The microbiological basis of diaper dermatitis is not frankly established but a better understanding of microbial colonization may help in developing appropriate therapies.

A study characterized and compared the bacterial communities, by using 16S-rRNA gene sequencing technology, obtained from the buttock skin sites of children with diaper dermatitis and healthy controls. The study also describes Bacterial diversity in the buttock lesion area and subsequent recovery after emollient treatment.

 The study found-

• Staphylococcus and Anaerococcus to be predominant in the total skin microbiome, in the buttock skin of children with or without diaper dermatitis.
• The overall skin bacterial richness and diversity are higher in children with diaper dermatitis, on comparing with the healthy group.
• The abundance of Proteobacteria being significantly higher in children with diaper dermatitis, on comparing with the healthy group.
• The richness of Enterococcus, Erwinia and Pseudomonas was significantly higher in the diaper dermatitis group
• the levels of Clostridium and Actinomyces were significantly lower in the diaper dermatitis group than in healthy children.
• The richness of Staphylococcus aureus was significantly higher in the diaper dermatitis group than in healthy children.
• Staphylococcus epidermidis and Bifidobacterium longum was lower in the diaper dermatitis group than in healthy children. Staphylococcus epidermidis and Staphylococcus haemolyticus, the dominant species found in buttock skin, recovered earlier after the disease had improved through emollient treatment.

Thus it was concluded that Staphylococcus epidermidis, as skin probiotic bacterium, and B longum, Clostridium butyricum and Lactobacillus ruminis, the intestinal probiotic bacteria, are significantly decreased in diaper dermatitis lesions. 

These changes in the buttock skin microflora indicate an imbalance in the microflora, further suggesting undergoing dynamic changes in the intestinal microflora. Thus this study suggests that probiotic bacterial supplementation may prove beneficial in the treatment and prevention of diaper dermatitis.

Source: Exp Dermatol. 2019 Nov;28(11):1289-1297. doi: 10.1111/exd.14028. Epub 2019 Sep 16. PMID: 31472099.