What is the best treatment for diaper rash?

From the Guidelines

The best treatment for diaper rash is to keep the affected area clean and dry while applying a thick layer of protective barrier cream or ointment containing zinc oxide (such as Desitin, Balmex, or Butt Paste) or petroleum jelly (like Vaseline or Aquaphor) after each diaper change. This approach is based on general principles of skin care and wound healing, although the provided evidence does not directly address diaper rash treatment. The key elements of this treatment include:

• Washing the area gently with warm water and mild soap
• Patting the area dry completely
• Allowing some diaper-free time several times daily to expose the skin to air
• Changing diapers frequently, at least every 2-3 hours and immediately after bowel movements, to minimize skin contact with moisture and irritants For more severe rashes, a thin layer of 1% hydrocortisone cream may be applied for up to 7 days, but it's crucial to avoid using it for longer periods without medical advice 1. If the rash appears infected (with bright red patches, yellow crusting, or pimples), it's essential to consult a healthcare provider as an antifungal or antibiotic cream may be needed 1. These treatments work by creating a protective barrier against moisture and irritants while allowing the skin to heal naturally. Most diaper rashes improve within 3-4 days with proper care. It's also important to note that some treatments should be avoided, such as greasy creams for basic care, manipulation of skin, hot blow-drying of the hair, wearing of tight shoes, topical acne medications, and topical steroids, as they may irritate the skin or worsen the condition 1. Instead, gentle soaps and shampoos, moisturizer treatment, avoidance of sun exposure, and use of sunscreen with high sun protection factor (e.g., SPF30) are recommended 1. Additionally, treatment of xerotic and eczematous skin, pruritus, and fissures may be necessary in some cases, and should be managed with emollients, topical steroid preparations, and other therapies as needed 1.

From the FDA Drug Label

Uses: Forms a moisture barrier that prevents and helps treat effects associated with diaper rash from wetness, urine, or stool. Temporarily protects and helps relieve chapped or cracked skin. Helps treat and prevent diaper rash Protects chafed skin due to diaper rash - helps protect skin from wetness The best treatment for diaper rash is to use a moisture barrier such as dimethicone 2 or zinc oxide 3 to prevent and help treat the effects associated with diaper rash.

• Dimethicone 2 and zinc oxide 3 are both used to help treat and prevent diaper rash.
• They both protect the skin from wetness and help relieve chapped or cracked skin.

From the Research

Treatment Options for Diaper Rash

The best treatment for diaper rash involves a combination of keeping the skin dry, using barrier creams, and applying mild topical corticosteroids. Some key points to consider include:

• Keeping the skin in the nappy area as dry as possible with frequent nappy changes 4
• Using superabsorbent disposable diapers to reduce the incidence of diaper dermatitis 4
• Applying barrier creams to protect the infant's skin and mild topical corticosteroids to reduce inflammation 4, 5
• Avoiding tight-fitting diapers and washing the area as infrequently as possible 6
• Using topical skin barrier repair cosmetic products, such as zinc gluconate-taurine/zinc oxide and panthenol/glycerin/Butyrospermum parkii butter barrier cream, to cure and/or prevent diaper dermatitis 7

Novel Therapeutic Approaches

Recent studies have explored novel combinations of topical agents that target multiple mechanisms in diaper dermatitis, including:

• Zinc gluconate, zinc oxide, dexpanthenol, and taurine, which create a protective barrier over the skin and reduce the impact of external irritants 8
• Nonsteroidal, nonantibiotic, anti-inflammatory, and moisturizing agents, which can be used to manage sensitive and delicate skin in the diaper area 8

Prevention and Management

To prevent and manage diaper dermatitis, it is essential to:

• Change diapers frequently to keep the skin dry 4, 5
• Use superabsorbent disposable diapers to reduce moisture 4, 5
• Apply barrier creams and mild topical corticosteroids as needed 4, 5
• Avoid irritants and infections, and seek medical attention if the eruption lasts for more than 3 days or is clinically atypical 5