Diaper (Nappy) Rash

This rash is typically seen in newborn babies and infants and is confined to the nappy area - lower abdomen, groin, genital area and the buttocks. The area becomes red, scaly often with fissures and erosions. The lesions can be in the form of small patches or large confluent areas may be present.

Prolonged contact with urine and stool retained in the diaper causes irritation and development of rash. Warm and moist skin under the diaper provides ideal environment for the development of a fungus called Candida albicans, which sometimes is the cause of diaper rash. Patches due to Candida infection are red, with a scalloped border and a sharply demarcated edge.

Treatment

Frequent changing of diapers and meticulous washing of the genitals is extremely important. After cleaning leave the area open to dry making sure that no moisture is left in the groin or in the skin folds.

Diaper rash is more common with disposable diapers, hence it is advisable to use cotton diapers instead of disposable ones. Disposable diapers containing a super-absorbent material are now available, and can maintain a relatively dry environment. Still, they should be used sparingly.

Frequent application of a bland protective agent (Zinc oxide paste) after cleaning and drying of the area may suffice to prevent diaper rash.

If the rash persists an anti-fungal ointment containing nystatin/miconazole/clotrimazole/ ketoconazole can be used.

If there is lot of redness and itching mild corticosteroid ointment (0.5-1% hydrocortisone) may be used for a limited period of time.

If diaper rash keeps recurring after successful treatment, it may become necessary to prescribe a course of oral anti-fungal agents.

In the end it would be worth remembering that in societies where diapers are not used, there are no diaper rashes.