From the FDA Drug Label
Directions Change wet and soiled diapers promptly Cleanse the diaper area and allow to dry Apply ointment liberally as often as necessary. With each diaper change, especially at betime or anytime when exposure to wet diapers may be prolonged Uses Helps treat and prevent diaper rash Protects chafed skin due to diaper rash - helps protect skin from wetness The first line treatment for an 11-month-old girl with erythematous, sharply demarcated dermatitis in the diaper area, suggestive of diaper dermatitis (diaper rash), is to:
- Change wet and soiled diapers promptly
- Cleanse the diaper area and allow to dry
- Apply zinc oxide ointment liberally as often as necessary, especially with each diaper change 1, 1
From the Research
The first-line treatment for an 11-month-old girl with erythematous, sharply demarcated dermatitis in the diaper area is a combination of a low-potency topical corticosteroid and an antifungal cream, as this presentation is consistent with candidal diaper dermatitis. Apply 1% hydrocortisone cream and nystatin cream (100,000 units/g) to the affected area with each diaper change for 7-10 days.
Key Considerations
- Keep the diaper area clean and dry by changing diapers frequently, gently cleansing with water or alcohol-free wipes, allowing the skin to air-dry completely before applying medication, and avoiding tight diapers.
- The beefy red appearance with satellite lesions and sharp borders is characteristic of a Candida albicans infection, which commonly occurs in this warm, moist environment, especially after antibiotic use or during teething.
- The antifungal treats the yeast infection while the mild corticosteroid reduces inflammation and discomfort.
Treatment Rationale
- According to 2, a study comparing the efficacy and safety of two antifungal pastes in infants with diaper dermatitis, both clotrimazole and nystatin were effective in reducing symptom scores and achieving clinical cure.
- However, clotrimazole was superior to nystatin in terms of reduction in symptom score and global assessment of clinical response.
- The study 3 also highlights the importance of nonmedical skincare practices, such as using barrier emollients and improved diaper technology, in preventing and treating diaper dermatitis.
Monitoring and Follow-up
- If no improvement occurs within 3-5 days or if the condition worsens, seek further medical evaluation as a different diagnosis or stronger treatment may be needed.
- It is essential to monitor the infant's response to treatment and adjust the treatment plan as needed to ensure the best possible outcome.