Nappy Rash
Summary
This is a summary of nappy rash, a form of irritant contact dermatitis that affects many children due to exposure to irritants. Easily treated with improved hygiene, castor oil and zinc ointement.
Basics
A nappy rash is a form of irritant contact dermatitis. This is usually due to contact with irritants. The erythematous eruption, with/without scaling that usually occurs in the areas where there is contact with the nappy, and often sparing the flexure regions. Once there is a superimposed infection, such as fungal or bacterial, then the skin folds will also become affected.
Irritants
- Persistent moisture
- Irregular cleaning and drying
- Diarrhea
Management
General
- Changing of soiled nappies
- Expose nappy area to some fresh air when possible, especially if there is a severe nappy dermatitis
- Educate the caregiver on the correct nappy hygiene: washing, rinsing and drying of the nappy when it becomes soiled.
Medical
- Zinc and castor oil topical apply ointment after each nappy change.
Note
Moisture-absorbing powders such as talcum, are able to reduce the amount of moisture but they may also lead to other problems. The powder may act as an irritant when inhaled by the baby. Starch based powders may also act as food-source for an infection. For this reason, they are not adviced in the treatment of nappy rash.
Out of interest, it is worth knowing that Johnson and Johnson appears to be stopping the sale of talc baby powder. One of the reason is that people are demanding a more natural powder made of starches. The other reason is that talc powder comes from mines that are easily contaminated with asbestos. The public has been made aware that occasionally there is asbestos in the talc baby powder, which we know to be a carcinogen. Read more on J&J here.
Out of interest, it is worth knowing that Johnson and Johnson appears to be stopping the sale of talc baby powder. One of the reason is that people are demanding a more natural powder made of starches. The other reason is that talc powder comes from mines that are easily contaminated with asbestos. The public has been made aware that occasionally there is asbestos in the talc baby powder, which we know to be a carcinogen. Read more on J&J here.
Keep in Mind
If the rash involves the flexures, the health care professional should suspect the possibility of candida and they should provide treatment with an Imidazole.
- Clotrimazole 1% topical apply cream beneath the zinc and castor oil ointment after each nappy change until the symptoms have resolved.
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