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Medical Author:

John Mersch, MD, FAAP

John Mersch, MD, FAAP

Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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One-fourth to one-half of babies experience diaper rash. Of these, 15%-50% are due to yeast. Yeast diaper rashes tend to decrease as children get older and end when the infant stops using diapers. The air exposure afforded by underwear lessens the establishment of an infection on macerated skin surfaces. This explains the tongue-in-cheek opinion of pediatricians that a quick cure for diaper rash (contact or infectious) is successful toilet training.

If few C. albicans organisms are present, they may not be significant. However, symptoms are aggravated with more extensive infection. One study noted C. albicans was present in 37-40 patients with diaper rash, suggesting that C. albicans infection from the gastrointestinal tract plays a major role in diaper rash. Another study noted that 30% of healthy infants and 92% of infants with diaper rash had C. albicans in the stool. This reveals a definite relationship between Candida colonization of the stool and diaper dermatitis. However, such information does not reveal the entire picture. The actual presence of C. albicans in the stool in and of itself is not the entire story since 80% of healthy adult intestinal tracts are colonized by C. albicans. These generally asymptomatic (having no symptoms) adults may also develop groin Candida infections should they become immune compromised or suffer from extremely poor hygiene. Several studies have shown promising results of lessening the incidence and severity of Candida infection when probiotics (for example, yogurt with "active cultures") are taken whenever antibiotics are necessary.

Antibiotic use can lead to increased growth of Candida species. Thus, the fact that the use of commonly prescribed antibiotics such as amoxicillin increases the risk for developing diaper rash is not surprising. Amoxicillin use in infants decreases the number of bacteria and increases the number of C. albicans.

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