Update: October 2018
Diaper dermatitis (PD) in newborns is intermittent
inflammation of the skin in the buttocks and inner thighs under
exposure to a number of factors:
- Mechanical – rubbing the skin against a cloth diaper, gauze or
- Chemicals – ammonia, salts of fatty acids, digestive
- Physical factors – high humidity and temperature
- Microbial factors – Escherichia coli and other microorganisms
pathogenic and conditionally pathogenic
Causes of PD
The main reason for the development of PD in infants is a violation of the rules.
hygiene. При несвоевременной смене the diaper, а также
the use of diapers and gauze, which is generally unacceptable,
exposure to the above factors occurs and the risk increases
the appearance of inflammation.
The role of the microbial flora, in particular the fungi of the genus
Candida. At the same time, PD is not candida of the skin, but fungal
the infection may aggravate the course of the disease or contribute
its early emergence under conditions of hygiene
It may also be noted that some children are more prone to PD,
among them are children prone to allergies, with impaired water-salt
exchange, with atopic dermatitis, immunodeficiency, children with
unstable stool or having a high level of ammonia in the urine.
Artificial feeding can also be a factor
influencing the development of the disease.
Пару слов о the diaperх
Many mothers are faced with the assurances of relatives that they wear
diapers are bad. Neitherчего подобного! Diaper dermatitis in children,
diapers are ten times less common than
children who are simply swaddled or tied with gauze
diapers. With the observance of preventive measures and proper
the use of modern diapers, the risk of this disease
is minimal. It should not be too early to stop using
diapers, forming his wrong hygienic skill.
Before one and a half years it makes no sense to stop using them, about this
More details can be found in the articles on potty training.
Features of the skin in infants.
- The skin of a child at this age is still immature: the epidermis
very thin and easily injured, connective tissue in the dermis is still
small, and the basement membrane is very fragile.
- The skin of the child contains a small amount of water.
- The skin is easily injured.
- Imperfect work of the immune system.
- Bad thermoregulation.
All these features contribute to the development of PD.
Symptoms of diaper dermatitis
The prevalence of the disease varies from 30 to 50% in different
according to More common in girls than boys. Process can
be local, the affected area may be small and
show a slight reddening of the skin, and may be deep
skin lesions with infiltration.
The main symptoms of PD are:
- Hyperemia (redness) of the skin in the area of the buttocks, perineum and
inguinal folds, there may be small bubbles filled with fluid
or peeling in this area. In the initial stages of hyperemia may
be very limited with time and progression
diseases area and depth of damage increase.
- In severe cases, there are ulcers in the affected area,
swelling, ulceration, tissue infiltration.
- The child becomes restless, crying, does not sleep well, can
Breastfed babies often
PD localized around the anus, because the feces of these children have
alkaline environment, in contrast to children on the chest
With the predominance of mechanical factors – redness appears
primarily in the zone of closest contact with the edges
the diaper, что может быть при неправильном подборе размера
the diaper. Redness appears in the area of the inguinal folds,
gluteal folds and lower abdomen. When joining others
factors, hyperemia increases.
Diaper dermatitis complicated by candidiasis
bright red areas localized in the fold area with
whitish ulcers. If PD does not pass during treatment for
three days, it is likely that a fungal infection has joined.
What does diaper dermatitis look like (fig. 1) and complicated
candidiasis (Fig. 2)
When it is necessary to interrupt diaper treatment
dermatitis at home and consult a doctor:
- Dermatitis fever
- The area of the lesion increases dramatically, the skin thickens,
becomes edematous, skin tone changes to purple or
- Delay in physical and / or psychomotor development in the background
- Появление гнойничковых высыпаний на фоне PD
- The lack of effect of treatment for 3-5 days
It is usually sufficient to diagnose this disease.
Inspection and collection history. Differentiate diaper dermatitis
can be with allergic rashes (see rash on the body of a child),
which appear usually after changing hygiene products
child care (napkins, diapers, soap, bathing foam,
cream) as well as atopic dermatitis and hemorrhagic in children. Should
be aware that antibacterial wet wipes cannot be used
An important question is how and how to treat PD in home
conditions. Treatment включает в себя несколько простых пунктов.
Proper hygiene care
- After a baby’s bowel or bladder emptying,
the diaper must be removed.
- Rinse the crotch area, buttocks, thighs under a warm stream
water, pay special attention to the folds.
- From cosmetic products for hygiene is permissible to use
hypoallergenic baby soap, but it is possible to do the usual
water Other means (foam, liquid soap, gel) do not use
- Dry the baby’s skin by gently wetting it with a soft towel. Neither
in any case, do not rub the skin with a towel.
- Apply a thin layer of a special cream to the affected areas (o
they are described in more detail below).
- Leave the child to take an air bath for 20-30 minutes, if
there is a possibility.
These manipulations must be performed at every shift.
Use of ointments
- The best among them are ointments containing zinc oxide. To them
refers to “Desitin.” Such ointments have a “tightening” effect and
reduce the harmful effects of mucus and other secretions
- Antimicrobial ointments, for example, “Drapolen” have
antiseptic, protective and moisturizing
- Ointments containing dexpanthenol, for example, “Bepanten” (Panthenol,
Pantoderm) stimulate the healing process and reduce inflammation
- Antifungal ointments are used for complications of candidal
infection, they are prescribed only by a doctor.
- With severe inflammation, ointments with
и, они также назначаются только
Neitherкогда не используйте крем и присыпку одновременно, так как в
This results in small lumps that traumatize the skin.
- Discard the use of powder at all.
- If necessary, use a cream under the diaper, you can often
even for prophylaxis use a cream with dexpanthenol.
- The diaper change should be after each emptying.
bowel or bladder, that is, on average at least 8 times per
- Disclaimer diapers and gauze diapers.
- Consider the gender of the child when choosing diapers, as in this
case, the best absorption occurs in different areas
the diaper, в зависимости от пола baby
- Daily intake of vitamin D in the prophylactic dose at the age
from 3 weeks to 3 years (see rickets in a child). By reducing the level
Vitamin D decreases immunity, increases sweating, which can
provoke, including diaper dermatitis.
Автор: Ревус Олеся Григорьевна врач-невролог