From the Guidelines
For severe diaper rash, the most effective treatment approach is to use emollient and liners to reduce friction from nappy/diaper elastic on skin, as recommended by the British Journal of Dermatology in 2024 1. This approach is supported by high-level evidence and is considered a key recommendation for managing severe diaper rash. The use of emollient and liners can help to reduce friction and irritation, promoting healing and preventing further skin damage.
Key Recommendations
- Use emollient to clean the nappy/diaper area, as this can help to reduce friction and irritation 1.
- Apply a hydrogel dressing on wounds in the nappy/diaper area to promote healing and protect the skin 1.
- Use a well-fitted nappy/diaper and remove the outer elastic layer around the legs to reduce friction 1.
- Use a nappy/diaper liner covered in emollient to reduce movement of nappy on skin and promote healing 1.
Additional Considerations
- Cloth or disposable nappies/diapers can be used in conjunction with the above recommendations, as long as they are well-fitted and do not cause further irritation 1.
- It is essential to change diapers frequently, ideally as soon as they become wet or soiled, to prevent further skin irritation and promote healing.
- Allow for diaper-free time several times daily to help the area air dry and promote healing.
By following these recommendations, individuals with severe diaper rash can reduce their risk of complications, promote healing, and improve their overall quality of life. As noted in the British Journal of Dermatology in 2024, these recommendations are based on high-level evidence and are considered best practice for managing severe diaper rash 1.
From the FDA Drug Label
When using this product ... Consult a doctor. for the treatment of diaper rash. Stop use and ask a doctor if condition worsens, symptoms persist for more than 7 days or clear up and occur again within a few days The treatment recommendations for severe diaper rash are to consult a doctor. If the condition worsens or symptoms persist, one should stop use and ask a doctor 2.
- For children under 2 years of age, a doctor should be asked before applying hydrocortisone for skin irritation, inflammation, and rashes 2.
- It is essential to follow the doctor's advice for the treatment of severe diaper rash.
From the Research
Treatment Recommendations for Severe Diaper Rash
Severe diaper rash, also known as diaper dermatitis, is an acute inflammatory reaction that occurs in the diaper-covered area. The following are some treatment recommendations based on available evidence:
- Topical skin barrier repair cosmetic products, such as zinc gluconate-taurine/zinc oxide and panthenol/glycerin/Butyrospermum parkii butter barrier cream, may be effective in treating mild to moderate diaper dermatitis 3.
- Novel combinations of topical agents, including zinc gluconate, zinc oxide, dexpanthenol, and taurine, may target multiple mechanisms in diaper dermatitis and provide a new therapeutic approach 4.
- Antifungal pastes, such as clotrimazole or nystatin, may be effective in treating diaper dermatitis complicated by Candida superinfection 5, 6.
- Topical miconazole nitrate ointment may be effective in treating diaper dermatitis complicated by candidiasis 6.
Prevention and Management
Prevention and management of diaper dermatitis involve appropriate skin care practices, such as:
- Cleansing the diaper area with baby wipes or water and a washcloth 7.
- Bathing with a liquid baby cleanser twice weekly 7.
- Applying ointments containing zinc oxide or petrolatum with or without vitamin A 7.
- Using topical barrier creams or ointments to protect the skin from urine and feces 3, 4.
Considerations
It is essential to note that high-quality randomized clinical trials are needed to show the effectiveness of skin care practices for controlling and preventing diaper dermatitis 7. Additionally, the choice of treatment should be based on the severity and cause of the diaper rash, as well as the individual's overall health and medical history.