Diaper Dermatitis (Diaper Rash)

What is diaper dermatitis (diaper rash)?

Diaper dermatitis, commonly known as diaper rash, is a term used to describe different skin rashes in the diapered area. The rash is usually red, scaling and, rarely, ulcerated. It is most commonly seen in infants between the ages of 9 and 12 months, but may begin within the first two months of life.

What causes diaper rash?

Possible contributors to diaper rash include the following:

  • Irritation. This is from urine and feces trapped in the diaper.

  • Candida diaper dermatitis. Dermatitis caused by a yeast infection in the diaper area, often preceded by diaper dermatitis.

  • Seborrheic diaper dermatitis. A common, chronic skin condition that can affect the diaper area as well as other locations on the body.

Other less common causes of dermatitis in the diaper area include the following:

  • Impetigo. Dermatitis caused by a bacterial infection.

  • Perianal streptococcal disease. Dermatitis caused by group A streptococcus.

  • Allergic dermatitis. A type of dermatitis that is rare in the first two years of life, but may be caused by soaps and detergents, or the diaper.

What are the symptoms of diaper rash?

The symptoms of diaper rash vary depending on the cause of the dermatitis, and may be different for each child who is affected. The following are common characteristics of the rash that may occur with each type of infection:

  • Candida diaper dermatitis. This rash usually begins in the creases or folds of the thighs and in the diaper area, and then spreads. The rash is usually a deep red, shiny rash with red, satellite lesions. This type of rash may be associated with thrush, a yeast infection in the baby's mouth.

  • Seborrheic diaper dermatitis. This rash also affects the skin folds in the groin area and is usually pink. Infants may also have this rash on their face, scalp, or neck at the same time.

  • Contact diaper dermatitis. This rash is mostly seen on the buttocks and may extend to the thighs, stomach, and waist area, but does not generally involve folds in the area. The rash is usually red and shiny.

The symptoms of diaper dermatitis may resemble other skin conditions. Always consult your child's primary care provider for a diagnosis.

How is diaper rash diagnosed?

Diaper rash is usually diagnosed based on the location and appearance of the rash during physical examination of your child. In addition, your child's primary care provider may do skin scraping to aid in the diagnosis.

Treatment for diaper rash

Treatment for diaper rash will vary based on the cause of the dermatitis. Specific treatment for diaper dermatitis will also be determined by your primary care provider based on:

  • Your child's age, overall health, and medical history

  • Extent of the disease

  • Your child's tolerance for specific medications, procedures, or therapies

  • Expectations for the course of the disease

  • Your opinion or preference

Treatment may include:

  • Removal of the diaper for a few days

  • Medicated diaper cream (as prescribed by your child's primary care provider)

  • Anti-inflammatory creams

  • Moisture-resistant diaper creams

Proper skin care is also very important in preventing diaper dermatitis. This includes:

  • Keeping the diaper area clean and dry

  • Changing diapers frequently

  • Allowing the diaper area to air dry at times

  • Limiting the use of soap and other harsh cleaners in the diaper area

The rash should resolve in two to three days. Call your primary care provider if it does not improve, gets worse, you see open sores, or it appears extremely painful.

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Reviewed by Venita Kaul, MD, FAAP

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