Atopic dermatitis (eczema)

The term Diaper Dermatitis refers to a red rash in the nappy area. Diaper Dermatitis is also known by the following synonymous terms: Napkin dermatitis, Irritant diaper dermatitis, Diaper rash, Nappy rash and Diaper eczema.

It is important to realize that Diaper Dermatitis is not a specific diagnosis, but simply refers to a red rash in the nappy area that can be caused by a variety of different skin conditions.

The commoner causes of nappy rash are as follows:

 

• Primary irritant dermatitis
• Seborrheic dermatitis
• Atopic dermatitis
• Candida infection
• Allergic Contact Dermatitis
• Psoriasis
• Acrodermatitis Enteropathica (Zinc deficiency)

The are in addition to the above 7 conditions at least another 15 conditions that can present as a Diaper Dermatitis.The overwhelming majority of cases of Diaper Dermatitis are however, caused by Primary irritant dermatitis. This is the result of the irritant effect of urine and faeces on the skin.

Exposure to urine and faeces affects the skin in the following ways:

 

• Urea in urine has a mild irritant effect on skin
• Moistness increases the skins frictional co-efficient and as a result the skin becomes increasingly susceptible to chafing.
• An alkaline enviroment has a direct irritant effect on the skin. The raised Ph is caused by faecal enzymes that reacts with urea in urine to produce ammonia.
• Various enzymes in faeces degrades fats and proteins in the skin.
• Irritated skin becomes very susceptible to Candida and bacterial infection.

The basic treatment of Diaper Dermatitis is therefore to minimize exposure to urine and faeces. That means more regular nappy changes and using more absorbent nappies. Zinc containing barrier creams can help to protect the skin against irritants. Low potency topical corticosteroids can be used on inflamed areas and moisturizers must be used frequently.