Recommended Treatment for Diaper Rash
For diaper rash treatment, apply zinc oxide barrier cream liberally with each diaper change, especially at bedtime or when exposure to wet diapers may be prolonged. 1
Prevention and First-Line Treatment
- Change wet and soiled diapers promptly to minimize skin exposure to moisture and irritants 1
- Cleanse the diaper area thoroughly and allow to dry completely before applying treatment 1
- Use emollients instead of water or commercial wipes containing alcohol or fragrances that can irritate the skin 2
- Apply zinc oxide barrier cream liberally to protect skin from wetness and prevent further irritation 1
- Consider using zinc oxide powder after bathing to thoroughly dry the skin, which has been associated with reduced rates of skin irritation 2
Advanced Treatment Strategies
- For persistent diaper rash, use a nappy/diaper liner covered in emollient to reduce friction against the skin 2
- Apply wound dressing or additional barrier cream to bony prominences and trauma-exposed sites 2
- For blistered skin in the diaper area, consider using a hydrogel dressing 2
- 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 2
Management of Complicated Diaper Rash
- Look for signs of bacterial infection (crusting or weeping) or fungal infection, which require specific antimicrobial treatment 2
- For diaper rash complicated by candidiasis, miconazole nitrate 0.25% ointment is significantly more effective than zinc oxide/petrolatum alone 3
- Clotrimazole-containing pastes have shown superior efficacy compared to nystatin for treating diaper dermatitis with fungal infection 4
Treatment Approach (A-B-C-D-E)
- Airing: Allow diaper-free time to promote healing 5
- Barrier: Apply zinc oxide barrier cream liberally with each diaper change 1
- Cleansing: Gently clean the area with emollients rather than wipes containing alcohol or fragrances 2
- Diaper selection: Consider using super-absorbent disposable diapers to keep moisture away from skin 2
- Education: Instruct caregivers on proper diaper changing techniques and early intervention 5
Common Pitfalls to Avoid
- Avoid using commercial wipes containing alcohol or fragrances that can further irritate inflamed skin 2
- Don't skip thorough drying of the skin before applying powder or barrier cream 2
- Be aware that babies with sensitive skin, particularly those with atopic tendencies, may be more susceptible to diaper rash and may require more aggressive prevention measures 2
- Don't ignore signs of fungal or bacterial infection, which require specific antimicrobial treatment beyond standard barrier creams 2, 3