Why does my baby have NAPPY RASH?

Your baby’s skin is very delicate especially in the first few months after birth. The skin is likely to be irritated by some things such as washing detergent, bathing soap, certain types of fabric, and baby jellies.

One of the most common causes of skin irritation is the effect of napkins or diapers. A baby is likely to develop dermatitis on the buttocks, genitals, lower abdomen, or in the folds of the thigh, a condition that is commonly referred to as diaper or nappy rash.

Your baby’s skin and diapers

The outside layer of skin normally forms a protective barrier, that prevents infection. One of the primary causes of dermatitis in the diaper area is prolonged skin contact with wetness. Under these circumstances, natural oils are stripped away. The outer layer of skin gets damaged, increasing susceptibility to infection by bacteria.

Diaper rash is a term that covers a broad variety of skin conditions, that occur on the same area of the body. Some babies are more prone to diaper rash than others.

Why does my baby get diaper rash?

A baby’s bottom is more susceptible to nappy rash, because of the time spent in the nappy. The skin is exposed to high level of moisture, little air, a host of chemical irritants and infectious organisms present in the urine and the faeces. Friction caused by the rubbing of the nappy against baby’s skin, may also cause a rash.

The skin first gets irritated by the moisture, and is further weakened by the friction caused by the rubbing of the nappy.

Irritating substances, and infectious organisms in the stools and urine facilitate the development of the rash.

Other causes include aggressive and frequent cleaning of the nappy area using harsh soaps, dressing the baby in tight nappies, using rubber pants, or other occlusive fabrics over the diaper area.

Urine itself can also aggravate the condition.

Types of nappy rash                                                                                                                                      There are various types of diaper or nappy rash. Their classification depends on the cause and nature of the rash. The rashes are most severe at 7-9 months and reduce later on as the baby’s skin matures and becomes less sensitive.

Perianal dermatitis                                                                                                                                          This kind of rash is very common in bottle-fed babies. It is characterised by redness around the anus. This redness is caused by the alkalinity of the stool. Babies who are breastfed develop this kind of rash, only when they start taking other kinds of food.

Chaffing dermatitis

This is the most common kind of diaper or nappy rash, that babies experience. The skin is red only where there is most friction but not in the skin folds. This condition often comes and goes. Usually there is no discomfort unless the baby develops an infection in the sore areas.

Atopic dermatitis

This is a kind of skin irritation that develops as an itchy rash. Initially it appears on other parts of the body, then spreads to the diaper or nappy area. It is common in babies aged 6 to 12 months.

Seborrhoeic dermatitis                                                                                                                      Seborrhoeic dermatitis is equivalent to cradle cap, which occurs on the baby’s head. It is scaly and greasy in appearance, and may be worse in the folds of the skin. It is a deep red rash with yellowish scales. The rash may begin from the scalp, or from the nappy area then spread.

Candida dermatitis                                                                                                                                       
Yeast, or candida dermatitis, is the most common infectious cause of diaper rash. The affected areas are raised, and quite red with distinct borders. Satellite lesions may occur around the edges. Yeast is part of the normal skin flora, and is often an opportunistic invader, when simple diaper rash is untreated. It is particularly common after treatment with antibiotics, which kill the good bacteria that normally keep the yeast population in check. Usual treatments for diaper rash will not clear it up. Repeated or difficult to resolve episodes of yeast infection, may warrant further medical attention, since this is sometimes associated with diabetes or immune problems. It appears in the creases between the abdomen and the thighs.

Intertrigo                                                                                                                                                                 In this case, the friction of the skin rubbing against another part of the skin causes a rash. The areas that are mostly affected are the folds of skin between the thighs, the lower abdomen and the armpits. The affected areas, burn on contact with urine leaving a raw area of the skin. This rash appears as reddened areas that may ooze, and is often uncomfortable when the diaper is wet. Intertrigo can also be found on other areas of the body, where there are deep skin folds that tend to trap moisture.

Tide-mark dermatitis                                                                                                                                         
It is a flat, red rash caused by simple chafing of the diaper against tender skin, initiating a friction rash. This type of rash is not seen in the skin folds. It may be more pronounced around the edges of the diaper, at the waist and leg bands. The baby generally doesn’t appear to experience much discomfort.

Sometimes the chemicals or detergents in the diaper are contributing factors, and may result in contact dermatitis. These rashes should clear up easily with proper attention. Ignoring the condition may lead to a secondary infection, that is more difficult to resolve.

Another infectious cause of diaper rash is impetigo. This bacterial infection is characterised by blisters, that ooze and crust.

END: BL 07/54-55

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