Fungal diaper dermatitis in children. Inflammatory process on delicate skin or diaper dermatitis in children: symptoms and treatment, photo of the disease and rules for caring for the baby. Traditional methods of treatment

Adults often look with envy at the delicate, velvety skin of children, so thin and soft that you just want to touch it with your cheek. However, this sophistication and tenderness needs enhanced protection. Otherwise, the baby’s butt instantly “blooms” and begins to give him mass discomfort. You will learn about what diaper dermatitis is and how to deal with it in this article.

What it is

Diaper dermatitis is an inflammatory process on the skin, localized mainly in the most sensitive places - in the perineum, in the sacral area, in the tender femoral and gluteal folds, in the inguinal folds of the skin. This inflammation worries both the child and his parents quite a lot. The rash can be minor and quite extensive, look like separate rashes or merge into one large eczema; it can be either dry or weeping.

To combat this phenomenon, which affects six out of ten Russian babies, and if hygiene rules care and all ten, humanity invented disposable diapers, however, this only slightly reduced the number of skin diseases.

Diaper dermatitis remains one of the most common complaints with which parents turn to pediatricians.

Why does it happen?

The problem has two main causes: external stimuli and internal factors. In practice, there is always a combination of both.

Internal reasons

Newborn babies have very thin skin that does not have such a developed degree of protection as the skin of adults. It is especially sensitive to any influence - temperature, humidity, the presence of pathogenic microorganisms. It absorbs moisture faster, gets wet, and the pores expand. This structural feature of the dermis is characteristic of children under one and a half to two years old. Then the skin becomes denser and less susceptible to inflammation.

Children who have problems with the balance of beneficial and opportunistic bacteria are most susceptible to diaper dermatitis. Such conditions sometimes occur due to long-term use of antibiotics. Children with reduced immunity after an illness are also more susceptible to negative local effects on the skin. Children who are genetically predisposed to allergies in general and its skin manifestations in particular quite often suffer from diaper dermatitis.

External reasons

External irritants are well known and obvious - these are feces and urine. Diaper dermatitis always occurs due to the fact that the baby's skin comes into contact with ammonia, which is contained in urine, with urea. But the most dangerous combination of urine and feces, because in this case the skin is not only injured by the aggressive environment of urine, but also becomes infected with opportunistic microbes that leave the intestines along with feces. Inflammation develops in conditions of lack of air flow, which is created under a diaper or wet diaper. In such a space it is much easier for bacteria to multiply.

The most aggressive is concentrated urine. It becomes like this during periods of fluid loss by the body.

If a child is sick, his temperature is elevated, if he sweats, then less urine is released. The less urine, the more concentrated it is.

Another external reason is mechanical friction of the diaper. Irritation from diapers is quite painful, especially when urine or feces come into contact with them. Feces themselves can change acidity depending on the child’s nutrition and even without urine can cause quite serious skin lesions. More often, children of the second half of the year suffer from diaper dermatitis, since complementary feeding, which the mother introduces from about 6 months, significantly changes the composition of the intestinal contents, acidity increases, and the composition of urine when eaten not only mother's milk, but also juices, changes significantly.

Supporting factors

A poor-quality diaper that does not retain moisture well is more likely to cause dermatitis in intimate area than a good diaper that separates liquid from feces and is impregnated with a softening balm. But even an excellent and expensive diaper will not save the child from the inflammatory process if parents rarely change it, allow it to overflow, and also wipe the child when changing the diaper rather than wash it.

Violation of hygiene rules - the most common auxiliary factor against which inflammatory processes develop under the diaper. Moreover, violations include not only insufficient water procedures, but also excessive washing, especially if parents use soap for this every time. Soap dries the skin, makes it more fragile and vulnerable, microcracks are more easily formed on it, in which pathogenic bacteria multiply well.

It is enough to use soap only when the baby has pooped himself. If there was no bowel movement, you can simply wash the child plain water. Overheating also affects the appearance of inflammation. If the room is tropically hot, the baby sweats. The temperature under the diaper is higher than outside it; therefore, not only urine and feces, but also the salty environment of sweat act on the skin.

Symptoms and signs

Mothers can easily identify the first symptoms of diaper dermatitis without any special knowledge in the field of medicine:

The child's skin turns red and visibly swells. The affected area may be reddish or deep red and slightly swollen. Inflammation does not have clearly defined boundaries; it is blurred.
Outside the Diaper the skin remains clean and healthy.
The swelling is unevenly distributed. Where there was the closest contact with urine or feces, hyperemia is more pronounced. Nearby there may be “islands” of completely healthy light skin, alternating with other inflamed fragments.

Inflammation changes all the time. If in the morning fragments of redness and swelling looked a certain way, then by lunchtime they can merge, decrease or increase, and change their location.
“Fresh” inflammations are characterized by the appearance of a small, weeping rash. Older foci of inflammation dry out and peel off.

Dermatitis that is associated with a bacterial or fungal infection looks more “picturesque.” In addition to all of the above signs, the affected areas are covered with a serous coating, film, and eczema with loose edges is formed. With fungal diaper dermatitis, the edges of the eczema may be white or grayish.

In general, the child behaves restlessly, cries, eats less willingly and sleeps very poorly. Pain, itching, and tingling intensify significantly immediately after the baby pees, and some time after he has a bowel movement, provided that he does all this in a diaper. With a large area of damage, inflammation can also affect the mucous membranes of the genital organs - under foreskin in boys and the labia minora and the vaginal opening in girls.

Body temperature may rise slightly if the dermatitis is extensive. Minor inflammatory processes are not accompanied by fever.

Diagnostics

The task of a pediatrician is not only to confirm or refute diaper dermatitis in an infant, but also to distinguish it from others skin diseases- atopic or allergic dermatitis, seborrheic inflammation or contact dermatitis. These conditions require different treatments using various medications.

Diaper dermatitis is diagnosed quite easily based on its characteristic visual signs. It can be more difficult to determine which bacterium or fungus caused the secondary inflammation if there is an associated infection.

Treatment

Treatment of diaper dermatitis always begins with a revision of the parents' approach to compliance with hygiene rules when caring for the child. It is important that the diaper is changed as often as possible, without waiting until it becomes too full and bloated. After defecation, changing the diaper is mandatory, with the obligatory washing of the child with warm soapy water. Air baths are very useful, so parents often need to remove the baby’s diaper and allow the skin to “breathe.”

Quite often, mild diaper dermatitis can be dealt with simply by following the rules of hygiene and using air baths.

In case of a more extensive lesion that greatly bothers the child, in addition to the correction of care, the doctor may additionally prescribe some pharmaceutical products. In choosing drugs, he will adhere to the rule “wet - dry, dry - moisturize” . Therefore, for weeping rashes and wet eczema, drying agents such as mash are usually prescribed "Tsindol" or ointment "Desitin". For dry skin in affected areas, mild anti-inflammatory and moisturizing creams are prescribed: "Bepanten", "Drapolen" or children's "Panthenol".

If the doctor determines that a fungal infection has joined the inflammation, he may advise local application nystatin ointment or Clotrimazole. For bacterial complications, use antibiotic ointments. Helps quickly cure bacterial inflammation "Baneotsin" and tetracycline ointment.

Allergy medications are not usually prescribed. If the problem does not resolve within a week, despite the prescribed treatment, then the doctor may recommend hormonal ointments such as "Advantan". Parents will treat the baby at home; there are usually no indications for hospitalization for diaper dermatitis. From folk remedies pediatricians fully approve sea buckthorn oil on dry areas of inflamed skin, washing with chamomile decoction for weeping rashes.

It is strictly forbidden to lubricate inflamed areas of the skin with brilliant green, iodine, or sprinkle generously with powder. You should not wash your child with a solution of potassium permanganate. Manual removal of dried crusts is prohibited to avoid additional infection.

The diaper must be the right size. Disposable panties that are too big or too small only increase the negative mechanical impact on the skin. It is especially important to choose good and high-quality diapers for nighttime sleep, because the child stays in them longer than during the day. Such hygiene products must have excellent ability to absorb liquid. It is best to give preference to diapers with a gel-forming outer layer. All the liquid that gets into them turns into a gel; the baby’s skin, even after a long stay in the diaper, does not come into contact with urine.

For daily hygiene, it is important to use only children's cosmetics and care products. Adult soap or cream is not suitable for children's skin and, in addition to the prerequisites for the development of diaper dermatitis, also creates an excellent platform for the development of contact allergies.
When washing, it is important to ensure that so that a stream of water washes all the folds of the skin, since urine and particles of feces that may remain in them will certainly cause an inflammatory process in the most painful place - in the folded area.

After bathing or washing, you do not need to dry your child with a towel., since this only increases the possibility of causing microtrauma to the skin. It is best to gently blot the skin with a dry and clean diaper.
Opponents of wearing disposable diapers argue that they are harmful and dangerous, especially for boys. This harm is not medically justified and is greatly exaggerated. If a child who grows up in diapers begins to suffer from diaper dermatitis, it makes sense to switch to diapers at least at night.

Manifestations of diaper dermatitis are stronger in children who are on artificial feeding. This is due to the different acidity of the stool that is formed in children fed formula. To minimize risks and save your baby from such a nuisance as diaper rash, you need to carefully consider the choice of the mixture itself. It is best if it is fully adapted for children under 6 months and partially adapted for children from six months.
If parents prefer to use gauze diapers or reusable panty diapers with fabric or gauze inserts, then they should be washed only with baby soap or a special hypoallergenic powder, then boiled for 10 minutes and only then rinsed with cooled, pre-boiled water. This will help reduce the risk of developing inflammation in groin area and in the genital area.

You can learn more about childhood filmic dermatitis from Dr. Komorowski by watching the video below.

Diaper dermatitis is irritation of the skin in areas of contact with a diaper or diaper. Inflammation occurs in newborns and infants, most often at the age of 9–12 months.

Diaper dermatitis plagues adults who are forced to use diapers due to illness. In older children, pronounced irritation and inflammation of the skin is caused by prolonged diarrhea.

Causes

The main provoking factor is poor body hygiene. Regardless of age, the accumulation of irritating substances negatively affects the condition of the skin.

Causes dermatitis:

prolonged contact with urine, feces;
elevated temperature, humidity;
fungal proliferation.

Studies have proven that many children suffering from diaper dermatitis have yeast fungi, the causative agents of candidiasis, found in their stool and intestines. Don't confuse the two diseases. Candidiasis is a more dangerous disease; it must be combated using other methods.

Helpful information:

taking antibiotics against the background of candidiasis infection is one of the causes of unpleasant symptoms on the skin. Instead of antifungal drugs, uninformed people take antibiotics;
The trouble is that antibacterial drugs do not work on yeast fungi. Self-medication and improper therapy lead to the development of a fungal infection with irritation of the epidermis, severe inflammation, the appearance of blisters and small wounds.

Other causes of dermatitis in children:

hereditary, allergic diseases – enteropathic acrodermatitis, atopic dermatitis;
poor diet lacking biotin, zinc, riboflavin;
new hygiene products for the care of baby’s delicate skin;
another brand or type of diaper.

Symptoms of the disease

Disease with bright pronounced signs difficult to confuse with other pathologies:

severe inflammation develops in the area of the buttocks and genitals;
the skin turns red and peels;
in severe cases, weeping areas appear;
sometimes the epidermis becomes covered with small pimples and wounds form;
places greatest inflammation– between the buttocks, in skin folds;
touching the affected areas causes pain; the child is capricious, crying, trying to pull off the diaper.

Note! All symptoms are noticeable in places where the diaper, diaper and skin come into contact. Have you found similar signs behind the ears, on the cheeks? Look for another reason. Your baby has a different pathology.

general information

What does diaper dermatitis look like in children? Symptoms are similar for several types of damage to delicate skin caused by external irritants. Several forms of the disease develop in the diaper or diaper area:

attrition. Mild irritation, often goes away without a trace. Timely hygiene measures prevent complications;
Signs: a small rash of bright red color, blisters covered with yellow scales. Rashes appear in the diaper area and gradually spread higher. The rash does not particularly bother children.
marginal dermatitis. Occurs when the epidermis constantly rubs against the edge of the diaper. Easy to treat, goes away without a trace;
candidal dermatitis. Bright red rash, dry or weeping areas of skin on the buttocks and perineum. If left untreated, pathogens enter the body;
staphylococcal form. The skin is strewn with blisters. Burst blisters become covered with dirty yellow crusts, the skin around them turns red and scars. From the diaper area, the blisters move to the lower abdomen and thighs.

You can find out about oral dermatitis at this address.

Candidiasis diaper dermatitis

Symptoms:

bright red foci of inflammation appear in the inguinal folds and perineal area;
skin – weeping or dry, flaky;
The child is acting restless. Sleep is disturbed, the baby often cries;
specific therapy is required.

Special ointments will help get rid of yeast fungi of the genus Candida albicans - Ketoconazole, Batrafen, Clortimazole, Miconazole. Apply effective products to the affected areas three times a day. The course of treatment is at least a month.

Important! Taking hormonal drugs is prohibited. The use of potent drugs will further weaken the body and complicate the course of the disease.

Treatment methods

In case of inflammation in places of contact with a diaper or diaper consult a doctor. Without laboratory research you can skip the development of a fungal infection.

The following will help eliminate unpleasant symptoms:

proper skin care for your baby;
the use of special ointments, creams;
use of traditional medicine.

How to treat diaper dermatitis in children under one year old? Information for parents:

Change diapers or nappies more often. A day - at least four times;
after urination, defecation, wash the genital area, buttocks warm water. Preferably - flow-through;
Don't miss a single fold. It accumulates there greatest number ammonia, feces, bile salts;
exclude hygienic skin care products. Use only high-quality hypoallergenic soap. Other means are not suitable;
After toileting the buttocks and genitals, gently blot the delicate body, do not rub the inflamed skin. Use a soft terry towel;
treat inflammation areas with lanolin, zinc ointment, Vaseline;
use zinc powder. The product dries and disinfects perfectly.

Do you suspect that the irritation was caused by recently purchased diapers of a different brand or new products for caring for your baby’s delicate skin? Stop using them and monitor the condition of your skin. Are your suspicions confirmed? Get rid of allergens without regret.

Note! If you are trying to eliminate the inflammation, but nothing is working, be sure to visit a doctor in a day or two. It is possible that Candida yeast is active in your baby.

Medications

Use effective means for the treatment of diaper dermatitis in children:

Desitin ointment with zinc oxide heals wounds, tightens the skin, protects against irritants;
cream Bepanten softens the skin, accelerates the regeneration of damaged tissues;
cream Bepanten-plus contains chlorhexidine. The product not only heals, but also disinfects. The composition is effective for pronounced symptoms;
Drapolene cream softens, disinfects, moisturizes. After application, a protective film remains on the epidermis. The remedy is indicated for mild cases of the disease;
drug Dexpanthenol reduces inflammation, accelerates skin restoration;
Baneocin. Powder for external use is indicated for diseases complicated by staphylococcal, streptococcal infection. Contains antibiotics neomycin and bacitracin. Use only on the recommendation of a doctor!

Important! Do you have any ointments with zinc oxide? Find regular Vaseline and lubricate the inflamed areas. Positive reviews deserve formulations with pure lanolin.

Traditional medicine recipes

Combine medications and “grandmother’s methods.” Alternate procedures, note what helps better.

Proven recipes:

baths with medicinal herbs. Take 1 tbsp. l. chamomile, string, calendula, pour 1 liter of boiling water. Let it brew for half an hour. Strain and pour the infusion into the bath. Bathe your baby with a healing infusion several times a day;
oat baths. Take oatmeal, preferably finely ground, put it in gauze, and put it in warm water. Wait until milky white traces of the oatmeal. Bathing duration is 10 minutes. Another option is to pour the strained oat broth into the bath. For 1 glass of raw materials – 1 liter of water.

Diaper dermatitis in adults

Unfortunately, diapers are not just for babies. A useful device is used when caring for disabled people and bedridden patients. The use of a protective agent causes the same problems as in children.

Causes of irritation in the diaper area in adults:

lack of movement;
poor body care in the genital area;
staying in a used diaper for a long time;
taking digestive enzymes that enhance the irritating properties of urine and feces;
weak skin ability to regenerate.

Treatment methods:

rubbing with decoctions of medicinal herbs;
frequent diaper changes;
thorough toilet of the genitals, buttocks, thighs;
air baths. Leave the patient alone for a while underwear. The epidermis will ventilate and dry out;
treatment of folds with ointments with zinc oxide, lanolin, baby powder;
the addition of a fungal infection requires the use of Clotrimazole, Miconazole, Batrafen;
apply Bepanten, D-Panthenol, Desitin to areas of inflammation;
when pathogenic microflora is detected, Baneocin is needed.

Food for thought:

Without careful skin care, bedridden patients develop not only an inflammatory process in the genital area, but also bedsores;
It is easier to monitor the condition of the skin than to treat complications. Both you and the helpless person requiring care will suffer;
it is difficult for the patient to cope with the unpleasant manifestations of dermatitis. Take care of his health, prevent irritation of the epidermis.

Important! Buy diapers by size. Before going to the pharmacy, check the patient’s body weight. Each weight has its own size. Diapers that are too tight will do harm, not good.

Prevention measures

Remember simple rules:

strictly follow the rules of hygiene;
use quality diapers;
change them for newborns after each bowel movement, and for older children - at least three times per day;
Be sure to put on a new diaper before going to bed;
wash the genital area and buttocks of the baby every time after changing the diaper. Use warm running water;
use hygiene products less often, especially with fragrances;
air baths are required. Let the baby be undressed;
treat the epidermis with special ointments with zinc, cream with lanolin, cosmetic petroleum jelly.

When caring for a bedridden patient:

change diapers on time;
treat your skin with products containing zinc and lanolin;
wipe the genital area, all folds with decoctions of string, calendula, chamomile;
after toileting the genitals, allow the skin to breathe without protective equipment;
use powder that dries out the skin.

Careful care, adherence to hygiene rules, and proper selection of diapers will prevent serious damage to the skin - diaper dermatitis. At the first symptoms, consult your doctor and correct your mistakes immediately. It is parents who are most often to blame for irritations on the baby’s skin.

Infants in the first year of life often develop inflammatory skin lesions. The most common phenomenon is diaper dermatitis, which is characterized by redness and irritation of the skin in the groin area, and in advanced cases may be accompanied by the appearance of rashes, pustules, weeping wounds and peeling.

The development of inflammation is facilitated by the characteristics of delicate children's skin, which is sensitive to negative impact external factors: mechanical (wet diapers or diapers), physical (high humidity and temperature), chemical (exposure to ammonia, digestive enzymes). The attachment of microbial agents to inflamed skin can cause complications of dermatitis and have toxic effect on sensitive skin child.

Diaper dermatitis in children in the first years of life is a widespread phenomenon; if unfavorable symptoms appear, you should consult a pediatrician or allergist. A specialist will help you choose the necessary medications and tell you how to treat diaper dermatitis.

Symptoms of diaper dermatitis can appear from the first weeks of a baby’s life, and the peak of the disease occurs from 7 to 12 months, when the diet becomes more varied and complementary foods are added to the baby’s menu. The main factors provoking the development of dermatitis are:

Increased humidity and temperature under diapers or in a diaper
Difficulty in accessing air to the skin
Friction from diapers and clothes
Presence of chemical irritants in urine and feces (ammonia, bile salts)
Infection of the skin with pathogenic microflora or fungi

A favorable background for the occurrence of dermatitis is created due to immaturity skin infants, imperfections of its thermoregulatory and immune function. The development of diaper dermatitis is promoted by congenital allergic diseases (atopic or seborrheic dermatitis), in addition, an irritation reaction may appear in response to improper feeding and early introduction of complementary foods.

In some cases, symptoms of dermatitis occur when using hygiene products or new diapers of the wrong size that chafe the skin.

The development of irritation can be provoked by insufficient hygienic care and a long stay of the baby in dirty diapers. When urine comes into contact with feces, ammonia reacts with uric acid and food enzymes, which increases the irritant effect on the skin.
In some cases, a child has an increased predisposition to the development of diaper dermatitis, which is associated with the skin’s reaction to irritants and a tendency to allergies. This reaction is observed in children with disorders water-salt metabolism, increased levels of ammonia in the urine and intestinal disorders(dysbacteriosis).

Violation of the barrier function of the skin is often accompanied by a secondary infection caused by streptococci or fungi of the genus Candida. In such cases they talk about candidal dermatitis. Often, candidiasis diaper dermatitis develops as a result of treating a child with antibiotics. wide range actions.

These drugs kill bacteria but are ineffective against Candida yeast, which is present in the intestines and stool of most children. As a result, fungal growth increases and the infection attacks the skin.

Thus, the main factors provoking the disease are physiological characteristics skin of babies, and violation of hygienic care rules.

Symptoms

The main symptoms of diaper dermatitis are redness and irritation of the skin in the baby's groin, thighs and buttocks. In areas of direct contact with the diaper, blistering rashes, areas of peeling and weeping may appear. In advanced cases, ulcerations and pustules form on the inflamed skin, and swelling is observed. Irritation and redness in the area anus often occurs in formula-fed children and is caused by alkaline stool.

Redness and inflammation of the skin are observed in places subject to mechanical friction when in contact with diapers or clothing. Persistent diaper rash in skin folds and on the buttocks can appear in children with seborrheic dermatitis. The course of diaper dermatitis has a wave-like character; an exacerbation of symptoms can be caused by any provoking factor, high air humidity, food allergens, or insufficient hygiene.

Candidal diaper dermatitis in children manifests itself by the appearance of pink papules and erythematous plaques, spreading to the groin area, genitals and buttocks. Foci of dermatitis are red spots with jagged edges, the appearance of weeping, painful areas and the spread of pustules are noted. The child becomes restless, capricious, and often cries. If symptoms of diaper dermatitis persist on the skin for more than 72 hours and traditional treatment does not give results, it is assumed that the skin is damaged by a fungal infection.

Depending on the symptoms, diaper dermatitis is usually divided into three degrees:

Easy. There is moderate redness of the skin, the appearance of a rash, peeling and irritation of the inflamed areas.
Average. Inflamed skin becomes covered with papules and erosions, an infiltrate forms in the deep folds of the skin, and the risk of secondary infection increases.
Heavy. Abundant rashes and blisters filled with serous fluid appear. Extensive infiltrates, deep erosions, and wet areas are formed. Dermatitis spreads, involving and affecting large areas of the skin.

In some cases, diaper dermatitis may indicate the development serious illnesses. The child must be seen urgently by a doctor if his temperature has risen sharply, ulcers and severe swelling have appeared on the inflamed skin, and the skin has acquired a purplish-bluish color. Medical assistance It is also necessary in cases where treatment of dermatitis at home for 5-7 days does not give a positive result.

The treatment of diaper dermatitis is based on careful hygiene and proper care. Most manifestations of dermatitis disappear in response to simple measures such as air treatments and frequent diaper changes. Fast treatment Diaper dermatitis is possible if the following rules are observed:

Avoid prolonged contact of the baby's skin with wet diapers or nappies.
Observe temperature regime, do not allow the skin to overheat, do not wrap the child up, choose the right clothes.
After each bowel movement and urination, wash the baby and carefully treat skin folds.
Give the baby air baths, leaving him without clothes for 15-20 minutes several times a day.
Use high-quality disposable diapers that absorb moisture well.
Change diapers every 3-4 hours.

Further treatment tactics will depend on the severity of symptoms. Diaper dermatitis, not complicated by a microbial infection, can be treated fairly quickly with proper hygienic care. If the skin is dry and flaky, use emollient ointments and creams that have an anti-inflammatory and healing effect. If there are weeping areas, creams and ointments with a drying effect, and a variety of powders are prescribed. Good result noted when using ointments containing zinc oxide (Desitin); D-Panthenol and Bepanten ointments are popular. Drapolen cream has excellent antiseptic, disinfectant and healing effects.

After hygiene procedures, the child’s skin must be powdered with special baby powders or lubricated with oils. It is recommended to use hypoallergenic children's cosmetics. These are a variety of gels, cleansing and moisturizing lotions, and body milk. Baby oils after bathing, which create a protective film on the skin, and treatment with creams containing natural ingredients (glycerin, beeswax, plant extracts, mineral oils) have a good effect on the skin.

For the treatment of candidiasis diaper dermatitis is prescribed antifungal ointments(Miconazole, Clotrimazole, Ketoconazole). The treatment regimen, duration and dosage should be recommended by the attending physician. When a fungal infection occurs hormonal drugs are not used, as they can complicate the course of the disease. Treatment should be aimed not only at the external elimination of the fungus, but also at the treatment of candidiasis in the oral cavity and intestines. For this purpose, the drug Defflucan is prescribed for oral administration.

For moderate and severe diaper dermatitis, you can use Bepanten ointment, which contains dexpanthenol. This component has pronounced regenerative properties, quickly heals damaged skin and restores its barrier function. Modern drug It is completely safe and can be used to treat even premature babies.

When a bacterial infection occurs, it is recommended to use the drug Baneocin in the form of powder for powder. Part medicine includes the antibiotics neomycin and bacitracin, which effectively cope with pathogenic microorganisms (staphylococci and streptococci). The powder should be applied to the affected areas after hygienic treatment up to 4 times a day.

Remember that the child should be seen by a doctor if the rash is pronounced and does not go away, but only gets worse after several days of active care. Pay attention to the following warning signs:

Diaper rash and rashes are accompanied by fever
The rash extends beyond the diaper and spreads to other areas of the body
Weeping, blisters and pustules appear on inflamed skin
The child is restless, cries a lot, or is excessively sleepy

These symptoms indicate the development of complications, the addition of a secondary infection and require proper treatment. Do not self-medicate, this may make the situation worse. Only a specialist can make the correct diagnosis and select effective drugs, which will quickly and without harm to the child’s health cope with unpleasant symptoms.

If diaper dermatitis is accompanied by complications, you may need to consult a dermatologist, but usually the disease is quite easy to treat and if preventive measures are followed, the likelihood of relapse of the disease is significantly reduced.

Treatment with folk remedies

Traditional medicine recipes will help you cope with the symptoms of diaper dermatitis. Before using them, do not forget to consult your doctor.

Baths with the addition of a decoction of oak bark, string, celandine, and sage have an excellent drying, soothing and anti-inflammatory effect.

Preventive measures

The main preventative measure aimed at preventing diaper dermatitis is maintaining dry and clean skin. Try to change diapers or diapers as often as possible; this must be done after each bowel movement or urination in newborns and at least 3-4 times a day in older children.

Choose disposable absorbent diapers with a special layer that quickly absorbs liquid and turns it into gel. Try to use only “breathable” diapers and select them according to size to avoid chafing and squeezing the baby’s delicate skin. Clothes and diapers should be made from natural cotton fabrics. They need to be washed with special children's hypoallergenic powders that do not contain alkaline components.

Give your baby air baths several times a day, leaving him naked for 15-20 minutes. Of course, the temperature in the room at this time should be comfortable for the baby. Contact with air is the most reliable and safe means in the treatment of diaper dermatitis.

Wash your baby's perineum thoroughly with cool water after each urination and bowel movement. After water procedures The skin in the genital area and buttocks should be dried with soft wipes and treated with mild protective creams containing lanolin, petroleum jelly, zinc, or apply special oils.

Baby powder will help protect your skin from chafing and irritation. If you experience symptoms of diaper dermatitis, you should stop using alkaline soap, as it dries out the skin. To wash, use mild hypoallergenic soap, or wash your child only with warm water.

When a fungal infection is attached, along with drugs that eliminate Candida fungus, you should use anti-wetting powders and special creams containing antifungal components to treat the skin. During this period, in addition to regularly washing the baby, it is recommended to iron diapers and clothes with a hot iron, and thoroughly wash your hands before any contact with the baby’s skin.

Review your diet and temporarily stop complementary foods in the form of sour juices, fruits and kefir. This will help reduce the acidity of the stool, which causes severe irritation of the skin. Bathe your baby more often, adding to the water decoctions of medicinal herbs that have anti-inflammatory and drying effects (chamomile, oak bark, celandine). These measures will help you quickly cope with the symptoms of diaper dermatitis and prevent its recurrence.

Diaper dermatitis (ND) in newborns is a periodic inflammation of the skin in the buttocks and inner thighs under the influence of a number of factors:

Mechanical - friction of the skin against the fabric of a diaper, gauze or diaper
Chemical – ammonia, fatty acid salts, digestive enzymes
Physical factors– increased humidity and temperature
Microbial factors— Escherichia coli and other pathogenic and opportunistic microorganisms

Causes of PD

The main reason for the development of PD in infants is a violation of hygiene rules. If the diaper is not changed in a timely manner, as well as the use of diapers and gauze, which is generally unacceptable, the impact of the above factors occurs and the risk of inflammation increases.

Microbial flora, in particular fungi of the genus Candida, may also play a role. At the same time, PD is not skin candidiasis, however, a fungal infection can aggravate the course of the disease or contribute to its early appearance in conditions of poor hygiene in the child.

It can also be noted that some children are more susceptible to PD, among them children prone to allergies, with impaired water-salt metabolism, with atopic dermatitis, with immunodeficiency, children with unstable stool or high level ammonia in urine. Artificial feeding may also be one of the factors influencing the development of the disease.

A few words about diapers

Many mothers are faced with assurances from relatives that wearing diapers is harmful. Nothing like this! Diaper dermatitis in children who wear diapers is ten times less common than in children who are simply swaddled or have gauze diapers tied on them. If you follow preventive measures and use modern diapers correctly, the risk of this disease minimal. You should also not stop using diapers early, developing incorrect hygiene habits. Before one and a half years, there is no point in stopping their use; you can learn more about this in articles related to potty training.

Features of the skin in young children.

The skin of a child at this age is still immature: the epidermis is very thin and easily injured, connective tissue there is still little in the dermis, and the basement membrane is very fragile.
A child's skin contains little water.
The skin is easily injured.
Imperfect functioning of the immune system.
Poor thermoregulation.

All these features contribute to the development of PD.

Symptoms of diaper dermatitis

The prevalence of the disease varies from 30 to 50% according to various sources. More common in girls than boys. The process can be local, the affected area can be small and manifest itself as slight redness on the skin, or there can be deep skin damage 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 blisters filled with liquid or in this area. On initial stages hyperemia can be very limited; with time and progression of the disease, the area and depth of the lesion increases.
In severe cases, ulcers appear in the affected area, swelling, ulcerations, and tissue infiltration.
The child becomes restless, cries, sleeps poorly, and appetite may decrease.

Children who are bottle-fed often have PD localized around the anus, since the stool of such children is alkaline, unlike breastfed children.

If mechanical factors predominate, redness appears first in the area of closest contact with the edges of the diaper, which can happen if the diaper size is incorrectly selected. Redness appears in the area of the groin folds, buttock folds and lower abdomen. When other factors are added, hyperemia intensifies.

Diaper dermatitis, complicated by candidiasis, manifests itself as bright red areas localized in the area of folds with whitish ulcers. If PD does not go away with treatment within three days, then it is likely that a fungal infection has occurred.

What does diaper dermatitis look like (Fig. 1) and complicated by candidiasis (Fig. 2)

In what cases is it necessary to interrupt treatment of diaper dermatitis at home and consult a doctor:

Diagnostics

To diagnose this disease, as a rule, examination and history taking are sufficient. Diaper dermatitis can be differentiated from allergic rashes (see), which usually appear after changing baby care hygiene products (diaper wipes, soap, bathing foam, cream), as well as. You should know that.

Treatment

An important question is how and with what to treat PD at home. Treatment includes several simple points.

Proper hygiene care

After the baby has emptied his bowels or bladder, the diaper must be removed.
Rinse the perineum, buttocks, and thighs under warm running water, paying special attention to the folds.
From cosmetics For hygiene, it is permissible to use hypoallergenic baby soap, but you can get by with plain water. It is not recommended to use other products (foam, liquid soap, gel).
Dry the baby's skin by gently patting it with a soft towel. Do not rub your skin with a towel under any circumstances.
Apply a thin layer of a special cream to the affected areas (more about them below).
Leave the child to take an air bath for 20-30 minutes, if possible.

These manipulations must be performed every time you change the diaper.

Use of ointments

The best among them are ointments containing zinc oxide. These include "Desitin". Such ointments have a “tightening” effect and reduce the degree harmful effects mucus and other secretions from the baby.
Antimicrobial ointments, for example, "Drapolen" have an antiseptic effect, perform a protective and moisturizing function.
Ointments containing dexpanthenol, for example, "Bepanten" (Panthenol, Pantoderm) stimulate the healing process and reduce skin inflammation.
Antifungal ointments are used for complications of candida infection; they are prescribed only by a doctor.
In case of severe inflammation, ointments with corticosteroids can be prescribed and they are also prescribed only by a pediatrician.

Never use cream and powder at the same time, as this will result in the formation of small lumps that can injure the baby’s skin!

Prevention

Avoid using powder altogether.
If necessary, use creams under the diaper; you can often even use a cream with dexpanthenol for prevention.
The diaper should be changed after each bowel or bladder movement, that is, on average at least 8 times a day.
Refusal of diapers and gauze diapers.
Consider the sex of the child when choosing diapers, since in this case the best absorption occurs in different areas of the diaper, depending on the sex of the child.
Daily intake of vitamin D in a prophylactic dose from the age of 3 weeks to 3 years (see). When vitamin D levels decrease, immunity decreases and sweating increases, which can cause, among other things, diaper dermatitis.

The incidence of diaper dermatitis has increased since the invention of diapers. This fact has been proven medical research, and the point here is not the poor qualities of the diaper, but mainly the lack of basic knowledge when using it.

Causes

Diaper dermatitis is an irritation of the skin, expressed in the appearance of hyperemia, weeping spots, and rashes. The causes of the disease are trivial factors, among which the first place comes out:

Improper use of diapers;
Chemical irritants contained in urine and feces (contact d-t);
Microorganisms.

Some children have a congenital predisposition to the occurrence of dermatitis, especially AD. This pattern is detected in children whose parents suffer from allergic diseases. They may also have an allergic reaction. The peak incidence of diaper dermatitis occurs when a child is between 6 months and a year old, that is, during the period when the baby becomes more active and his diet begins to be enriched with new foods.

Proper Use The diaper does not harm the baby, moreover, it is convenient for the baby and his mother. The diaper must be changed at least once every 4 hours, otherwise, in a cramped space, the child’s skin begins to get wet, under the influence of humidity and in the absence of air, the child’s skin becomes irritated.

The baby does not have to wear diapers all day; the ideal option is to use them during walks and at night. A high-quality diaper should absorb all the liquid without leaving moisture on the surface, and its size should completely fit the baby’s body.

Symptoms

A slight redness on the buttocks, in the inguinal folds, around the child’s genitals is already defined by a pediatrician as diaper dermatitis. In the future, the first symptoms may be joined by a pinpoint rash and the appearance of weeping spots.

A small child reacts heavily to the slightest irritation of the skin, becomes capricious, lethargic, refuses to eat, and night sleep is disturbed. Inflammation intensifies in those places where the skin is constantly in contact with urine and feces components.

Simultaneous exposure to urine and feces greatly increases the inflammation of irritated skin, large rashes and swelling appear. Signs of the disease intensify in warm and dry weather, as the urine becomes concentrated, which means that a small amount of it contains a large accumulation of ammonia and other caustic compounds.

In children weakened by diseases or premature, the barrier functions of the skin do not function sufficiently and therefore the negative influence of pathogenic microorganisms - fungi, bacteria - can join the usual skin irritation.

When exposed to yeast-like fungi, a condition called candidiasis diaper dermatitis develops. When a fungus is added to the course of diaper dermatitis, the skin condition continues to deteriorate, severe swelling appears, excessive redness of the skin of the body, skin irritation extends to the thighs, covers the entire surface of the buttocks and genitals.

A diagnosis of candidiasis diaper dermatitis is made if regular diaper rash does not go away within three days with proper care. Candidal dermatitis can also occur after treatment of other diseases with antibiotics.

Diaper dermatitis includes different conditions of the skin and therefore has a classification:

Abrasions - the skin turns red in those parts of the body where there is the greatest contact with the diaper, swaddles or onesies. This type of dermatitis is easy and resolves on its own after eliminating the cause.
Regional dermatitis - redness of the skin appears in those places where the baby’s skin comes into contact with the elastic band of diapers, on the thighs.
Perianal dermatitis is redness of the skin in the folds around the anus. Occurs mainly in children who are bottle-fed. The formulas consumed by the child increase the acidity of the stool, which is a skin irritant.
Atopic dermatitis is accompanied by severe itching and irritation of the skin. Symptoms of the disease are also detected on the child’s face, arms, and neck. This form of dermatitis is typical for children older than six months - it is at this time that children begin to try new, sometimes allergenic foods.
Seborrheic dermatitis . In addition to redness and rashes in the groin area, the child develops plaques covered with a greasy yellowish crust on the head and torso.
Candidal dermatitis develops in weakened children and after treatment with antibiotics. Bright red rashes, sometimes pustules, appear in the groin and buttocks.
Impetigo occurs under the influence of staphylococci and streptococci on inflamed skin. Clinical picture is displayed by the appearance of blisters of various shapes, on which a brownish crust appears after opening. The rash can spread to the thighs, abdomen, and back.

May also be relevant for adults

Although diaper dermatitis is predominantly a childhood disease, cases of its occurrence in adults have been reported. For the most part, these are bedridden patients who do not control urination and bowel movements. The urine of adults contains a larger amount of excreted decay products, so signs of dermatitis develop in them at the slightest retention of biological fluid on the skin. The treating patients in most cases are elderly people with reduced skin regeneration; this feature of the body also affects the rapid occurrence of dermatitis.

Inflammation of the skin in adult patients is expressed in its irritation, the appearance of red spots, dryness, and peeling. Skin irritation may increase if the patient is taking enzymes to treat illnesses digestive system. Diaper dermatitis in adults predisposes to the development of bedsores, which are difficult to treat, and their infection can lead to serious complications.

Principles of treatment

Already at the first appearance of symptoms, parents need to know how to treat diaper dermatitis. Delaying the process can lead to secondary infection and extensive skin damage including pathological process not only the upper layer of the epidermis, but also the deep layers.

In the first years of his life, a baby’s skin is quite delicate and does not have the same barrier properties as an adult’s, so the slightest inflammation can cause considerable suffering to your child.

Treatment for diaper dermatitis involves proper care for the skin. It is necessary to change wet diapers and diapers in a timely manner.

After irritation occurs, it is necessary to maximize the contact of the child’s bare skin with air, that is, the baby most must spend the day naked. Try to do without drugs, because main way treatment in in this case– air baths.

Bathing in a decoction of string and a solution of weak potassium permanganate will help reduce skin irritation. If diaper rash occurs after a new complementary food, you need to temporarily exclude it from the diet.

Your doctor may recommend the use of anti-inflammatory creams and ointments, possibly emollients. Good effect Bepanten, D-Panthenol, Tsindol, ointments with lanolin are available; they are applied only to the child’s previously washed and dried skin.

Baneocin powder is applied to skin irritations when a secondary infection occurs - this can only be done on the recommendation of a doctor, because it contains antibiotics. Some mothers manage to use baneocin regularly as a powder as soon as the child develops symptoms. Remember that self-medication with antibiotics is very dangerous.

If you suspect bacterial infection The pediatrician may prescribe a bacteriological culture for a pathogenic pathogen, dysbacteriosis, or a blood test. The principles of treatment of dermatitis in adults are similar to the treatment of the disease in children.

Prevention

Severe diaper dermatitis causes a lot of suffering to the child, so parents should take all measures to prevent the disease. Basic preventive measures They are quite simple and anyone can follow them.

Proper use and selection of diapers. When purchasing, you need to choose models with good air permeability. The diaper should fit perfectly on the child’s body, that is, it should not press or fall off.
Using wet wipes to wipe the skin during walks, in conditions where it is impossible to wash the baby in water. You need to choose baby wipes, and if a rash occurs, change the brand.
The diaper is changed after each bowel movement and at least once every 4 hours. After removing the baby's diaper, you need to wash and treat the folds and skin in the groin area with protective baby cream.
Creams with strong fragrances should not be used on a child’s skin.
The baby should take air baths every day.

Preventative measures and constant skin care will prevent the occurrence of not only diaper rash, but also other more serious skin problems.

3 comments

Hello, please give me some advice. The baby is two months old, a few days ago we switched to other diapers, cheaper ones, and then diaper dermatitis appeared on the bottom. I wash it with string and potassium permanganate, when I wash it, she cries a lot, she has become very capricious. What other effective and safe means can be done

Hello,

Firstly, you should change the diapers back, or switch to regular diapers, at least for a while. At this age, almost everything is prohibited, and any medications will not get rid of the causes and the allergy can progress further.

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All information is presented for educational purposes. Do not self-medicate, it is dangerous! Only a doctor can make an accurate diagnosis.