Diaper rash

introduction

The diaper rash - also known as diaper rash - is the name for a characteristic skin rash in babies and toddlers in the diaper area.
Around two thirds of all swaddled children suffer from a diaper rash at least once in their lifetime, although this can be more or less intense. The frequency maximum is around the 9th to 12th month of life.

Contrary to what is often assumed, however, it is not only babies and toddlers who can get diaper rash. This rash can occur much more at all ages, provided that the person concerned has a reason to wear a diaper (e.g. Incontinence in old age).
The rash can typically be recognized by the sometimes painful reddening of the skin in the diaper area, with small oozing blisters, larger bases, swellings (Edema), Dandruff, skin injuries (Erosions) and scabs are found. The skin in the anal and genital regions is particularly affected, but also the regions adjacent to the diaper area such as the groin, buttocks, thighs, lower abdomen and back.

Also read: Baby Rash - What's Behind It?

Causes of a diaper rash

The main cause of diaper rash is due to the combination of repeated urine- and Chair contact the skin with a coexisting one warm-humid Environment created by a diaper closing almost impermeable to air and water. Especially the high plastic and rubber content in the diapers leads to one Heat build-upwhich after a short time leads to "swelling" of the skin. This "swelling" damages the skin so that the natural protective barrier is attacked and repeated contact with urine and stool or with the substances that attack the skin (e.g. urea, digestive enzymes) can cause additional irritation. The reaction of the skin to this permanent irritation is then the characteristic rash, the impaired barrier function in turn also facilitates an additional infection of this skin area bacteria and Mushrooms.

Other causes for the development of a diaper rash can be allergic reaction of the child on certain detergents, fabric softeners or components of the diaper material as well as excessive use of skin care products.

But also children’s own diseases such as Neurodermatitis, psoriasis, seborrheic eczema or a general impaired Defense system can be a risk factor for a diaper rash.

Fungal infection

If diaper rash is more severe or if it is not treated in time, it can lead to an infection by fungi, more precisely an infection by Candida albicans come. This mushroom belongs to the group of Yeasts and is a normal part of the skin flora.
Usually it is not infectious. However, if the skin is very irritated, warm and damp, as is the case with diaper rash, these are ideal conditions for fungal growth. A fungal infection develops. If there is no treatment, this can spread further and be painful. A fungal infection is treated with a standard antifungal (against mushrooms) creamthat is applied to the appropriate skin area. Oral ingestion may be necessary in severe cases.

Diaper rash during teething

While the little ones are teething, the child's organism is particularly challenged and stressed, so that during this time, among other things, skin rashes can often occur when teething. Parts of the body at risk of a rash, such as the diaper area, can sometimes be slightly affected.
The reasons for this are, on the one hand, that the children often feel excited while they are teething and sweat more, so that the warm, humid environment under the diaper is promoted.

Read more on the subject at: Rash when teething

At the same time, the fever indicates that the child's own defense system is working at full speed, but can also be more susceptible to infections.
On the other hand, teething is often accompanied by changes in the stool, which can lead to diarrhea in some children.
In addition, the composition of both the child's urine and stool is changed during teething and its components are significantly more aggressive, which additionally attacks the skin in the diaper area.

Read more on the subject at: Diarrhea while teething

All things considered, it makes it clear why a diaper rash can occur during teething and therefore special attention should be paid to skin care for babies, especially skin care for the diaper area, during this time.

Here are tips for: Baby skin care

Symptoms

As a rule, the diaper rash is limited more or less sharply to the diaper area, with the buttocks and genital areas of the child being most affected.
In more pronounced cases, the rash can also spread to adjacent areas of the body (lower back / stomach, groin, thighs). Symptoms that accompany the rash can include itching, oozing, and painful areas of the skin.

If the affected skin becomes infected with fungi or bacteria in the course of the process, severe inflammatory reactions with fever can also occur.
In particularly severe cases, larger blisters can also form, which can burst and leave open, painful areas of skin or even cause deep tissue damage (Erosions, Ulcerationbleeding areas).
What is feared is the development of a rag lichen (Impetigo contagiosa), which occurs when a certain bacterium (Staphylococcus aureus) settles. This skin condition is highly contagious and should be treated with antibiotic ointments or an antibiotic.

Also read the topic: Pus pimples on the child's bottom

fever

A simple diaper rash caused by permanent irritation of the skin in the diaper area does not usually result in a fever. Fever usually only occurs when the rash "superinfected“Has, that is, when it affects the skin that has been damaged by the irritation bacteria or Mushrooms settle and a infection trigger. At this moment the fever is an expression of the fight of the body's own immune system against the pathogens that cause illness. Depending on the extent of the infection, the increase in temperature and the increase in the parameters of the infection in the blood can also vary.

Please also read the topic: Fever in baby

Vesicles

The Blistering is nothing unusual with a diaper rash, as this is caused by the irritation arise. However, it depends on the color of the bubbles. If these are red, they probably belong to the inflammation that already exists.
However, if they are small and white, this may indicate the existence of one Fungal infection suggest that is treated with antifungal ointments.

Is a diaper rash contagious?

Basically it is a simple diaper rash not infectious, since this is only an inflammation of the skin that does not correlate directly with a pathogen.

However, if there is one Secondary infection by fungi (Candida albicans) or less often bacteria (Staphylococci) it is possible that other children could be infected. However, this is only the case if the clothes or towels of the two children are shared and the skin of the second child is already irritated.

A Transfer to parents is with normal skin flora Not possible.

However, what can play a role is that Re-infection of the same child. If the towels and pads used are not adequately cleaned, the child may be infected again after successful treatment of the last infection. However, this new infection can easily be prevented if the towels and sheets are washed at an appropriately hot temperature.

therapy

Both non-drug and drug measures help with a diaper rash, although non-drug therapy should be attempted first for a simple non-infectious diaper rash.
This includes frequent changing of diapers (approx. Every 2 hours), gentle intimate hygiene (without soaps and creams) and occasional kicking in the air without a diaper (make sure that the children do not get cold).

Drug therapies are usually only resorted to if the rash is very severe or infected with fungi or bacteria.
Various ointments are then used that contain agents against the respective fungi (antimycotics) or bacteria (antibiotics) as well as anti-inflammatory ointments containing cortisone or antiseptics (e.g. chlorhexidine).
In the case of more severe infections, it may sometimes be necessary to use antibiotics or antimycotics in tablet form.
In addition to these conventional medical, drug therapies, various home remedies or homeopathic active ingredients or applications can be included in the therapy.

Anoint

One way to treat diaper rash is to use an ointment containing zinc (ingredient: zinc oxide).
The zinc ointment is applied directly to the affected areas once or twice a day and supports the wound healing of the itchy, painful and possibly oozing skin in the diaper area.

In the Multilind® Healing ointment it is a zinc ointment that is particularly suitable for treatment due to its composition.
The applied zinc ointment forms a kind of protective film on the skin, which protects the skin under the diaper from the build-up of heat. At the same time, however, it also relieves the itching and works anti-inflammatory such as disinfectant and removes moisture from already oozing skin so that it can heal better.
One should make sure that the (zinc) ointments applied no Contain preservatives and fragrances, as these may in turn cause skin irritation.
Strongly sealing, fatty ointments - just like powder - avoided as they can actually make the diaper rash worse.

Please also read our article on this Multilind®

In addition to zinc-containing ointments to support the skin barrier, depending on the extent of the skin inflammation or if the skin is infected with fungi or bacteria cortisone Ointments and ointments with antibiotics or antimycotics additives are used (these are usually prescribed by the attending physician).

Home remedies

The simplest means of treating mild diaper rash are firstly thorough cleaning the skin in the corresponding area and on the other hand that careful drying. The use of soaps should be avoided here, as these can be painful for the child. In addition, it should be ensured that you should not rub with a towel but dab it off, as rubbing the skin additionally irritates and could be painful for the child. If dabbing is also painful, you can blow dry the area.

They also count primarily pain reliever and anti-inflammatory Remedies that have a calming effect on the skin and sometimes even have antibacterial effects are common home remedies for a diaper rash.
In the form of creams, baths or compresses / wraps, natural products such as chamomile, Oak bark, Vinegar water, rose water, Healing earth, Natural yoghurt, black tea, propolis tincture or Marigold be applied to the rash in the diaper area.

One is also important frequent diaper changes, not just after every bowel movement, but approximately every 2 hours.
When cleaning the diaper area, care should be taken to ensure that no perfumed creams, oils or wet wipes.
However, the tried and tested powdering of the diaper area should waived (any breathing problems the child may experience may be related to this). In addition, powders often clump together and irritate the skin again. It is much better to apply zinc-containing ointments or creams made from natural products, which put a kind of protective film over the stressed skin.

However, the most effective means is fresh air. So let your child kick or run around the house without a diaper as often as possible so that no moisture can accumulate in the genital region.

homeopathy

The (accompanying) homeopathic therapy options include oak bark baths, baths with added chamomile, yarrow or wheat bran. The effect is based on the reduction of pain and inflammation reactions. Also the gift of fennel- or Nettle tea, Washings with vinegar water and applications of healing earth or natural yoghurt on the affected areas can be tried.
Calendula- Ointment or propolis tincture has a disinfectant and healing effect when applied to skin affected by diaper rash.

Duration of a diaper rash

Usually a diaper rash lasts only 3 to 4 daysprovided that it is treated correctly by the parents. However, if the skin inflammation is not treated adequately or not at all, it can happen that a fungus settles on the inflamed region and a Fungal infection evokes. This is definitely through the Pediatrician requires treatment, otherwise the infection can spread further.

But even with correct treatment by the parents, the diaper rash may not have healed after 4 days. In this case, too, it is well advised to visit the pediatrician to prevent possible fungal infections or the like.