The ultimate goal in management of diaper rash is prevention. This can be achieved through:
- Maintaining skin integrity to prevent damage to the stratum corneum (the skin’s barrier).
- Keeping the baby dry which means frequent diaper changes. It is the ideal way to treat and prevent irritant diaper dermatitis. The frequency of diaper dermatitis decreases with increased number of diaper changes. Soiled diapers should be changed as soon as possible. If diaper dermatitis is present, diapers should be changed at least every 2 hours during the day and once at night. If possible the infant should go without a diaper.
- Wash all diapers in detergent and bleach them in hot water. The detergent is the cleansing agent and bleach will disinfect and whiten. Adding a laundry booster or vinegar to the wash cycle will eliminate odors, counteract ammonia and rinse out residue.
- Some fabric softener may be added to keep the diapers soft and to prevent friction.
- Water alone or “baby wipes” containing a non soap cleanser may be used. However, after stooling, cleanse the skin with soap and water, pat dry and put a clean diaper. Diaper cream or ointments may be applied as prophylaxis, especially at night.
Treatment of diaper rash
Treatment of a diaper rash will depend on the severity and etiology of the rash. If a mild, irritant, noninfected dermatitis is found, a cream may be all that is needed. A cream containing zinc oxide will be appropriate as zinc oxide is a skin protectant and soothing. A severe diaper rash will require aggressive treatment. Sometimes zinc pates can also be applied as they contain higher concentrations of zinc oxide, moisturizers, and other additives to aid in protection, prevention, healing and comfort.
It is suggested with some of these products, to cover the paste with a thin layer of petroleum jelly so that the paste does not stick to the diaper or to prevent opposing skin surfaces from sticking together
Finally what may work for one child may not work for another. Give the treatment at least 3-5 days to work. Some children may need to change products or require an alternative in management. Sometimes the rash will get worse before it gets better. Healing time may also vary in children