DIAPER RASH
You
can't do without diapers but at the same time you
have to deal with problems associated with diapers.
No doubt it is a wonderful invention but still it
causes great discomfort if care is not taken. A
rash in the diaper area might be caused by friction,
irritants, allergies, infections, seborrhea, psoriasis,
diarrhea, or a long list of systemic diseases. Skin
wetness is the common denominator underlying the
various causes of diaper rash. Urinary wetness increases
skin friction, raises the skin pH, makes the skin
less cohesive, and makes it more permeable. These
effects combine to intensify the action of stool
enzymes or other irritants that then inflame the
skin. In all of the diaper rashes mentioned above,
the outermost layer of skin--stratum corneum--has
been damaged. With this protective layer breached,
it is easy for microorganisms such as yeast or bacteria
to invade the inflamed skin. This makes the rash
worse and less responsive to the usual treatments.
Types of rashes:
Irritant rash:
This is most conspicuous on the exposed areas, such
as the round part of the buttocks. It tends to spare
skin folds and creases. It's generally the result
of contact with stool enzymes or irritants such
as harsh soaps, baby wipes, detergents, or topical
medicines.
Allergic rash:
This may occur in combination with an irritant rash
or by itself. It is also more common in exposed
areas. The rash looks like poison oak.
Intertrigo:
Moist heat causes this common type of diaper rash
that occurs deep in the skin folds. The involved
skin looks thin, as if it has lost several layers.
Seborrhea rash:
A salmon-colored, greasy rash with yellowish scales
characterizes this diaper rash that is also worse
in the skin folds.
Psoriasis:
This stubborn rash doesn't necessarily look distinctive.
Other signs of psoriasis usually accompany the diaper
rash, such as pitting of the nails or dark red areas
with sharp borders and fine silvery scales on the
trunk, face, or scalp.
Causes:
Yeast is by far the most common type of organism
found in a diaper rash. The organism is quite prevalent
and thrives in warm, moist skin. Yeast involvement
should be suspected in any diaper rash that has
not improved dramatically with 72 hours of appropriate
therapy. Current or recent antibiotic use makes
a yeast infection even more likely, since this reduces
the amount of the skin's "good" bacteria that fight
infection. Classically, a yeast rash is beefy red
with sharp raised borders and white scales. Small
satellite lesions surround the main rash. Even without
the classic pattern, yeast is often present.
How to prevent diaper rash:
Change dirty diapers as soon as possible, gently
cleaning the diaper area to reduce exposure to urine
and stool. Airing out the diaper area can help prevent
rashes.
Breastfeeding, avoiding unnecessary antibiotics,
and taking yogurt or beneficial bacteria when antibiotics
are needed can prevent diaper rashes.
Treatment:
Normally common diaper rashes are treated with frequent
diaper changes, airing out, and protective lotions
or creams while the baby is in the diaper. Yeast
diaper rashes require the addition of an anti-yeast
cream. The treatment of other specific diaper rashes
varies depending on the specific type.