Diaper rash

Synonyms in the broadest sense

Dermatitis ammoniacalis, dermatitis pseudosyphilitica papulosa, dermatitis glutealis infantum, erythema papulosum posterosivum, erythema gluteale, posterosive syphiloid

English: diaper rash

definition

More than two thirds of all infants develop diaper rash, which is caused by a flat, irritated inflammation

• Redness
• Wetness and
• Pustules

is marked in the diaper area. Often the children develop acute diaper rash several times during their diaper changing age. The development of diaper rash is influenced by a number of factors, such as diarrhea (Diarrhea) or less frequent diaper changes, favored.
As a complication, additional fungal colonization can occur during such an inflammatory period Candida albicanswhereupon a so-called diaper thrush forms, or in the rarer case bacteria settle in the area of ​​the inflammation. The main therapeutic measures to be mentioned are the observance of preventive measures or the use of ointments.

Epidemiology

Almost all children develop some form of diaper rash at least once during their diaper age. In addition, the occurrence is influenced by hygiene and diet as well as the climate.

root cause

Infants empty their bladders very often during the day, especially at the beginning. If the child lies in the moist, warm diaper for a long time, this leads to swelling of the top layer of skin, the cornea. This disrupts the natural protective function of the skin and promotes the development of inflammation. But not only prolonged lying in urine can lead to a Diaper rash lead in the diaper area, even feces or soap residues cause a barrier disruption of the skin when lying in the area of ​​the diaper for a long time.

Because the changed layer of the cornea makes the skin more susceptible to pathogens, in particular Mushrooms, is, there is often an additional infection of the inflamed area as the disease progresses Candida albicans, a type of mushroom. It has not yet been sufficiently clarified whether bacteria actually penetrate more easily and lead to an infection.

Otherwise, it is known that a child's poor state of health favors the development of diaper rash. The disposition (predisposition) one psoriasis (psoriasis) or any other inflammatory skin disease that causes itching (eczema) can be the cause of diaper rash.

Fungi as the cause

If the diaper rash is not treated correctly, it occurs due to the moist and warm environment Fungal spores on the inflamed skin on the bottom. This will then Diaper thrush or Candidiasis called. Usually it is the yeast fungus Candida albicans. Diaper thrush can be applied to the severely reddened skin, with additional Pustules and Dandruff detect. Often the inflammation also spreads to the genital area. But it can also spread towards the thighs, buttocks and back. Because the diaper thrush is often strong for the baby itching and Pain means therapy should be started as soon as possible. In this case, a doctor should be consulted who will prescribe special ointments against the fungus.

Symptoms

The symptoms that a sick child shows depend on the severity of the diaper rash. Usually the first thing that stands out is the reddened, sensitive skin under the diaper. Sometimes it appears too dry and scaly. Even in severe cases, vesicles can form, which may detach and then cause open, easily bleeding wounds. At this stage, the dermatitis can also spread to areas outside the diaper.

Since the affected area of ​​skin is painful and sensitive, the child may experience pain when urinating, sleep poorly and be irritated. If there is also a settlement with the Candida fungus albicans, you can see moist, shiny red spots in the gluteal folds and genital region, which have a sharp border and scales can be found on the edge. In the area you can see isolated pustules or nodules (Papula). In contrast, with a bacterial infection, weeping reddened areas with pustules or blisters appear again and again. These can lead to open and bleeding wounds that heal, but often leave scars.

diagnosis

Diaper rash is generally diagnosed by carefully inspecting the child's skin, as it has a typical symptom and appearance. If it is suspected that the inflamed region is also infected with fungi, the doctor will also examine other regions in which the fungal colonization can appear, such as on the mucous membrane in the mouth, where white deposits can be found in such a case.

If the skin irritation of the diaper dermatitis lasts longer than usual, a smear is often taken to rule out other diseases in order to be able to clarify the cause microbiologically. Possible germs of the disease are detected and can then be treated systematically.

Is diaper rash contagious?

If she Diaper dermatits is contagious depends on the course and cause of the disease. Develops the dermatits without Fungal or bacterial infection, it is not infectious. But an accompanying fungal infection in particular is contagious. During this time children should do not attend any care facilitiesto avoid infecting other children. The Clothing worn only once be and then washed on high heat to reduce the risk of infection.

Duration of diaper rash

Diaper rash is inflammation of the skin on the baby's bottom. From Diaper thrush one speaks when bacteria or Mushrooms settle on the inflamed area. The diaper rash is caused by the moisture and warmth on the bottom. If the diaper is not changed often enough, skin irritation occurs and the bottom becomes sore. Depending on the initial findings, diaper rash, if properly treated, only lasts a few days. It is important to change the diaper regularly and to keep your bottom dry. Can support zinc-containing creams cream on the affected areas. In the event of severe inflammation or relapses despite correct therapy, a doctor to be visited. They can prescribe special creams or ointments. Accordingly, healing can take a few days. But with the right therapy, the inflammation should heal quickly.

You can find more information on the subject here: Diaper rash

Does diaper rash also exist in adults?

Not only babies and toddlers can be affected by diaper rash. Even adults the under Incontinence, so bladder and rectal weakness and are dependent on templates, can get sick. Usually the inflammation occurs after one bacterial diarrhea on. Diet, hygiene, climate and social factors can cause diaper rash to develop. However, adults are not affected as often as babies because an adult's skin is less permeable and the barrier function is more mature.

If the skin around the buttocks is reddened and irritated, it does not always have to be diaper rash. It can also be a Fungal attack, one psoriasis, that is psoriasis or bacterial inflammation. Accordingly, it is important to see a doctor in the event of a protracted course despite therapy or relapses. This can clarify the cause of the inflammation and initiate correct therapy.

therapy

The treatment consists mainly in changing diapers about six times a day and drying the children in the process. These measures prevent the damp and wet environment in the diaper and reduce friction and heat build-up. The use of breathable diapers also helps to prevent diaper rash from developing. When changing the diaper, it is important not to additionally irritate the region of the diaper rash with rubbing or soap. Therefore, it is best to dab the affected area with clean water. In addition, the use of zinc ointments, such as Penaten® Creme, and zinc oils lead to rapid healing due to their drying and skin-protecting properties. Short baths in weakly acidic soap solutions with additives to combat the infection have also proven successful (antiseptic). In any case, greasy ointments should not be used!

If the pathogen has become colonized, there are also local ointments that contain the corresponding fungi (antifungal) or bacteria (antibacterial) kill.

Only in severe cases is the treatment extended to the whole body. For example, a fungal infection with Candida albicans can make it necessary to treat the gastrointestinal tract in order to eliminate the pathogen there. Or a severe bacterial infection, for example with Staphylococcus aureus, can result in therapy with antibiotics, which act as an infusion or tablet systemically throughout the body. In such pronounced forms, hydrocortisone ointments are sometimes used for short periods to combat the inflammation.

Therapy in adults

Although the skin in adults has a better developed barrier function than in small children, diaper rash can also develop in adults if they are dependent on wearing diapers due to urinary and / or fecal incontinence. In adults, however, there are other differential diagnoses that may be considered; if diaper rash is suspected, there is not always one. The Therapy in adults looks similar to that in toddlers. Moisture-absorbing substances such as zinc oxide are used. As well as ointments like Multilind, which have potent fungicidal properties. More often than in young children it can be in adults Hydrocortisone are used because adults are not as prone to side effects as small children due to their increased body weight. Fungal or bacterial infections also occur antifungal substances or antibacterial drugs how antibiotics are used.

Ointment / cream / multilind

Especially creams and ointments that have a moisture-repellent effect are used in diaper rash. These creams and ointments mostly consist of zinc oxide, which has moisture-absorbing properties and slight disinfecting effects.

Ointments based on zinc oxide are suitable both for the therapy of an existing diaper rash and for the prophylaxis of such. The pastes with zinc oxide are sometimes also made with cod liver oil or paraffin oil, which makes them easier to apply and is more gentle on the child's irritated skin.

Tannolact fat cream can also be used.

Care creams with fragrances and preservatives, as well as cleaning wipes, should again be avoided, as they can irritate the skin and lead to intolerance.
If an accompanying fungal or bacterial infection occurs, this can be treated with antifungal (against fungi) and antibacterial agents, in the form of bath additives or ointments. Products with natural remedies are also used for diaper rash. Chamomile in particular is used here. Chamomile is used for its disinfectant and anti-inflammatory effects. In addition to chamomile, natural herbs such as bear moss, speedwell, thyme, marigold, oak and sage are used. They usually support the healing process, have a fungicidal and drying effect.

Highly greasy ointments should be avoided in the event of a fungal infection. In the case of a severe form of diaper rash, the Multilind® cream can be used. It contains the active ingredient nystatin, an antifungal agent that kills fungi. It acts very quickly and reliably against the most common causative yeasts such as Candida albicans and is also well tolerated. A positive feature of the Multilind cream is that the active ingredient is not absorbed by the body and therefore only works where it is applied. In addition to nystatin, the multilind ointment is also mixed with zinc oxide, so that the ointment also has an anti-weeping and anti-inflammatory effect. Zinc oxide also reduces itching.

Medication

In diaper rash, it occurs due to the irritation of the skin, due to the reduced barrier function of the skin, easier to infection. In this case, medical treatment should be given under medical supervision. If it is a fungal or bacterial infection, everyone should clothesthat have come into contact with the infected skin, often changed and washed hotto kill the pathogens. Antifungal drugs or antibiotics against bacteria are then prescribed for treatment. Wound protection pastes with the active ingredients dexpanthenol are used against fungal or bacterial infections (has a regenerating and anti-inflammatory effect), zinc or cod liver oil applied. Active ingredients such as nystatin and clotrimazole are also preferred, as they are also helpful against mild inflammation, fungi and bacteria. As a rule, healing occurs after a few days. The Treatment should continue for a few days after healing take place, as otherwise diaper rash can quickly come back again. If it is a very therapy-resistant bacterial infection that does not respond to ointments or the like, the Treatment via the bloodstream in the form of tablets or infusions respectively.

If a fungal infection occurs as part of diaper rash (mostly with Candida albicans = Diaper thrush), it is advisable to treat the gastrointestinal tract at the same time, as these fungal infections can spread easily and often also affect the oral mucosa.In severe cases, an anti-inflammatory low-potency hydrocortisone is prescribed by the doctor. However, this should be used very carefully, as tissue shrinkage of the skin (atrophy) can come. The skin becomes thinner and more fragile.

homeopathy

There are various homeopathic remedies for the treatment and prevention of diaper rash. However, a Doctor or midwife Asked for advice on whether homeopathic remedies are suitable for treating the skin in order to avoid a serious course of the disease. From a homeopathic point of view, diaper rash is an internal weakness or weakness of the immune system and can occur after treatment with antibiotics. Is suitable for treating diaper rash Chamomilla. This is also used for teething problems and diarrhea, among other things. The means are also suitable borax, Croton tiglium and Silicea. The globules can be given three times a day for about a week. If the redness does not improve or the rash widens, a doctor should be seen.

Home remedies for diaper rash

Various home remedies can be used to prevent and treat diaper rash. For cleaning the irritated skin are among other things olive oil or almond oil. Oil wipes or oils with additives and fragrances should be used avoided as the baby's skin may also react to it. It can also help gently dab breast milk on the affected areas of the skin. After cleaning the skin can also be occasional Chamomile seat baths contribute to healing. Attention should be paid to the correct water temperature. In general, you should keep your bottom dry and change your diaper regularly. It is recommended to leave the baby without a diaper more often so that air can get to the skin on the bottom.

Black tea used to treat diaper rash

A well-known home remedy for treating diaper rash is black tea. For this you should let the tea steep for about half an hour. Then soak a few compresses or towels with the tea. After cleaning the skin, the buttocks are carefully dabbed with the compresses or towels and left to air dry. This process should be repeated regularly after changing the diaper until the skin has healed.

Treatment with hip baths

To treat diaper rash you can also Hip baths be applied. Among other things, it is suitable for this chamomile. Add hot water to the chamomile flowers from the pharmacy and let them steep. Let the water cool down enough for the baby to feel comfortable and sit in it for about 5-10 minutes. Chamomile works pain reliever and anti-inflammatory. In general, babies and toddlers should not be bathed more than three times a week in order not to irritate the natural skin barrier. In babies, the protective acid mantle is not yet fully developed and therefore the skin is more sensitive and more susceptible to external stimuli.

prophylaxis

There are a few things parents can do when changing diapers for their children to make diaper rash less likely to develop. Above all else, one is important frequent changing of the diaper; at least six times a day and ideally shortly after the urine or stool. When changing diapers, a pH-neutral soap should be used and rinsed well with clear, warm water. The washing direction is from front to back and then the damp area is dabbed with a soft towel to avoid friction. Depending on the weather, it is also an advantage to let the child air dry without a diaper or to let the child crawl around with a bare bottom, i.e. without a diaper. The use of disposable diapers instead of plastic diapers also has a preventive effect.

It has also been shown that diaper rash occurs less frequently in breastfed children because their stool has a different composition. If the child is bottle-fed, the use of hypoallergenic baby food (HA food) to prevent the development of diaper rash.

forecast

Usually, diaper rash heals after a few days if the measures described above are taken. Even an additional infection with a bacterium or a fungus leads to a cure within a few days with the right therapy.

However, if a child has repeated outbreaks of the disease, this should be clarified more precisely by a doctor. Sometimes there can be another disease behind this that weakens the child's immune system and easily causes diaper rash to develop, or you can find certain places in the child's body where the relevant pathogens have accumulated and from which they repeatedly lead to the outbreak of the disease.