ABOUT DIAPER RASH IN BABIES IN BRIEF

General 

With the needs to wear diapers 24/7, babies’ soft and delicate bottom is exposed constantly to microorganisms breeding , moisture and excrements . For this reason parents /caregivers use  topical diaper area cream to prevent/ treat diaper rash. 

Diaper dermatitis is one of infants and toddlers most common skin disease, accounting for 10-20% of all skin diseases, and 25% of dermatologist visits . It affects 7and 35 % of infants at some point and as long as the diaper is used .

Diaper rash is a form of skin irritation , that is painful , cause itchy skin , with inflammation of the skin of the diaper area. In these areas , the skin has to overcome harsh conditions resulting from continuous contact of the diaper , friction , wetness from the urine and feces and decrease moisturization .. As such the skin barrier become ineffective against microorganisms, fecal and urine waste, sweat , moisture and water .There is a PH changes as well . Microorganisms which are integral part of the flora such as fungus and bacteria can proliferate and lead to infection .Some ingredients used for baby skin may cause irritation or even allergy further worsening the diaper rash .

Cause 

Diaper dermatitis rash is caused by contact of the skin and the urine and stool , wetness , friction , , irritation , urine and stool PH , and microorganisms (yeasts , bacteria ) infecting the area and worsening diaper rash . 

Other causes or predisposing factors are chafing due to friction against the diaper, tight clothing , household products such as soaps , baby wipes, diapers ,laundry detergents and fabric softeners .Some foods consumed by the breastfeeding mother or during food changes periods ,m as well as it occurs around 9-10 months of age with no complete clear reason . 

Newborn skin PH – normally the skin PH is acid ,( from 4 to 5.5 ) which is optimal to counter and endure external attacks .In premature babies , the corium does not fulfil its function as a barrier compared to full term and adults .

Moisture – In newborn babies , the use of a 24/7 diaper ,decreasing moisture evaporation and wetness from the urine and stools, increase the risk for dermatitis rash ., where the dermis is attacked and become irritated and inflamed. Quantitively , the number of natural moisturizing factors in baby’s skin is smaller than in adults. The amount of water inside the topmost layer ( stratum corneum ) is higher in infants compared to adult’s skin . The rate of trans epidermal water loss is higher compared to adult . In short , baby layer of skin is more sensitive, gentle , and softer. Baby’s skin need moisture ( as in the womb ) ,however our external environment is dry and therefore babies develop various skin problems early in life .

         Tip – It is better to use moisturizer to restore moisture to the baby’s skin , and slow down the rate of trans epidermal water loss .if you put the moisturizer on your baby while he is still damp , it helps lock the water molecules in the skin which is great .

The skin barrier -Feces and urine includes irritating enzymes to the skin , and water alone is not enough to remove substances that don’t dissolve in water .Changes in skin PH ,  intestinal enzymes becomes more irritating to the skin , the barrier function is lost and a severe and painful Rash can result .

Treatment 

The treatment target predisposing factors ( better diaper type ,better wipes , watching the child with diarrhea , taking specific food ,,taking antibiotics , existing oral thrush in a baby ,  etc. ), prevention and treatment as necessary with creams or other applied by caregiver fingers to care for the resulting inflammation , microorganisms  adding infection , restore moisture and sooth and care for pain and discomfort from the inflammation .

Comments and misconception about treatment -There is a perception that diaper cream should be applied from birth . There is actual suggestion and tendency to use more preventive creams with non medicated anti-inflammatory ingredients when diaper rash occurs .Some say to use diaper cream as needed ,, but we need to keep the diaper dry all times, because then the chance to develop diaper rash decreases -however it is not practical .