Nappy rash: prevention and care for your baby’s well-being

Nappy rash is a form of dermatitis that develops in the genital area of infants and children who use diapers to absorb the excretion of urine and feces

It is also known as diaper dermatitis or diaper erythema.

After atopic dermatitis, nappy rash is the most common form of dermatitis in early childhood.

What causes nappy rash?

Nappy rash is an irritant contact dermatitis which causes damage to the skin’s barrier function. If the child is atopic, they already have a partially damaged skin barrier and it is therefore even easier for them to develop nappy rash.

What are the main triggers of nappy rash?

• Urine in the diaper creates a warm, moist environment that facilitates the maceration of the skin.
• Enzymes in feces and fecal bacteria can attack and destroy the cells of the stratum corneum, as well as contour lipids.
• When exposed to this humid heat, urine develops ammonium hydroxide (ammonia) which has a very alkaline pH and causes extreme skin irritation, to the point it can resemble sunburn.
• The damage caused to the skin triggers the overgrowth of bacteria and yeasts, such as candida, which further contribute to skin irritation.

What does nappy rash look like?

The clinical picture of nappy rash is a very inflammatory dermatitis that is limited to the genital area that is covered by the diaper.

In some cases, and especially in those that are not treated properly, nappy rash can cause eroding and exudating patches of skin, and/or the formation of bumpy, erythematous nodules.

Nappy rash causes serious discomfort to the infant. Infants with nappy rash are restless, will cry incessantly, and will try to scratch or rub the affected area. They become particularly agitated immediately after passing urine or having had a bowel movement.

How to prevent nappy rash

Preventing nappy rash requires a two-pronged approach on both the diaper and the skin. The choice of diaper: Modern, disposable paper diapers are very breathable, which reduces the risk of nappy rash developing. Washable, reusable cotton diapers, on the other hand, are more occluding and can increase the chance of nappy rash. Changing the diaper: the more frequent the diaper change, the lower the risk of nappy rash. Cleaning during diaper changes: wash the genital area at every diaper change with a gentle detergent, such as Eudermic Cleansing Base, that respects the natural protective properties of the skin. Ensure the area is meticulously dried so as not to leave any residue moisture. The application of creams: there are many commercially-available products that are marketed for the diaper region. These creams, or even pastes, are usually oily and contain zinc oxide alongside other protectants that waterproof the skin against the irritants of urine and feces. However, the notion of waterproofing is mistaken, as it prevents the skin from breathing which can cause skin maceration and inflammation. Instead, with protective and anti-inflammatory properties, a small amount of Soothing Cream

should be applied at every diaper change and massaged until completely absorbed.

How to treat nappy rash

Treatment of nappy rash will depend on how serious the dermatitis is. If the affected area is mainly reddened, remove any fecal or urine residue with lukewarm water only. Avoid the use of any detergents so as not to further irritate the skin. After ensuring the area is completely dry, apply a small amount of Soothing Cream and massage well. By continuing this routine at every diaper change and ensuring the nappy is being changed regularly, the nappy rash will soon regress.

If, on the other hand, the nappy rash is very inflamed, eroded and/or moist, apply PEG Ointment after washing and drying the affected area during diaper changes. PEG Ointment has healing and anti-inflammatory properties and, as it is very thick, only a small amount of product should be applied. Massage PEG Ointment into a thin film that covers the entire inflamed area.