Doctor's Notes on Diaper Rash
Diaper rash is inflammation of the skin under a diaper. It usually occurs in children under 2 years of age but can occur in adults with incontinence and/or paralyzed patients. Signs and symptoms include a red rash that may cover part or all of the buttocks, genitalia and possibly the skin folds. In some patients with a skin condition (seborrhea), the skin develops an oily, yellowish rash in the diaper area and on other body sites.
Causes of diaper rash include friction on the skin by the diaper, irritation from urine and feces trapped by the diaper, fungal infection (Candida) due to moist environmental conditions that promote fungal growth, allergic reaction to diaper wipes or laundry chemicals used to clean diapers. Seborrhea skin disease is another cause of diaper rash.
Diaper Rash Symptoms
Identifying a diaper rash is usually fairly easy. The rash is located on areas of skin immediately underneath the diaper area.
The skin is red and irritated. It may appear all over your baby's bottom or genital area, or only in certain places. It may or may not involve the folds of the skin.
Diaper Rash Causes
- Friction: Most diaper rash is caused by friction that develops when sensitive baby skin is rubbed by wet diapers. This results in a red, shiny rash on exposed areas.
- Irritation: The skin under the diaper gets red from irritants such as feces, urine, or cleaning agents. Irritation can be caused by the diaper or by the acid in urine and bowel movements. This rash appears red in the area where the diaper has rubbed and is normally not seen in the folds of the skin.
- Candidal infection: The rash of a candidal infection, also known as fungal or yeast infection, usually has a bright, beefy red appearance and is very common after the use of antibiotics. Candida is a fungal microorganism that is typically found in warm, moist places such as in the mouth. In fact, Candida is the same organism that causes thrush.
- Allergic reaction: The rash may be a reaction to diaper wipes, diapers, laundry detergent, soap, lotion, or the elastic in plastic pants. Children who have a previous history of eczema may be more susceptible to diaper rashes.
- Seborrhea: This is an oily, yellow-colored rash that may also be seen in other areas of the body, such as the face, head, and neck.
Whether you've never changed a diaper before or you're an old pro, you'll get plenty of practice with your new baby. Most parents have made common mistakes, like putting a diaper on backward or lopsided, or even getting an unexpected spray of urine from their baby boy. These step-by-step tips will help you master the art of diaper changing and fix any first-time mistakes fast.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.