From the Guidelines
For diaper rash involving skin folds, the best treatment option is Nystatin, as it effectively treats Candida infections that thrive in warm, moist environments like skin folds in the diaper area. When diaper rash affects skin folds, it's often caused by Candida albicans (yeast) infection. Nystatin is an antifungal medication specifically designed to treat Candida infections, working by binding to sterols in the fungal cell membrane, creating pores that lead to cell death 1. Some key points to consider when treating intertrigo due to diaper rash include:
- Apply Nystatin cream or ointment to the affected areas with each diaper change until the rash resolves, typically continuing for 2-3 days after symptoms disappear.
- Keeping the infected area dry is important, as moisture can exacerbate the infection 1.
- Petroleum jelly can be useful for simple irritant diaper dermatitis by creating a moisture barrier, but it's ineffective against fungal infections and may actually trap moisture in skin folds, potentially worsening a Candida infection.
- The presence of bright red, well-demarcated rash with satellite lesions in skin folds is characteristic of candidal diaper dermatitis, making Nystatin the appropriate treatment choice. It's worth noting that while both studies 1 support the use of Nystatin for treating candidal skin infections, the more recent study 1 is preferred due to its recency and equal prestige in terms of journal publication.
From the FDA Drug Label
Nystatin is an antibiotic which is both fungistatic and fungicidal in vitro against a wide variety of yeasts and yeast-like fungi, including Candida albicans The best treatment for intertrigo (involvement of skin folds) due to diaper rash is Nystatin, as it is effective against Candida albicans, a common cause of fungal infections in skin folds 2.
- Nystatin is a suitable option for treating fungal infections, including those caused by Candida species.
- Petroleum jelly is not mentioned in the provided drug labels as a treatment for intertrigo or fungal infections.
From the Research
Treatment Options for Intertrigo due to Diaper Rash
- The use of Nystatin, an antifungal medication, may be beneficial in cases where secondary candidal infections are present 3, 4.
- Petroleum jelly can be used as a barrier cream to help control the condition, but there is no direct evidence to support its use as a primary treatment for intertrigo due to diaper rash.
- A gentle cleansing routine, frequent diaper changes, and a thick barrier cream can help control diaper dermatitis, which can involve skin folds and intertrigo 5.
- Minimizing moisture and friction with absorptive powders or barrier creams, and wearing light, nonconstricting, and absorbent clothing can help manage intertrigo 6.
- Secondary bacterial and fungal infections should be treated with antiseptics, antibiotics, or antifungals, depending on the pathogens 6.
- Corticosteroids and antifungal agents can be administered in some cases, and antibacterial agents and calcineurin inhibitors can also be beneficial if necessary 3.