Nappy rash: an irritating itch

Nappy rash is a common form of inflamed skin (dermatitis) that appears as a patchwork of bright red
skin on your baby’s bottom.

It is often related to wet or infrequently changed nappies, skin sensitivity, and chafing. It usually affects babies, though anyone who wears a nappy regularly can develop the condition.

As annoying and irritating as it is, it usually clears up with simple at-home treatments, such as air drying, more frequent nappy changes and ointment.

Sometimes, you’ll need a prescription medication to treat the rash.

As a parent you can worry if the rash is severe or unusual, gets worse despite home treatment, bleeds, itches or oozes or causes burning or pain with urination or a bowel movement and is accompanied by a fever.

Avoid products that seem to trigger your baby’s rash. Wash your baby’s bottom with water after each nappy change.  Avoid soaps and wipes that contain alcohol or fragrance.

Try to give your baby as much nappy-free time as possible, so that his/her skin has a chance to stay dry and start healing.

When you do use nappies, change them frequently and apply a nappy rash cream, lotion, paste or ointment to act as a barrier between your baby’s skin and a dirty nappy.

In the past, it was common to use powders, such as cornstarch or talcum powder, to protect a baby’s skin and absorb excess moisture. Doctors no longer recommend this as inhaled powder can irritate a baby’s lungs.

Causes

Irritation from stool and urine – Prolonged exposure to urine or stool can irritate a baby’s sensitive skin. Your baby may be more prone to nappy rash if he or she is experiencing frequent bowel movements or diarrhoea because faeces are more irritating than urine.

Chafing or rubbing – Tight-fitting nappies or clothing that rubs against the skin can lead to a rash.

Irritation from a new product – Your baby’s skin may react to baby wipes, a new brand of disposable nappies, or a detergent, bleach or fabric softener used to wash cloth nappies.

Other substances that can add to the problem include ingredients found in some baby lotions, powders and oils.

Bacterial or yeast (fungal) infection – What begins as a simple skin infection may spread to the surrounding region. These rashes can be found within the creases of the skin, and there may be red dots scattered around the creases.

Introduction of new foods – As babies start to eat solid foods, the content of their stool changes. This increases the likelihood of nappy rash.

Changes in your baby’s diet can also increase the frequency of stools, which can lead to nappy rash. If your baby is breast-fed, he or she may develop nappy rash in response to something the mother has eaten.

Sensitive skin – Babies with skin conditions, such as atopic dermatitis or seborrheic dermatitis (eczema), may be more likely to develop nappy rash.

Use of antibiotics – Antibiotics kill bacteria – the good kinds as well as the bad. When a baby takes antibiotics, bacteria that keep yeast growth in check may be depleted, resulting in nappy rash. Antibiotic use also increases the risk of diarrhoea.

Breast-fed babies whose mothers take antibiotics are also at increased risk of diaper rash.

Symptoms

Skin signs – Nappy rash is marked by red, tender-looking skin in the buttocks, thighs and genitals.

Child irritability – You may notice your baby seems more uncomfortable than usual, especially during nappy changes. The child might cry when the nappy area is washed or touched.

Treatment

The best treatment for nappy rash is to keep your baby’s skin as clean and dry as possible. However, if the rash persists, the following might be helpful:

• A mild hydrocortisone (steroid) cream
• An anti-fungal cream, if your baby has a fungal infection
• Topical or oral antibiotics, if it is a a bacterial infection

Prevention and home remedies

• Keeping nappy area clean and dry
• Increasing airflow
• Zinc oxide is the active ingredient in many nappy rash products.
• As a general rule, stick with
  products designed for babies.
• Bathing daily.
• Rinse your baby’s bottom with warm water as part of each nappy change.
• After changing nappies, wash your hands well.

Are disposable nappies better than cloth ones?

Many parents wonder about what kind of nappy to use. When it comes to preventing nappy rash, there’s no compelling evidence that cloth nappies are better than disposable nappies or vice versa.

Dr Dulcy Rakumakoe. Picture: Refilwe Modise

For more news your way, download The Citizen’s app for iOS and Android.