: First, the warm, moist environment that prevails under a diaper favors the spread of germs within the area covered by the diaper. In addition, the development of diaper dermatitis is favored by the fact that the protective horny layer of the skin is damaged by the prevailing warmth and moisture in the diaper area. This damage in the run-up to diaper dermatitis can cause harmful substances to penetrate the skin more easily. Such causative substances of diaper dermatitis emanate, for example, from urine (such as ammonia) and feces. Various diseases of an affected infant, skin irritation caused by too-tight diapers, allergies or a weakened immune system are also possible causes for the development of diaper dermatitis.
Symptoms, complaints, and signs
Diaper dermatitis is characterized primarily by skin irritation in areas that come into contact with diapers. This usually involves sore baby bottoms. Mainly newborns in the first three months of life are affected. Nevertheless, diaper dermatitis can develop at any age in individuals who suffer from fecal or urinary incontinence and must wear diapers. The affected area of skin appears indistinctly red. The erythema on the buttocks begins to ooze. Papules (skin nodules) and pustules often appear at the border of the rash. In some cases, the pustules may spread further to the inner thighs, abdomen, or lower back. If a fungal infection is also present, the symptoms become more severe. The itching of the skin becomes unbearable. In addition, burning pain may also occur. The skin is then much more reddened than in simple diaper dermatitis. The sharply defined edges are conspicuous by fine scaling. In the case of an additional infection with streptococci or staphylococci, greater tissue damage can occur. In these cases, large blisters often form, which can even lead to skin detachment. More rarely, fever also occurs and the rash spreads to the entire body. Then a so-called bork lichen (pus lichen) can also form, which after bursting and healing leads to a yellowish scab on the skin. Diaper dermatitis usually heals within a short time without consequences.
Diagnosis and course
Diaper dermatitis is usually diagnosed by a physician initially based on the rash typical of the condition. Typically, when diaper dermatitis is present, the rash extends from a patient’s buttocks to the lower abdomen and genitals. The thighs may also be affected by the rash that occurs with diaper dermatitis. As a further step, it is usually necessary to rule out other diseases that may be hiding behind a present rash. Possible diseases that cause similar symptoms as diaper dermatitis include neurodermatitis, allergies or psoriasis. With early and appropriate treatment of diaper dermatitis, the disease takes an uncomplicated course in most cases; healing is then possible within a few days. Occasionally, diaper dermatitis can lead to complications; for example, diaper dermatitis may recur.Very rarely, diaper dermatitis may extend beyond the diaper area.
Complications
Normally, diaper dermatitis heals quickly with appropriate measures. Occasionally, however, complications can occur, for example, if there are multiple recurrences, causing the skin to become irritated over and over again. Diarrhea or therapy with antibiotics can also aggravate what is in itself a harmless clinical picture. If recurrences occur despite suitable treatment methods, it is advisable to consult a doctor in order to rule out possible allergies, a weak immune system or other diseases that can promote inflammatory processes. Another possible complication of diaper dermatitis is that the rash may spread to other parts of the body and may also appear on the face, head or arms and legs. In rare cases, it can also spread to the whole body and cause scaly skin redness everywhere. If a skin fungus is triggered due to diaper dermatitis and treatment with cortisone is given, this can cause the skin to become thinner in the affected areas, making it even more sensitive to irritation. Fungal disease can also promote diaper thrush and spread to the intestines.
When should you go to the doctor?
If infants, children or people who must wear a diaper show changes in the appearance of the skin around the abdomen, they should be monitored further. In many cases, a change and optimization of hygiene in dealing with the wearing of the diaper is sufficient to achieve an improvement in the overall situation. Irritations of the skin can be treated on one’s own responsibility by changing a diaper more frequently or applying creams and care products for relief. Normally, there is already significant relief or freedom from symptoms without medical consultation if personal hygiene is improved. If long-term impairments occur or if there is a sudden increase in symptoms, consultation with a doctor is advisable. If the changes in the skin’s appearance continue to spread, if pain occurs or if pustules develop, there is a need for action. Itching and open wounds should be examined by a doctor. If fever, general malaise or a feeling of illness develops, a visit to the doctor is necessary. Medical care should be initiated to avoid complications or secondary diseases. If skin changes occur in the area of the thighs, back or abdomen, this is considered a cause for concern. Consultation with a physician is required to make a diagnosis. If problems with locomotion are evident, the affected person also needs medical help.
Treatment and therapy
As part of the therapy of diaper dermatitis, the factors that have promoted the development of diaper dermatitis are usually combated first. For example, in the case of diaper dermatitis, it is recommended to prevent congestion of moisture and heat, as well as friction caused by inappropriate diapers. To ensure this, disposable diapers that are permeable to air can be preferred for diaper dermatitis. Also, experts recommend frequent changing of diapers in case of diaper dermatitis. If possible, it can have a positive effect on combating diaper dermatitis if an affected baby or toddler can spend some periods of the day completely without diapers. In various cases, in addition to combating the causative factors of diaper dermatitis, supplementary symptom treatment may also be necessary. This can happen, for example, when diaper dermatitis reveals an infection caused by bacteria or fungi. A corresponding infection associated with diaper dermatitis can be treated after consultation with the physician, for example, by administering antibiotic or antifungal (fungus-fighting) medications.
Prevention
Diaper rash can be prevented primarily by avoiding factors that may promote the condition. Accordingly, one factor that can prevent diaper dermatitis is, for example, preventing great heat and moisture in the diaper area. It also makes sense to avoid skin irritations. In addition, protective lotions can reduce the risk of germs penetrating the skin and subsequent diaper dermatitis.
Aftercare
Because diaper dermatitis usually resolves quickly with consistent care and use of prescribed medications, no separate follow-up care is generally required. Accordingly, diaper dermatitis is not a disease that requires long-term therapy. Rather, diaper dermatitis is a temporary, local skin irritation that is not contagious and in which blood tests are not normally relevant. However, separate follow-up for diaper dermatitis may be necessary if the condition is potentially chronic. This can occur when the skin is so irritated by constant inflammation that the dermatitis does not subside and secondary diseases such as fungus, weakened immune system occur. In such cases, the skin must be regularly examined by a specialist after the acute symptoms have subsided. The aim here is to ensure that the prescribed medication is effective or, if necessary, can be adapted to the skin condition. In the area of aftercare, the main concern is to prevent the threat of chronification. However, these are exceptional cases and not the typical diaper dermatitis that affects most babies at some point in their lives during diaper time.
What you can do yourself
As a rule, diaper dermatitis can be treated very well by home remedies and special measures yourself. In principle, it is advisable to temporarily do without the diaper completely, if that is possible. Affected children should ideally be placed naked on a blanket in a heated room for at least one hour a day. Older children should be allowed to run around naked a lot. This is especially recommended in the summer. This way, fresh air gets on the irritated skin and the inflammations can heal faster. Otherwise, diapers should not be changed only when they are full. It is better to change them at least after every meal. When changing diapers, the bottom should be cleaned with a warm washcloth and wipes containing oil. Afterwards, the area should be dabbed and ideally also blow-dried dry. On the one hand, it is important to ensure that it does not get too hot. On the other hand, male children must definitely be placed on their stomachs so that no urine stream can get into the hair dryer. Creams containing zinc can accelerate healing. Baby powder, on the other hand, should not be used under any circumstances. In some cases, it may help to switch to a different brand of diaper. Disposable diapers are generally better than cloth diapers.
