Diaper Rashes are one of the most common reasons for excessive crying in babies and a source of anxiety in new parents. If you are a parent it is highly likely that you have been through sleepless nights trying to calm a baby with diaper rashes, used numerous creams or home remedies.
In this article, we will understand what causes diaper rashes, how to effectively treat them, and most importantly how to prevent diaper rashes.
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What are diaper rashes and what do they look like ?
Any rash that occurs in diaper area is called a diaper rash even though diaper may not always be the direct cause for it. In general most common types of diaper rashes inlcude
- Irritant Diaper dermatitis (most common)
- Yeast (candidal) diaper rash
- Miliaria (prickly heat)
The most common variety, irritant diaper dermatitis or commonly referred to as the diaper rash can be easily identified as redness with shallow ulcerations distributed in buttock, thighs, lower abdomen, perianal area.
It characteristically spares the creases, unlike yeast infection. If your baby is well and playful despite rashes it is most likely to be this variety of diaper rash.
Rarely diapers or products used in the diaper area could cause an allergic reaction and cause allergic diaper dermatitis. Chemicals in various baby products like fragrances, dyes, emulsifiers in creams could be the culprit. These typically occur after use of a certain product and subside when the inciting agent is stopped.
How common are Diaper rashes?
What causes Diaper rashes?
Once you understand what causes diaper rashes, it becomes extremely easy to prevent them from occurring in the first place.
Diaper rashes or diaper dermatitis is actually not related to the diaper but in fact is related to the combination of factors in the diaper area. Let’s take a look at these factors
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Moisture
Prolonged excess humidity or overhydration causes breakdown of skin which impairs its ability to function as a barrier to infection.
-
Irritants
Various irritants can come in contact with the delicate layer of skin and cause breakdown of protective layers, like
- Urine or stools : contains enzymes which on prolonged contact with skin can cause irritation and breakdown.
- Alcohol wipes
- Soaps with added fragrances
- Detergents used for cloth diapers
- Harsh chemicals from creams, lotions and soaps
-
Friction
- Due to tight diapers
- Prolonged diaper use
- Infrequent changes
All these factors work together to increase the pH of the skin from the acidic to alkaline.
An acidic skin surface is essential for the maintenance of the normal microflora, which provides anti-microbial protection against invasion by pathogenic bacteria and yeasts.
This altered pH activates several enzymes in the feces which damage the skin.
How to prevent diaper rashes?
So here is our checklist to prevent diaper rashes
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- Frequent diaper changes Change diapers frequently to avoid moisture and prolonged contact of urine or feces. Then comes the question, how frequently should I change the diapers?
While 2-4 hrs is an ideal period to change diapers, the appropriate answer would be to change as frequently as required. So it is extremely important to constantly check the diapers, especially if you are using cloth diapers, to make sure that cute little bottom isn’t sitting in too much moisture.
Most disposable diapers come equipped with moisture indicator strips that change color on contact with moisture.
- Use super-absorbent diapers
Diapering technology has seen a tremendous advancement in recent years and as a result, most diaper companies can produce diapers that promise good absorbency.
If you are environmentally conscious or simply are accustomed to cloth diapers then make sure to use multiple layers of skin-friendly material like pure cotton to increase the absorbency. Check frequently to make sure your baby is dry.
I always recommend cloth diapers during the day as its easy to keep an eye on, and disposable ones during the night when you and your baby both need a good night’s sleep.
- Cleaning with warm water
You can simply use warm water to clean the diaper area instead of store-bought baby wipes, which is not only safe and soothing, it’s also the most economical.
- Rash cream
Since moisture is a risk factor for diaper rashes it is important to create an oil-based barrier to protect the skin. This can either be any moisturizing oil or emollient cream.
- Use gentle detergents
Detergent soaps can in general be a strong irritant, even more so for a baby’s delicate skin.
Choose a gentle baby-friendly detergent or an after-wash cloth conditioner to wash away any harsh chemicals. Rinsing manually or using a rinse cycle in the washing machine also helps rinse away any harsh chemicals.
- Diaper-free time
Make sure you give your baby plenty of diaper-free time at regular intervals. Immediately after a bowel movement allow some diaper-free time for your child. You will get accustomed to their urine and bowel patterns and will be able to judge and allocate a diaper-free time based on their routine.
How to effectively treat diaper rashes at home?
Air
The most effective treatment of diaper rash is airing out the rash. Do away with the diapers altogether. This ensures that no further irritation or bacterial contamination occurs and also maintains dryness.
Barrier
Use a diaper paste or ointment to protect the skin from ongoing irritation like stool or urine. Use a generous amount and create a thick layer over the rash. These should contain zinc oxide that soothes and acts as an effective barrier from further damage.
Clean
Keep skin clean. Wash your hands before and after a diaper change. Bacterial contamination of a diaper rash can make the rash much worse.
Use clean warm water with a soft cotton cloth to clean the area.
Be extremely gentle and use dabbing motions instead of rubbing. If the rashes are severe and the skin is peeling then use warm water in a squeeze bottle to wash out the area and gently dab to dry.
Never rub or wipe the area.
Disposable diapers
While being diaper-free is most suitable, if you absolutely must use a diaper then use a disposable diaper which is one or two sizes larger during an episode of diaper rash. This is particularly important if you regularly use cloth diapers.
Educate
The best way to treat diaper rash is to prevent one. Educate yourself about how to prevent a recurrence of diaper rash.
When to see a doctor?
While most diaper rashes respond well to home treatment, it is important to know when to seek medical help. Be cautious and seek immediate help if you see any of the following signs:
- If your child develops any sign of infection like fever, refusal of feeds, decreased activity.
- If the rash extends beyond the diaper area.
- Rash that has pus or pus-filled blisters or deep ulcers.
- Rash that does not improve in 72hrs despite all measures or the one that gets worse by the hour
- Blood in stools.
- Repeated episodes of diaper rashes could be an indicator of other serious diseases.
Frequently Asked Questions
It is important to understand that a barrier should be something that forms a lipid film over the skin thereby preventing excess moisture to seep in.
Using talcum powder as a barrier to moisture does not effectively work as this does not form a lipid film. Also, accidentally inhaled talcum powder has been shown to cause lung cancer and Ovarian cancer. It is not recommended.
Following several claims of ovarian and lung cancer overuse of talcum powder, many people started substituting talcum powder with cornstarch.
However, according to AAP (American Academy of Pediatrics), corn starch powder may not be safe and can cause lung problems in addition to damaging growing lungs in babies as well in adults. It is not recommended.
Like we discussed in the article diaper rashes may not solely be a result of infrequent diaper changes. Follow all our suggestions in the section on how to prevent diaper rashes.
Withhold all baby care products.
Consider changing the detergent you use to wash cloth diapers. An allergic reaction to chemicals in baby skincare products or detergents may also cause diaper rash.
Also, see our article on Yeast diaper rashes to make sure you are not dealing with something other than a simple irritant rash
No, not on a routine basis.
However, if the rash is infected with bacteria then your baby might need a course of antibiotics. In such a case he will show obvious signs of infection like fever, refusal to eat, decreased activity, or irritability.
Similarly, if infected with candida(yeast) he might need antifungal ointments or oral medications.
All rashes are not the same and you should never use adult medications on children. Many formulations may contain steroids, which should not be used unless prescribed by your pediatrician.
Yes, you can. However, we do not see any added advantage of breast milk compared to rash creams. Breast milk is thin and runny if anything it might soothe the area for a short while, whereas a rash cream provides a good barrier.
Apart from following the ABCDEs of treatment, there are home-based alternatives that function to soothe the skin and might help the rashes like breast milk, coconut oil, almond oil.
No diaper rashes are not contagious.
There is no direct correlation of diaper rash with either cloth or disposable diapers. Cloth diapers are environmentally friendly and are economical in the long run. You can use either as long as you take the right precautions.
If you have any queries let us know in the comments below and we will be more than happy to answer them for you.
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