Diaper rash in infants

Diaper rash is an irritation that develops on the skin that is covered by a diaper, or more specifically, the buttocks and groin area. Mild cases are characterized by redness, while more severe cases result in sores (pimple-like bumps, pustules, or others). Though diaper rash is rarely contagious, the irritation can, on occasion, progress and develop into a bacterial or yeast infection.

Causes and triggers

Diaper rash can be caused by various factors, including friction, certain irritants (urine, feces, etc.), a change in skin pH, or an allergic reaction. Prolonged skin contact with urine and feces, the use of irritating cleansing products, episodes of diarrhea, and antibiotic use can all cause or worsen diaper rash.

Treatment

A variety of over-the-counter products, such as pastes and ointments containing zinc oxide (e.g., Zincofax) or petroleum jelly (e.g., Vaseline), can protect the affected or at-risk area by forming a barrier. The product should be applied with each diaper change, and it is not necessary to completely clean off the ointment or paste at diaper changes.

In the event of an infection, your healthcare provider may recommend an antibiotic or antifungal (e.g., Canesten).

Most cases of diaper rash can be treated at home by following the measures below:

• Change the child's diaper every two to four hours and after every bowel movement.
• Air out the skin on the buttocks as often as possible.
• After each bowel movement, clean the skin with a small amount of mild soap (e.g., Cetaphil) and water, and pat with a soft towel to dry.
• Opt for fragrance- and alcohol-free baby wipes and stop using if symptoms do not improve, as they may be contributing to the problem.
• In more severe cases, avoid rubbing the skin when washing. Instead, wash the skin using one of the techniques below to avoid further irritation:
  • Let warm water run over the skin.
  • Cleanse the skin by squeezing warm water from a plastic squeeze bottle.
  • Soak a washcloth in warm water and wring out onto the skin.
  • Loosen dried feces with mineral oil applied to a cotton ball.

The use of powders is not recommended because of the risk of accidental inhalation. Also, the use of a hair dryer to dry the child's buttocks is not advised since it could cause burns.

When should I see a medical professional?

• If the diaper rash persists for more than one week.
• If the irritation, pain or itching worsens.
• If the diaper rash spreads to other areas of the body, beyond the skin that is covered by the diaper.
• If blisters, pustules, open sores or scaly patches of skin develop.
• If the diaper rash occurs between skin folds.
• If the diaper rash is accompanied by fever, significant discomfort, vomiting or blood in the stools.
• If there is a related infection such as a urinary tract infection or an infection affecting the genitals.

For more information:

• Canadian Paediatric Society