Nappy Rash (Diaper Dermatitis)

The main factor is dampness due to urine and faeces. The commonest type is irritant contact dermatitis but consider also:

• Candida albicans (invariably present)

• seborrhoeic dermatitis

• atopic dermatitis

• psoriasis

Management

• Keep the area dry

• Change wet or soiled napkins often—use highly absorbable disposable nappies

• Wash gently with warm water and pat dry (do not rub)

• Avoid excessive bathing and soap (can use a soap substitute)

• Expose the bare skin to fresh air wherever possible

• Avoid powders and plastic pants

• With each nappy change, apply a barrier preparation (Vaseline or zinc cream) to protect the area

• Standard treatment for persistent or widespread rash 1% hydrocortisone (alone) or with nystatin or clotrimazole cream, e.g. Hydrozole (qid after changes)—can get separate steroid and antifungal creams and mix before application