Nappy rash

Nappy rash

Nappy rash is also known as diaper rash, diaper dermatitis or irritant contact dermatitis. 

-       It is  a red rash that occurs on the skin covered by a baby’s nappy. It is  usually the skin is irritated due to the urine and faeces touching baby’s sensitive skin for extended period of time. Could be due to yeast infection (Candida),

Common signs and symptoms of nappy rash 

Small pink spots or blotches around nappy area (mild), bright red rash get bigger (moderate), pimples, blisters, ulcers, large bumps or sore fills with pus (severe).

Baby may cry when passing urine or a bowel motion due to the stinging sensation, older infant may scratch when the diaper is removed.

Common medicines used to treat the condition and how to use the products? 

(a)    Barrier creams eg zinc and castor oil, zinc and shea butter (Vustela Vitamin Barrier Cream)

-       During each nappy change, wash the nappy area with non-soap cleanser, rinse and dry thoroughly and then apply barrier cream onto the nappy area

If nappy rash due to yeast infection,

(b) Topical antifungal medicines eg miconazole , clotrimazole

- Apply to affected are ONCE or TWICE daily. Continue to use 10-14 days when symptoms have cleared.

If nappy rash is inflamed,

(c)   Combination of topical antifungal and corticosteroid eg miconazole + hydrocortisone Resolve Plus or Micreme H 

-       Apply to red/angry area ONCE or TWICE daily. Maximum use of 14 days.

-       Continue to use topical antifungal only (eg miconazole) for 1-week after the rash has cleared up

Resolve pLus 1%

(d)  Healing or soothing preparations

Eg Bepanthen Ointment, Kiwiherb Baby Balm, Lucas Pawpaw Ointment,

-       To reduce redness, soothe, heal and protect the skin

-       Rinse affected area with lukewarm water and apply to affected area after nappy change

Bepanthen is good for skin healing (can be used for treatment and prevention) 

 Referral points  or red flags 

-       Suspected secondary bacterial infection

-       Baby becomes very grumpy and develop a fever

-       The rash get worse or does not go away in 2-3 days

-       The rash spreads to the abdomen, back, arms or face

-       Develops a rash during the first 6-weeks after birth

Advice for the customer (parents or caregivers) 

-       Change cloth or disposable diapers nappies frequently and as soon as possible when wet or soiled and use barrier cream  

-       Keep the skin clean and dry

-       Put diaper on loosely (too tight restrict airflow and irritate the baby’s skin

References

1.     Pharmacy Today Healthcare Guidebook

2.     https://medlineplus.gov/ency/article/000964.htm

3.     http://www.kidshealth.org.nz/nappy-rash