Diaper dermatitis is among the three most common skin diseases in small infants all over the world. Changing habits in rural as well as urban communities have increased the frequency of this condition. It is induced by the occlusion of the area covered by diapers due to the use of impermeable disposable diapers or rubber pants. Disposable diapers are convenient though expensive, and therefore not changed with the required frequency. In working households, the problem is often aggravated by the fact that infants are left in the care of either their slightly older siblings or their grandparents, who may not receive adequate instructions on how to deal with the diaper area.

Management

Diaper dermatitis can be prevented by cleaning the anogenital area with water as soon as the infant urinates or defecates. Soap may be an irritant if used often on sensitive skin. Leaving the area uncovered is also useful but may not be practical. Diaper dermatitis is often triggered by an episode of watery diarrhoea, which is usually acidic and more irritating to the skin. Application of a thick, drying cream, such as zinc oxide paste (petroleum jelly 50%, zinc oxide 50%) may prevent skin irritation due to diarrhoea. However, once diaper dermatitis is present, treatment should be addressed to the factors implicated, including humidity, maceration, and secondary infections with bacteria and fungi. Clioquinol, 1-2% powder, can be added to zinc oxide paste to help control secondary bacterial infections. Topical corticosteroids are best avoided in this area.