Diaper Dermatitis
Information on the causes, symptoms, and treatment of skin irritation caused by diaper use.
Symptoms and Causes
Diaper dermatitis is a rash that appears on skin usually covered by a diaper, typically affecting the buttocks, genital area, and thighs. Irritation is often accompanied by inflammation.
Contrary to common belief, this condition is not necessarily associated with inadequate hygiene, although it can be a contributing factor. Diaper dermatitis occurs due to hypersensitivity of the skin to constant friction.
Although it most frequently affects infants, it can occur in individuals of any age who use diapers. The prognosis is generally favorable if specialist recommendations are followed and appropriate treatment is applied.
Symptoms
Characteristic symptoms of diaper dermatitis include:
- Irritation on the buttocks, genital area, thighs, and occasionally the lower abdomen.
- Inflammation in the affected area.
- Itching.
- Burning sensation.
- Increased sensitivity.
- Discomfort.
- Irritability during diaper changes.
- In infants, frequent crying.
Causes
Diaper dermatitis can be caused by several factors:
- Irritation: Irritant diaper dermatitis is the most common type and is caused by repeated contact with urine and feces. In these cases, the inguinal fold is usually not affected.
- Yeast: Diaper candidiasis results from infection by fungi naturally present in the gastrointestinal tract. In this type, the inguinal fold is more affected than other areas and is often a consequence of prior antibiotic use.
- Allergy: Very sensitive skin may react to components of the diaper or hygiene products (elastic bands, dyes, fragrances).
- Bacterial infection: This is very rare and is caused by staphylococcal or streptococcal bacteria.
- Sometimes it occurs from prolonged exposure to a soiled or wet diaper.
- Poorly fitting diapers may cause friction on the skin.
Risk Factors
Risk factors for diaper dermatitis include:
- Diaper use.
- Sensitive skin.
- Episodes of diarrhea.
- Introduction of new foods that may alter the consistency and composition of stools.
Complications
Diaper dermatitis can lead to the following complications:
- Ulcers.
- Exudative lesions.
- Sores.
- Bleeding.
- Hypopigmentation (lighter areas of skin).
- Secondary infection of the affected area.
Prevention
The best ways to prevent diaper dermatitis include:
- Changing diapers frequently and immediately after bowel movements.
- Allowing the skin to breathe by removing the diaper whenever possible.
- Cleaning the skin and genital area with lukewarm water, avoiding soaps and wipes.
- Patting the skin dry gently instead of rubbing.
- Choosing appropriately sized diapers that fit snugly but do not compress.
Which Specialist Treats Diaper Dermatitis?
Medical-surgical dermatology and venereology and pediatrics are the specialists who typically manage diaper dermatitis.
Diagnosis
Diaper dermatitis is diagnosed through observation of the affected area.
Treatment
Treatment of diaper dermatitis generally involves following the same measures recommended for prevention. In addition to frequent diaper changes, cleaning the area with water only, avoiding rubbing, and allowing the skin to breathe, it is advisable to:
- Avoid talcum powders to prevent infection of any lesions.
- Apply protective barrier creams that isolate the epidermis and maintain hydration.
If dermatitis persists despite these measures, a specialist may prescribe topical medications:
- Hydrocortisone to reduce inflammation.
- Antifungals to treat candidiasis.
- Antibiotics, which may be oral, in cases of bacterial infection.
