In pediatric practice, diaper dermatitis is referred to as a contact
type of dermatosis, in most cases it occurs in infants due to wearing diapers
or diapers. Another name for pathology is diaper rash.
The frequency of occurrence of diaper dermatitis in infants (children under 12 months) is associated with the physiological structure of the skin. The immaturity of the epidermis, underdeveloped connective tissue structures of the dermis, unformed thermoregulation and immune response lead to skin damage and a decrease in the protective function. From the photo you can see that the localization of the process is limited to the perineum, inner thighs, anus and buttocks, namely in places of greatest contact with exogenous stimulus.
Factors leading to diaper dermatitis:
- Mechanical. Regular friction against a fabric or a diaper leads to local irritation, hyperemia and microcracks. It is noted in children from 3 to 12 months, which is associated with neuropsychic and physiological development, the activity of movements normally increases. Diaper dermatitis in newborns and babies up to 3 months is due to insufficient hygiene procedures and care. Small size diaper with compression band between the legs.
- Chemical. Contact of the skin with urine (ammonia) and feces (faeces enzymes, opportunistic flora, fatty acids) with an untimely diaper change. A reaction to fragrances, fragrances, alkaline ingredients in soap, laundry detergent, moisturizing oil, cream, or even a diaper.
- Physical. An immature thermoregulatory function with constant wearing of a diaper leads to excessive sweating, a local increase in temperature and humidity (“greenhouse effect”), as a result of which the permeability of the epidermis to chemical compounds and pathogens increases.
- Conditionally pathogenic and pathogenic microflora. Fecal masses act as an irritating factor due to nutritional characteristics, enzymatic activity and bacterial flora of the intestine. Perianal dermatitis develops , especially when using wet wipes rather than rinsing under running warm running water.
A fungal infection may accompany diaper dermatitis in children. The appointment of taking antibacterial drugs leads to a violation of the microflora, an increase in the activity and reproduction of a yeast-like fungus of the genus Candida . The study of the photo helps to see the white layers, which are easily separated from the surface, while the skin is intensely pink or red with ulcerations.
Symptoms of diaper dermatitis
The main symptom complex is hyperemia of the skin, the appearance of dryness, peeling and crusts, after a while weeping joins and vesicles filled with serous fluid form. In advanced cases, the contents of the vesicles become purulent – pustules, tissue edema appears. Microcracks are formed, which quickly turn into ulcers and ulcers.
The general well-being of the child changes, painful sensations appear, often naughty, appetite decreases, sleep is disturbed. Body temperature remains within the age norm, however, when the microbial flora is added, hyperthermia may occur.
According to the severity and features of the course, it is classified:
- mild: moderate hyperemia, pink or pale pink skin, crusts are possible, eliminated by drying and treatment with special solutions;
- medium: there is swelling of tissues with infiltration, skin color from bright pink to burgundy, pustules are characteristic;
- severe: the skin is tense, shiny, red or burgundy in color, pronounced weeping , crusts, ulcerations prone to fusion, deep painful cracks.
The absence of pathogenetic therapy leads to abscessing of the process, severe intoxication, and sepsis is possible. The condition is life-threatening for the baby.
Treatment of diaper dermatitis
The paramount principle in the treatment of diaper dermatitis in infants is proper care and hygiene. With mild to moderate severity, parents can independently prevent dermatosis.
It is recommended to wear disposable diapers, which are changed after each act of defecation and urination; in infants aged 1 to 4 months, the replacement frequency is 8 or more times. After that, the anogenital area is washed under a stream of warm running water with or without hypoallergenic liquid soap. The remaining moisture is blotted with an ironed diaper or towel .
To eliminate inflammation with soft cotton napkins, gently wipe the affected areas of the perineum with a decoction of medicinal herbs. It is impossible to get rid of plaque and crusts by friction. Bathing in a decoction of chamomile, string and calendula is allowed. Mandatory air baths from 10-30 minutes a day.
Treatment of the skin before putting on a diaper. When wet – dry, with crusts and dryness – moisturize. Medications:
- Washing with antiseptic solutions: Furacillin solution ; decoctions of medicinal plants: chamomile, string, oak bark , calendula, oats.
- Combined powders containing trace elements, minerals, talc and zinc oxide.
- Wound healing agents: Dexpanthenol ointment , Bepanten cream , D- panthenol ointment ; cream and paste Zinc Oxide , Desitin cream, Sudocrem ; cream Drapolene .
In some cases, the doctor may prescribe more active anti-inflammatory drugs for a short period – hormonal creams, antibacterial or antifungal drugs.
Sometimes antihistamines are prescribed for children with a burdened allergic history (atopic dermatitis, urticaria, etc.) in order to relieve severe swelling and inflammation. Treatment with the selection of a personal dosage is performed by the attending specialist.
Treatment in newborns of severe diaper dermatitis is carried out in a hospital.
Alternative treatment of diaper dermatitis
Alternative remedies for diaper dermatitis in children are carried out taking into account the accompanying symptoms and the clinical picture, so it is advisable to eliminate the treatment of weeping ulcers with a decoction of chamomile, string, oak bark , St.
Herbal decoction recipes:
- Take in the same proportion dry collection of chamomile, string and calendula (10 grams each), add 250 ml of boiling water, let it brew for 30-35 minutes, pass the mass through a sieve. Decoction wipe the damaged skin and add to the water when bathing.
- 2 tbsp. l. oak bark is brewed with 180 ml of boiling water, insisted for 25-35 minutes, filtered. The resulting solution is applied with a cotton pad on the skin or added to the bath while bathing.
Self-treatment of diaper dermatitis may become ineffective if the medicinal plant is not selected correctly or the required concentration and ratio of ingredients are not observed.
Losterin for diaper dermatitis
In the complex therapy of diaper dermatitis in children, zinc-naftalan paste “Losterin “. The paste is well suited for wounds and ulcers with signs of weeping , contains 2 main components:
- naftalan deresined : resinous compounds perform an antiphlogistic, soothing, antipruritic and drying effect; have an immunocorrective effect, as a result of which they also have an anti-inflammatory and desensitizing effect;
- zinc oxide: has adsorbing, astringent, soothing and drying properties; relieves signs of inflammation and inhibits the reproduction of pathogenic microorganisms; improves normal cell proliferation and promotes the healing of microcracks.
Zinc-naftalan paste Losterin can be prescribed as part of the complex treatment of dermatitis, used as monotherapy during the rehabilitation period, and also used to prevent and maintain the result.
Prevention of diaper dermatitis
Preventive measures are aimed at preventing the development of diaper rash, experts recommend:
- changing the diaper after each act of defecation and urination;
- selection of a diaper with a gel filler, the gel absorbs excess moisture better;
- consider the size and gender of the child when buying a diaper;
- do not apply cream and powder at the same time, the resulting lumps gather in natural folds and irritate the epidermis;
- do not use gauze diapers;
- observe the sleep and wakefulness regimen with air baths;
- carefully remove water droplets by blotting ;
- wearing clothes made from natural fabrics;
- dress your baby according to the season to avoid overheating and excessive sweating;
- in the autumn-spring period, give the child vitamin D to prevent rickets.