DIAPER RASH |
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DESCRIPTIONDiaper rash is a form of contact dermatitis that causes skin irritation in the area covered by a wet diaper. The skin around the genitals, rectum, and abdomen is involved. Diaper rash can affect any infant or young child who wears diapers.
Appropriate health care includes:
Self-care after diagnosis.
Physician's monitoring of general condition and medications, if home treatment fails to cure the rash.
SIGNS & SYMPTOMS
Moist, painful, red, spotty, and itchy (sometimes) skin in the diaper area. The skin may be cracked and fissured.
In male infants, a red, raw, and occasionally bloody area may appear around the meatus (the opening at the tip of the penis).
In female infants, a thin adhesive membrane may form between the vaginal lips.
CAUSES
Excessive ammonia on the wet diaper and skin caused by bacterial action. (Urine does not naturally contain ammonia.)
Monilia fungus infection--the same fungus that causes thrush.
Allergy to soap, detergent, fabric softener, lotion, powder, or other chemicals.
RISK FACTORS
Infrequent diaper changes.
Improper laundering of diapers.
Family history of skin allergies.
Hot, humid weather.
PREVENTING COMPLICATIONS OR RECURRENCE
Change your baby's diapers frequently.
Don't use waterproof diapers or pants at night.
Keep cloth diapers clean. After washing, rinse them twice to remove detergents and other chemicals.
BASIC INFORMATION
MEDICAL TESTS
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Urinalysis to rule out urinary-tract infection, which may complicate healing.
POSSIBLE COMPLICATIONSSecondary bacterial infection in the rash area.
PROBABLE OUTCOME
Usually curable with treatment. Recurrence is common.
TREATMENT
HOME CARE
Expose the baby's buttocks to air as much as possible.
Don't use waterproof pants during treatment--either in the day or at night. They keep skin wet and subject to rash or infection.
Change diapers frequently--even at night if the rash is extensive.
Don't use soap or boric acid to wash the baby's rash area. Cleanse with cotton dipped in mineral oil.
Discontinue using baby lotion, powder, ointment, or baby oil (except zinc oxide) unless prescribed by your doctor.
Apply small amounts of non-prescription zinc-oxide ointment to the baby's rash at the earliest sign of diaper rash, and 2 or 3 times a day thereafter.
If you wash your own diapers, add 1 cup of vinegar to the washing machine when it is half-full of rinse water. This neutralizes detergent residue.
If you use a diaper service, rinse the laundered diapers in 1 ounce of vinegar added to each gallon of water and dry before using.
MEDICATION
Your doctor may prescribe medicated anti-inflammatory ointments or creams, such as hydrocortisone, nystatin, or miconazole, to apply to the baby's skin.
See Medications section for information regarding medicines your doctor may prescribe.
ACTIVITY
No restrictions.
DIET & FLUIDS
No special diet.
OK TO GO TO SCHOOL?Yes. Keep diapers separate.
CALL YOUR DOCTOR IF
Home treatment doesn't cure the rash in 1 week.
The following occurs during treatment:
-- Fever.
-- Pustules in the rash area.
-- Male infant has a weak urinary stream.
-- Female infant develops adhesions of the vaginal lips.
New, unexplained symptoms develop. Medicine used in treatment may produce side effects.
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