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Diaper Rash Diaper rash or diaper dermatitis is one of the most common problems in infancy. The diaper area, tightly covered by plastic pants or plastic-covered diapers, is damp and warm. This environment encourages the growth of bacteria and yeast, and increases irritation from urine and stool. It used to be thought that urinary ammonia was a cause of diaper rash, but research has shown that the concentration of ammonia and the strength in a baby’s urine are the same in infants with or without diaper rash. The treatment of diaper rash is most successful if the reason for the diaper dermatitis is found. The baby’s skin may be more sensitive to irritants than that of older individuals. In fact, irritant dermatitis from exposure to urine or frequent, loose stools is the most common cause of diaper rash. Not uncommonly, yeast (candida albicans) may grow in the diaper area and can be found by culture of the area. The use of oral antibiotics (for example for ear infections) may encourage the overgrowth of yeast in the diaper area. Occasionally, bacteria may overgrow in the diaper area and require antibiotic treatment. An allergic reaction from a cream or ointment may also cause a rash in the diaper area. The diaper area should always be kept as dry as possible. When changing the diaper after urination, the area should be dried gently and exposed to air for a short period of time to dry completely. Washing the area each time that the baby urinates may be irritating. If commercial baby wipes are not irritating, they may be used after each bowel movement; if the commercial baby wipes are irritating, plain water may be used to clean after the bowel movement. Studies comparing cloth diapers to plastic covered, disposable diapers are not conclusive, but many doctors feel that the new thin disposable diapers decrease the incidence of diaper rash. Powders with cornstarch may be useful to decrease rubbing in the diaper area. Ointments, such as Desitin, Balmex, A & D ointment, or Triple Paste can prevent the skin from coming in contact with irritants, such as diarrhea. The doctor may prescribe a mild corticosteroid preparation to be applied to the affected areas if an irritant dermatitis is suspected. Yeast infections are best treated by using a prescription antifungal cream for three weeks. 1/01 Treatment Plan Apply the following antifungal times a day / after each diaper change: ______Spectazole cream ______Nystatin cream ______Ketoconazole cream Other: Apply the following anti-inflammatory agent times a day / after each diaper change: ______Hydrocortisone 1% ointment/cream ______Hydrocortisone 2.5% ointment/cream ______Aclovate ointment/cream ______Synalar ointment/cream Cover with a thick coating one of the following diaper rash preparations: - Triple Paste Desitin A & D ointment Zinc oxide paste Johnson & Johnson Diaper Rash Ointment. This is the medical opinion of Savannah River Dermatology. For additional information, please contact our office at 706‐691‐7079. 1/01