Diaper rash, or diaper dermatitis, is an irritating condition that develops on the skin covered by a diaper. It occurs most commonly in infants between ages 9 and 12 months and affects about 7 to 35% of infants at some point.

Fortunately, most cases are short-lived and resolved with home treatment. 

There are two main types of diaper rash: Rashes that are caused or worsened by a diaper (e.g., Irritant dermatitis, Yeast infection, Allergic reaction), Rashes that are not related to diaper use but are present in that area (e.g., Seborrheic dermatitis, Atopic dermatitis, Bacterial infection, Psoriasis, Scabies).

Treatment of diaper rash includes a combination of measures, with ABCDE being a useful way to remember all of these measures:

• A = air out the skin (by going diaper-free)
• B = barrier (a paste or ointment) to protect the skin
• C = cleaning the skin
• D = disposable diapers (using disposable rather than cloth diapers during a rash episode)
• E = educate (how to prevent a recurrence of diaper rash)

Most diaper products contain ingredients like zinc oxide and petrolatum, lanolin, paraffin, dimethicone, etc., which form a protective skin barrier against wetness. White petrolatum is also an inexpensive option.

A child may need an antifungal treatment in case of a yeast infection, which must be prescribed by the physician after the diagnosis. 

In case the child displays signs or symptoms of a skin infection, the healthcare provider may prescribe an antibiotic ointment or oral antibiotic.

If the childs skin becomes severely inflamed, the healthcare provider may recommend a mild, over-the-counter steroid ointment such as 1% hydrocortisone.  

To prevent diaper rash, it is advisable to change the diaper frequently to reduce contact between the skin and urine or feces. Disposable diapers are recommended during an episode of diaper rash because they are highly absorbent and specifically designed to minimize skin exposure to wetness. The caregiver should wash cloth diapers in hot water with bleach. They must clean the skin in the diaper area gently and carefully with warm water and a soft cloth. A mild, fragrance-free soap can be used if desired. Alcohol and fragrance-free Baby wipes should be used; importantly, they must be stopped if the skin becomes irritated or develops open sores. It is advised to use mineral oil applied to a cotton ball to loosen dried feces.

It is also crucial to seek medical advice in cases a child develops a fever (temperature above 100.4°F or 38°C) or has a bloody stool, a change in the pattern of wet or dirty diapers (e.g., constipation, diarrhea, frequent urination, etc.), or any other worrisome signs or symptoms.

Horii KA. Patient education: Diaper rash in infants and children (Beyond the Basics). UpToDate. 2022. https://www.uptodate.com/contents/diaper-rash-in-infants-and-children-beyond-the-basics/print