What treatment is recommended for diaper rash?

Treatment of Diaper Rash

For diaper rash treatment, use zinc oxide barrier cream with each diaper change, especially at bedtime or during prolonged exposure to wetness, after cleansing and drying the affected area thoroughly. 1

First-Line Treatment Approach

• Use emollient and soft cloth liners to reduce friction from diaper elastic on skin 2
• Clean diaper area with emollient ointment rather than water or commercial wipes 2
• For blistered skin, apply a hydrogel dressing such as Intrasite Conformable 2
• Apply zinc oxide barrier cream liberally with each diaper change to protect skin from wetness 1
• Change wet and soiled diapers promptly to minimize skin exposure to irritants 1, 3

Diaper Selection and Modification

• Use well-fitted standard diapers 2
• Trim off inner elastic of disposable diapers to reduce friction 2
• Line diaper with a soft cloth liner coated with emollient or paraffin-impregnated gauze 2
• Superabsorbent disposable diapers can help reduce the incidence of diaper dermatitis 3

Additional Treatment Options

• For mild to moderate cases:

  • Barrier creams containing zinc oxide are the mainstay of therapy 1, 3
  • Novel combinations including zinc gluconate, zinc oxide, dexpanthenol, and taurine have shown promising results 4, 5

• For cases with inflammation:

  • Mild topical corticosteroids may be used short-term to reduce inflammation 3
  • Apply barrier cream to protect skin from wetness 1, 3

Important Considerations and Cautions

• Keep the diaper area as dry as possible - this is the fundamental principle of treatment 3, 6
• Avoid:
  • Tight-fitting diapers that increase friction and occlusion 7
  • Excessive washing of the area 7
  • Alcohol-containing products that may enhance dryness 2
  • Fluorinated topical steroids in the diaper area 7

Treatment Algorithm

1. Frequent diaper changes to keep area dry 1, 3
2. Gentle cleansing with emollient rather than soap or wipes 2
3. Allow area to dry completely before applying barrier cream 1, 6
4. Apply zinc oxide barrier cream liberally 1
5. Use soft cloth liners if needed to reduce friction 2
6. For persistent cases, consider short-term mild topical corticosteroid 3
7. If no improvement or worsening occurs, evaluate for secondary infection or other conditions 3

The ABCDE approach to diaper rash treatment is effective: Airing, Barrier application, Cleansing properly, Diaper selection, and Education of caregivers 6.