Nappy rash is dermatitis confined to the area covered by the nappy. It is most commonly characterised by confluent erythema of the convex surfaces of the buttocks, the areas of the skin in closest contact with the nappy and it spares the groin folds. Nappy rash is not one distinct diagnosis, but is a multifactorial problems. Factors which contribute to primary irritant napkin rash include excess skin hydration (water in urine and stool), skin trauma (friction between nappy and skin), irritants (ammonia, faeces, soap and detergent residue) and candida albicans (present in faeces and infects damaged moist skin).

The relative contribution of each factor may vary between cases. It is not generally helpful to distinguish between these causes of primary irritant napkin rash as the treatment principals do not depend on this.

  • Treatments

    Various methods can be used to treat napkin dermatitis including disposable nappies, increase the frequency of nappy changing and cleaning the skin. Application of a barrier cream at every change (effective creams include zinc, white soft paraffin). Letting the child spend as long as possible without a nappy on, lying on a soft absorbent sheet that is changed as soon as it is wet and even sunlight plays a role in the treatment.

  • Advice

    Always keep your child’s nappy area clean and dry. Check and change your child’s nappy frequently (every 2 hours) and make sure the bottom is completely dry before closing up a fresh diaper. Give his/her bottom air as often as you can every day. Wear diapers loosely on the baby to allow air to circulate. Use a soap-free cleanser after bowel movements and use protective barrier creams which contain zinc and castor oil can help keep your child’s skin in good condition.

    If the skin is dry or cracked, apply the same protective barrier cream to protect the skin after washing off each bowel movement.

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