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Treatment of Dermatitis of the Diaper (Napkin Dermatitis)

  • Diaper dermatitis is one of the most common childhood disorders. 

What causes napkin dermatitis?

  • Diaper dermatitis has a multifactorial etiology:
    • When diapers are not changed for an extended period of time, urea splitting bacteria produce faecal enzymes and ammonia.
    • It could also be caused by the rubber or plastic in diapers
    • Insufficient buttock cleaning
    • Frequent loose stools. 
  • Overhydration damages the stratumcorneum, rupturing the skin barrier and increasing susceptibility to infection. 
  • Bacterial or fungal infection is common. 
  • If the diaper comes into direct contact with the skin, occluding the eccrine glands, miliariarubra-like lesions can develop.

What does napkin dermatitis look like?

  • The most common type of diaper dermatitis is irritant diaper dermatitis. It is present in anyone regardless of age. 
  • It appears as red, moist patches on the genital convexities and buttocks, which are in close contact with the diapers. 
  • Sometimes shallow erosions occur.

What are satellite lesions in diaper rash?

  • Secondary Candida infection is characterized by satellite papules and pustules on the lesion's periphery. 
  • Granuloma gluteale infantum is distinguished by reddish purple nodules on the buttock convexities.

How do you cure diaper rash fast?

  1. The majority of cases respond to better hygiene. 
  2. When the infant sleeps, the diaper should be left open to allow the skin to dry. Parents  should be instructed to change the diapers on a regular basis, and the diapers should be of high quality, such as supra-absorbent and disposable. 
  3. At each diaper change, the skin should be thoroughly cleaned. Avoid using soap; instead, use water or aqueous creams to clean.
  4. After cleaning, apply a barrier ointment to provide a lipid film over the skin's surface. This reduces skin wetting, friction, and contact with urine and feces. A zinc-containing barrier ointment aids in wound healing.
  5. In severe cases, a mild steroid cream, such as 1% hydrocortisone, is prescribed. Because Candida albicans and bacteria are frequently present, an appropriate topical antifungal or antibacterial cream can be used. 
  6. There are also creams that contain both steroids and antifungal agents. Steroids with moderate to high potency should not be used.


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