What is the treatment for diaper rash?

Treatment of Diaper Rash

For diaper rash treatment, use barrier creams containing zinc oxide to protect the infant's skin from moisture and irritants, clean the area with emollients instead of commercial wipes, and ensure the skin is thoroughly dried before applying any products. 1

Assessment and Identification

• Look for signs of bacterial infection (crusting or weeping) or fungal infection in patients with diaper rash, and identify any aggravating factors such as exposure to irritants 1
• Babies with sensitive skin, particularly those with atopic tendencies, may be more susceptible to diaper rash 1
• Diaper dermatitis results from an interaction of multiple factors including increased wetness, elevated pH due to urine, fecal enzymes, and microorganisms under the diaper 2

First-Line Treatment Strategies

• Use emollient to clean the diaper area instead of water or commercial wipes 1
• Apply barrier creams containing zinc oxide or petrolatum to protect the infant's skin from moisture and irritants 1, 3
• Ensure thorough drying of the skin before applying any products to maintain skin dryness and prevent worsening of diaper dermatitis 1
• Keep the diaper area as dry as possible with frequent diaper changes 2
• Use a diaper liner covered in emollient to reduce movement of diaper on skin 1
• For blistered skin in the diaper area, use a hydrogel dressing 1

Advanced Interventions

• For moderate cases, a zinc gluconate-taurine/zinc oxide with panthenol/glycerin/Butyrospermum parkii butter barrier cream applied twice daily has shown significant improvement in erythema after 30 days 4
• Trim off the inner elastic of disposable diapers to reduce friction, and line diaper with a soft cloth liner coated with emollient or paraffin-impregnated gauze 1
• Superabsorbent disposable diapers can help reduce the incidence of diaper dermatitis 2

Important Cautions and Contraindications

• Do NOT use hydrocortisone for the treatment of diaper rash without consulting a doctor 5
• Avoid using commercial wipes containing alcohol or fragrances that can irritate skin 1
• Avoid petrolatum, talc, and fluorinated topical steroidal medications 6
• Children under 2 years of age should not have hydrocortisone applied without consulting a doctor 5

When to Seek Medical Attention

• Seek medical evaluation for appropriate antimicrobial treatment if suspected infection occurs 1
• If the condition worsens or symptoms persist for more than 7 days, consult a healthcare provider 5
• If the rash clears up but returns within a few days, medical attention should be sought 5

Prevention Strategies

• Follow the "ABCDE" approach: Airing, Barrier application, Cleansing of the diaper area, Diaper selection, and Education of caregivers 7
• Use zinc oxide powder after bathing to thoroughly dry the skin 1
• Keep the skin in the diaper area as dry as possible with frequent diaper changes 2
• Bathing with a liquid baby cleanser twice weekly seems comparable with water alone for maintaining skin health 3