Dermatitis of the buttocks,
genitals, lower
abdomen, or
thigh folds of an infant or
toddler is called
diaper rash. The outside layer of skin normally forms a protective barrier that prevents infection; when the barrier fails, the child may develop a
rash in the area covered by the diaper. Diaper
rashes occur equally with cloth diapers and disposable diapers.
Description
Diaper dermatitis results from prolonged contact with irritants such as
moisture, chemical substances, and friction. Urine ammonia, formed from the breakdown of
urea by
fecal bacteria, is irritating to sensitive infant skin. Ammonia by itself does not cause skin breakdown. Only skin damaged by
infrequent diaper changes and constant
urine and
feces contact is prone to damage from
ammonia in urine. Inadequate fluid intake, heat, and detergents in diapers
aggravate the condition. Bouts of
diarrhea can quickly cause rashes in most children. Diaper rash begins with erythema in the
perianal region.
When parents and caretakers do not change the children's diapers often, feces is in contact with skin and
irritation develops in the perianal area. Urine left in diapers too long breaks down into ammonia, a chemical that is irritating to infant skin. Ammonia dermatitis of this type is a problem in the second half of the first year of life when the infant is producing a larger quantity of urine.
When the diaper area has prolonged skin contact with wetness the natural oils are stripped away, the outer layer of skin is damaged, and there is increased susceptibility to infection by bacteria or
yeast.
Barrier ointments can be valuable to treat rashes. Those that contain zinc oxide are especially effective. These creams and ointments protect already irritated skin