likelihood of diaper dermatitis developing. Below are some recommendations (Mayo Clinic, 2022). ● C hange diapers often. Remove wet or dirty diapers promptly. Ask staff members to do the same if the infant or toddler is in childcare. Disposable diapers that contain an absorbent gel are effective because they draw wetness away from the skin. ● Rinse the infant or toddler’s buttocks with warm water as part of each diaper change. A sink tub or water bottle can be used for this purpose. Moist washcloths, cotton balls, and baby wipes can aid in cleaning the skin. Be gentle. Use wipes that do not contain alcohol or fragrance. Alternatively, use a mild soap or a gentle nonsoap cleanser. ● Gently pat the skin dry with a clean towel or let it air dry. Do not scrub the skin. Do not use talcum powder. ● Apply cream, paste, or ointment regularly. If the infant or toddler gets rashes often, apply a cream, paste, or ointment during each diaper change. Petroleum jelly and zinc oxide are the time-proven ingredients in many diaper rash products. If the product applied at the previous diaper change is clean, leave it in place and add another layer on top of it. ● After changing diapers, wash hands well. Hand-washing can prevent the spread of bacteria or yeast to other parts of the infant or toddler’s body, the caregiver, or other children. ● Fasten diapers securely but not too tightly. A diaper that allows some airflow helps prevent diaper rashes. Too-tight diapers can rub the skin. Take a break from plastic or tight- fitting diaper covers. ● Give the infant or toddler more time without a diaper. When possible, let the infant or toddler go without a diaper. Exposing skin to air is a natural and gentle way to let it dry. To avoid messy accidents, try laying the bare-bottomed baby on a large towel and engage in some playtime. Gentle measures for diaper dermatitis include frequent diaper changing, air exposure, and gentle skin cleansing (Horii, 2022). Recommendations include: ● Topical barrier ointments or creams as the first-line treatment for mild to moderate diaper dermatitis. Suggestions include the addition of low-potency nonhalogenated topical corticosteroids such as 1% hydrocortisone for severely inflamed irritant diaper dermatitis. ● Addition of a topical antifungal agent in children in whom the diaper dermatitis appears to be or is confirmed to be complicated by Candida superinfection or in whom dermatitis has been present for at least 3 days. Do not use a combination of topical corticosteroids and antifungal creams to treat irritant diaper dermatitis. Most available combination creams contain topical corticosteroids that are too potent for infant skin and may cause unwanted corticosteroid side effects, such as skin atrophy and adrenal suppression. ● Powders (e.g., cornstarch, talcum powder) pose a significant respiratory risk if accidentally aspirated and should be avoided. Self-Assessment Quiz Question #3 Which of the following is a characteristic of moderate diaper dermatitis? a. Extensive erythema with a glossy appearance. b. Painful erosions, papules, and nodules. c. Mild asymptomatic erythema over limited skin areas. d. More extensive erythema with maceration or superficial erosions.
Common Causes Leaving on wet or soiled diapers for too long
The tender skin of infants can develop a rash if wet or soiled diapers are left on too long. Infants and toddlers may be more prone to diaper rash if they experience frequent bowel movements or diarrhea. Chafing or rubbing Tight-fitting diapers or clothing that rubs against the skin can lead to a rash. Using a new product The skin may react to a new brand of baby wipes, diapers, detergent, bleach, or fabric softener used to launder cloth diapers. Ingredients in lotions, powders, and oils might add to the problem.
Developing a bacterial or yeast (fungal) infection
What begins as a simple infection may spread to the surrounding skin. The area covered by a diaper is at risk because it is warm and moist, making a perfect breeding ground for bacteria and yeast. These rashes can be found within the creases of the skin. Red dots may be scattered around the creases. As infants start to eat solid foods, the content of their stool changes. This increases the likelihood of diaper rash. Changes in the diet can also increase the frequency of stools, which can lead to diaper rash. Breastfed infants might develop diaper rash in response to something the mother has eaten. Infants or toddlers with skin conditions such as atopic dermatitis (eczema) or seborrheic dermatitis may be more likely to develop diaper rash. The irritated skin of atopic dermatitis is usually in areas not covered by a diaper. Antibiotics can contribute to a rash by killing bacteria that keep yeast growth in check. Antibiotic use also increases the risk of diarrhea. Breastfed babies whose mothers take antibiotics are also at increased risk of diaper rash.
Introducing new foods
Having sensitive skin
Using antibiotics
(Mayo Clinic, 2022) The severity of irritant diaper dermatitis ranges from mild asymptomatic erythema to severe inflammation (Horii, 2022). ● Mild diaper dermatitis : Mild diaper dermatitis is characterized by scattered erythematous papules or mild asymptomatic erythema over limited skin areas with minimal maceration and frictional irritation. ● Moderate diaper dermatitis: Moderate diaper dermatitis is characterized by more extensive erythema with maceration or superficial erosions. Pain and discomfort are associated symptoms. ● Severe diaper dermatitis: Severe diaper dermatitis is characterized by extensive erythema with a glossy appearance, painful erosions, papules, and nodules. The best way to prevent diaper rash is to keep the diaper area clean and dry. A few simple strategies can help decrease the
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