Diaper Dermatitis - Causes, Prevention and Treatment
The diaper dermatitis, popularly called roasting, is a baby skin irritation, which appears in the areas covered by the diaper, usually by prolonged contact with feces or urine. The diaper dermatitis is a very common phenomenon and does not necessarily indicate parental neglect with baby hygiene.
The diaper dermatitis, also called diaper rash or diaper rash, is a direct irritation of the skin or indirectly caused by use of diapers. The rash is the most common skin lesions in first 2 years of the baby. Its peak incidence occurs between 9 and 12 months. The diaper dermatitis can also occur in older people who need to use diapers.
The rash is a typical dermatitis Irritant contact that occurs, among other reasons, the constant moisture in the area covered by the diaper. When the skin is constantly exposed to moisture, it is weakened and becomes more susceptible to physical, chemical or mechanical injury. In addition, the skin moist potentially irritating substance facilitates the absorption and promotes the proliferation of germs such as bacteria and fungi.
The diaper dermatitis is not a single injury but a generic term for various types of irritation that occur in the area covered by the diaper. The rash can have many causes, the most common are:
Prolonged skin covered by the diaper with urine and / or feces.
Rubbing or inappropriate size diaper friction with the baby's skin.
Excessive moisture caused by sweat in the areas covered by the diaper.
Contact dermatitis by chemicals present in the diaper.
Rash due to the heat and sweat inside the diaper.
Dermatitis seborrheic diaper.
Yeast infection, particularly candida.
Infection with bacteria.
Often, more than one of the above causes is present at the same time. Most cases of diaper rash skin irritation occurs due to the action of feces and urine. When both are present inside the diaper dermatitis risk is even greater. Bacteria faeces metabolise the urea present in the urine, producing ammonia, a substance that increases the pH of the medium. With a higher pH, digestive enzymes present in feces are activated and begin to act on proteins and fats present in the baby 's skin, causing inflammation. The inflammatory process associated to humidity, heat and the presence of bacteria increases the risk of skin infection, either by themselves bacteria or by fungi, such as Candida albicans.
Everyone has seen a diaper rash before. The baby has a redness, which may look "bright" or small papules (dot) redder. The injury is very painful, and the baby can show cranky throughout the day and difficulty sleeping at night. diaper changing the become more difficult as cleaning the skin usually causes pain, causing the child is agitated.
The area around the anus and buttocks are those that are in closer contact with the diaper and hence with feces and urine. This region is often affected by dermatitis, forming a diaper rash in the shape that resembles the letter W. In general, the regions of folds are spared.
The intensity of the rash can range from minor injuries and little reddish to diffuse and intense irritation throughout the area covered by the diaper. A light peeling skin is also common.
When rash occurs by irritation to the plastic diaper or friction, the lesions tend to be more peripheral, being located more on the sides of the thighs and belly region in greater contact with the diaper plastic.
When the baking persists for more than 3 days, the risk of contamination by bacteria or fungi increases.
The most important preventive action is to prevent the baby's skin stay too long in contact with feces or urine. Every time the baby evacuate, the diaper must be changed. If he did not evacuate, the diaper should be changed every 3 or 4 hours, or whenever it is full.
Disposable diapers are better than cloth diapers, because they absorb better the urine and reduce the moisture in the covered area. Look for the best brands, because they are more efficient. The higher the absorption capacity of the diaper, it is more secure against diaper rash.
Avoid too tight diapers because they can cause diaper rash friction.
Every exchange, baby skin should be cleaned gently with cotton or soft gauze. Rubbing too much baby's skin facilitates the emergence of irritation.
The use of ointments roasting serves to prevention and treatment of diaper dermatitis. The best ointments are those containing zinc oxide and petrolatum, as Hipoglos (Brazil) or halibut (Portugal). Apply a thick layer of each diaper change. If no stool, no need to clean up the remnants of the previous application, just apply a new layer on top of the old, without passing gauze or cotton. Ointments against diaper rash act by creating a physical barrier against moisture and irritants and reduce the friction of the diaper account the skin.
Not indicated more use of talcum powder for diaper rash. sodium bicarbonate and boric acid are also not indicated.
Treatment of mild cases can be done only with the preventive measures described above and salves for diaper rash. Avoid washing the area with soap or baked products that contain alcohol or perfume. Change the diaper often, every two hours, ideally. After the bath, if the environment is not cold, let the baby for a while without diapers to the skin to dry completely with air.
If, despite the control measures, dermatitis persists for more than 4 to 5 days, an ointment antifungal such as nystatin, miconazole and clotrimazole may be used. Ointments containing weak steroids can also help, but these should only be used with permission of the pediatrician.
In more severe cases with extensive fungal infection or bacteria, the use of antifungal or antibiotic orally can be indicated by a pediatrician. The rash should easily respond to treatment in two or three. Otherwise you do not notice improvement, take the baby to the pediatrician can evaluate it.
