Diaper dermatitis what to do. Diaper dermatitis treatment and symptoms, photos

One of the fairly common problems of children in the first year of life is diaper dermatitis. This is the name given to a complex of inflammatory changes in the superficial layers of a baby’s skin caused by exposure to unfavorable and irritating external factors. Diaper dermatitis usually affects the perineum, buttocks, and inguinal folds of a child. Inflammation may also spread to the upper thighs and lumbosacral region.

According to medical statistics, the disease is diagnosed in 35-50% of children in the first year of life. In adults, conditions similar in symptoms to infant diaper dermatitis are also possible. They are usually caused by insufficient hygienic skin care for bedridden patients who are unable to care for themselves and have insufficient control over the functioning of the pelvic organs. In most cases, this is diagnosed.

Why is it developing?

Until the 70s of the 20th century, the leading pathogenetic theory of the occurrence of diaper dermatitis was the so-called “ammonia concept”. The symptoms were thought to be due to long-term exposure to ammonia in the urine. It was this substance that was considered the most aggressive for infant skin. And since the characteristic inflammation occurred only in children who spent a long time in urine-contaminated diapers, dermatitis was called diaper dermatitis. This term is widely used in modern pediatrics.

Currently, views on the causes of diaper dermatitis have been revised. The disease is recognized as polyetiological, with both external and some internal factors having pathogenetic significance. These include:

• Mechanical damage to the epidermis by a diaper, diaper or any fabric adjacent directly to the baby’s skin.
• Swelling and maceration of the keratin layer of the dermis under conditions of high humidity. This is facilitated by untimely changing of diapers/diapers/underwear and the use of absorbent devices with a waterproof layer (oilcloth).
• Softening and damage to the epidermis due to exposure to various aggressive substances from the baby’s urine and feces. The most important are urea and its breakdown products, bile acids, residual amounts of digestive enzymes, and compounds secreted by intestinal microflora. An important pathogenetic point is the breakdown of urea to ammonia under the action of bacterial urease. In some cases, the key factor is altered stool acidity.
• Age-related characteristics of the skin of infants, which determine its insufficient barrier function compared to the dermis of an adult. The epidermis of a baby is thin, saturated with moisture, with a poorly developed keratin layer. The skin is quite loose due to the reduced amount of connective tissue, while it is abundantly supplied with blood and swells easily. All these features contribute to the easy appearance of microdamages with the subsequent development of inflammation.
• Microbial factor. In this case, it is not pathogenic bacteria that are important, but opportunistic microorganisms of the colon and skin microflora.

One child may have several causes of skin lesions at the same time. At the same time, diaper dermatitis does not develop in all children in similar conditions. How does the disease develop and what predisposes to it?

Questions of pathogenesis

Contributing factors include diarrhea, immunodeficiencies of various origins, dysbiosis (including those associated with antibiotic therapy), allergic reactions, and polyhypovitaminosis. Of great importance are systematic errors in everyday hygienic care, irrational use of emulsions, rare bathing, short duration of air baths, refusal of washing in favor of rubbing. Children with atopy, a “lymphatic” constitution, and immaturity of the digestive system at the time of introducing complementary foods are also predisposed to diaper dermatitis.

Despite the widespread availability of disposable care products and ongoing educational activities regarding infant hygiene, exposure to wet diapers (or a soiled diaper) remains the main trigger for diaper dermatitis.

Increased skin moisture increases friction between its surface and adjacent tissue. And the accompanying swelling of the epidermis significantly increases the likelihood of multiple microdamages. In a humid environment, the permeability of the skin barrier also changes, and the susceptibility of tissues to the action of digestive and bacterial enzymes, weak acids and alkalis increases. And urea breakdown products lead to changes in pH on the surface of the skin, which aggravates the situation.

Loose and swollen epidermis can no longer prevent the colonization of various microorganisms and the penetration of various substances. Inflammation occurs in it, which quickly affects the underlying layers of the skin. However, it is rarely aseptic. Under conditions of high humidity and altered acidity, opportunistic microorganisms are activated, which is why fungal diaper dermatitis is often diagnosed. A secondary bacterial infection – staphylococcal or streptococcal – is also possible.

Clinical picture

The main symptoms of diaper dermatitis:

• Redness (hyperemia) and soreness of the skin in the perineum, on the buttocks, inguinal folds, around the anus and genitals. Sometimes it affects the hips and even the sacrolumbar region.
• Lack of clearly defined boundaries between the affected area and healthy skin. Around the lesion there is an area of ​​dim, uneven and gradually fading hyperemia of small size. At the same time, the redness area is limited to the diaper.
• Uneven hyperemia. Often, in the depths of natural skin folds, there are areas of clearing with slightly pronounced signs of inflammation. Increased hyperemia is observed in places where urine flows, around the elastic bands of the diaper. When you have loose, sour, or overly fermented stool, the most pronounced redness appears around the anus.
• Slight swelling of the inflamed skin, due to which the site of inflammation becomes denser to the touch and may be slightly elevated. In severe forms of the disease, infiltration of the entire dermis and even the underlying tissues appears.
• The areas of inflammation are asymmetrical, irregular in shape, and prone to fusion as the disease progresses.
• Dryness, roughness of the affected skin, which is associated with the presence of a small papular rash. It is also possible that fine-plate, uneven peeling may appear, usually at the site of fading areas of inflammation.
• The appearance of a vesicular rash is possible - from single elements to drainage eroding areas. Opening of the blisters leads to the formation of weeping, painful surfaces, which become covered with thin serous crusts as they heal.

Candidiasis diaper dermatitis is accompanied by the appearance of bright, painful, hyperemic areas with multiple confluent erosions. And the addition of a bacterial infection leads to the formation of pustules, increased swelling and redness of the skin.

Associated symptoms

Diaper dermatitis in children is not accompanied by increased body temperature and intoxication. However, when symptoms of this disease appear, a child becomes moody and restless, which is associated with physical discomfort and even pain. His sleep may become worse.

Unpleasant sensations intensify after urination and defecation if the discharge gets into areas of inflamed skin. Therefore, when a child with diaper dermatitis is in a diaper or diaper, parents can note the connection between the time of crying and bowel or bladder emptying. With a widespread inflammatory process, even movements of the legs in the hip joints can cause anxiety in the baby. After all, they are accompanied by friction of the skin in the inguinal and buttock folds, which are often affected by inflammation.

Candidiasis diaper dermatitis

What is diaper dermatitis?

Diaper dermatitis is classified according to severity. In this case, the severity and prevalence of the main symptoms and the presence of signs of infectious complications are taken into account.

• Mild dermatitis. It is characterized by mild, mild hyperemia without obvious swelling and infiltration, and the appearance of foci of small papulo-maculous rash is possible. The source of inflammation occupies a small area and does not significantly affect the well-being and behavior of the child.
• Moderate dermatitis. The hyperemia is quite bright, extensive, accompanied by local swelling or even the appearance of individual foci of infiltration. The rash is predominantly small-papular and profuse. It is possible that individual erosions may appear at the site of single bursting vesicles with serous contents. The existing symptoms have a significant impact on the child’s well-being.
• Severe diaper dermatitis. The zone of pronounced hyperemia covers almost the entire area of ​​the skin under the diaper, often extending into the fold between the pubis and abdomen, thighs, and sacrum. This is accompanied by severe swelling, fairly deep infiltration, and the appearance of multiple deep weeping erosions and ulcerations. The rash is profuse, vesiculopapular and pustular. Severe diaper dermatitis is a consequence of infection and the development of complications.

Stages of diaper dermatitis

Diaper dermatitis is mild to moderate in severity in most cases. However, this disease can occur with various complications, which are mainly associated with secondary infection of tissues. These include the development of gluteal granuloma, abscesses, phlegmon, sepsis. Girls often develop vulvovaginitis.

Staphylococcal diaper dermatitis

Diagnostics

Diagnosis of diaper dermatitis is not difficult. The characteristic localization, appearance of the inflammation focus, infancy and identification of predisposing and provoking factors practically eliminate diagnostic error. Indication by parents (or caregivers) that a child has a rash, diaper rash, or “irritation” of the skin on the buttocks and perineum requires a thorough examination of the baby. In this case, the main task of the doctor is to carry out differential diagnosis and clarify the nature of the background and provoking conditions.

Diaper dermatitis should be distinguished from other types of dermatitis: allergic, contact,. It is important to understand that their presence is not an exclusionary factor. All these forms of skin lesions can contribute to the development of diaper dermatitis, acting as a background and aggravating process. In this case, the doctor will need to make appropriate adjustments to the basic treatment regimen.

Diaper dermatitis is not characterized by the appearance of redness and rash on other parts of the body. If foci of inflammation are detected on the face, flexor surfaces of the arms and legs, atopy and a general allergic reaction should be excluded. Localization of redness mainly in the anus requires examination of the child for intestinal infections, diarrhea syndrome, and enzyme deficiency. And the presence of well-defined diffuse hyperemia and the connection between its appearance and a change in diaper brand are grounds for excluding contact dermatitis.

If signs of infection are detected, it may be necessary to conduct a bacteriological examination of scrapings from inflamed areas of the skin. This is necessary to clarify the type and sensitivity of the pathogen.

Treatment

How to treat diaper dermatitis in a newborn is determined by the doctor. It is important not only to use certain medications, but also to adjust the care provided to the child. Therefore, the most important task of the pediatrician is to teach parents or other caregivers the skills of daily infant hygiene.

Treatment of diaper dermatitis is mainly local. Main groups of prescribed drugs:

• Local agents that promote regeneration and epithelization of affected tissues and have a mild nonspecific anti-inflammatory effect. Most often, ointment and cream for children based on dexpanthenol (Bepanten, D-Panthenol) are used for this purpose. Sea buckthorn oil can be used in consultation with your doctor.
• Agents with anti-inflammatory and drying effects. In mild cases, zinc-based powder is sufficient, but zinc ointment, Tsindol and Desitin are most often prescribed. Fukortsin is used to extinguish erosions.
• If diaper dermatitis is fungal in nature, antimycotic (antifungal) agents are indicated. For this purpose, nystatin ointment, Clotrimazole, and Diflucan are used.
• Bacterial infection is the basis for the use of agents with local antimicrobial action - for example, Baneocin, ointments with erythromycin, tetracycline and other antibiotics.
• Local glucocorticosteroids. The doctor makes a decision on their use if diaper dermatitis does not go away within 5-7 days of adequate therapy. The drug of choice is Advantan. But hormonal ointment, cream or emulsion cannot be used for a fungal infection.
• Antibacterial agents of systemic action - in case of development of purulent complications.
• Antiallergic drugs are not indicated for the treatment of diaper dermatitis. The exception is cases when allergic or contact dermatitis acts as a provoking factor.

As an auxiliary means, in consultation with a doctor, traditional medicine can be used: decoctions and infusions of plants with anti-inflammatory, antimicrobial effects.

Forecast

What parents and caregivers are most interested in is how long it takes for diaper rash to go away. The duration and prognosis of the disease depend on a number of factors: the root cause, the presence of background and predisposing conditions, and the severity of existing symptoms. The timeliness and completeness of treatment and adequate correction of hygienic care for the child are of great importance.

Uncomplicated, mild diaper dermatitis, if you follow the doctor’s recommendations, goes away without a trace within 3-4 days. The absence of irreducible predisposing factors (for example, lymphatic-hyperplastic constitution and insufficiency of cellular immunity) is a favorable sign. In these children, with proper care, symptoms usually do not return.

Rapidly progressing and complicated cases of dermatitis are the basis for classifying a child as at risk for developing a recurrent form of the disease. Unfavorable factors also include the presence of atopy, immunodeficiency, pathology of the digestive system, and social disadvantage of the parents in the infant.

Diaper dermatitis does not contribute to the development of other dermatological diseases and is not prone to transformation. The risk of its re-development is minimized when the child develops hygienic skills and refuses diapers.

Prevention

Adequate care of the skin of the perineum, regular washing and bathing of infants, daily repeated air baths, timely treatment of intestinal disorders and relief of allergic reactions - all this has a preventive effect. It is also important not to wrap the child up, to select the correct size diaper and to correctly combine the daily care products used with each other.

Diaper dermatitis is in most cases curable, its symptoms disappear within a fairly short time. Seeing a doctor early and following his recommendations will help prevent a severe and complicated course of the disease.

Babies in their first year of life often have skin problems. After all, a baby’s skin is very thin and delicate, and the immune system is not yet perfect enough to provide full protection. One of the common problems is diaper dermatitis in a child. Let's figure out what causes this disease, how it can be cured and how to avoid relapses.

Babies in the first year of life are absolutely defenseless and completely dependent on their parents. The skin of infants is thin and velvety, but it does not yet have a sufficient level of protection from negative external influences.

Therefore, in the presence of irritating factors, inflammation appears on children's skin. Let's figure out why diaper dermatitis develops in children and how you can avoid the occurrence of this disease.

general description

Young parents should know what diaper dermatitis is. This term in pediatrics refers to diaper rash that forms on the skin of the buttocks and groin. Inflammation of the skin is accompanied by pain and burning, so it greatly worries the baby.

The redness may be slight, but sometimes the rash covers the entire surface of the buttocks and the top of the legs. The affected surface can be either dry or weeping.

What causes?

It is not for nothing that the disease is called diaper dermatitis; its development is directly related to swaddling or wearing disposable diapers. The causes that cause the development of diaper rash are divided into four groups depending on the type of exposure.

Rubbing

Squeezing and rubbing the body with clothes or underwear provokes a violation of the integrity of the upper layer of the epidermis. And if the irritating factor affects the skin for a long time, then abrasions can develop into dermatitis.

Damage to the skin at the sites of abrasions is an entry point for infections, which is why inflammation develops. Diaper dermatitis develops, caused by mechanical factors, most often in children under the age of one year, since the epidermis of a newborn is very thin, so even a slight impact can lead to the formation of abrasions.

Advice! Dermatitis caused by mechanical rubbing of the skin can develop not only in the groin area, but also in the area of ​​the axillary folds. To avoid the development of the disease, clothes for a newborn are sewn with the seams facing outward so that rough seams do not rub the delicate skin.

Chemical

Diaper dermatitis in infants often develops due to insufficient hygienic care. If a child's diapers are rarely changed, the skin becomes irritated from prolonged contact with urine and feces, which leads to the development of dermatitis.

Another cause of skin irritation in babies is the use of inappropriate cosmetics and hygiene products for skin care, as well as the use of synthetic laundry detergent.

Temperature and humidity

Babies spend most of their time in diapers, and a specific microclimate is created underneath – humid and warm. Such conditions are perfect for the development of fungal infections. Therefore, inflammation in diaper dermatitis is often caused by yeast fungi.

A fungal infection often joins an existing inflammation, which further aggravates the situation. The development of a fungal disease, complicating the course of dermatitis, is especially common in a child who is undergoing antibiotic treatment.

Advice! It should be noted that the widespread distribution of high-quality disposable diapers has significantly reduced the likelihood of developing diaper dermatitis in infants. The fact is that when used correctly, diapers practically eliminate prolonged contact of the skin with physiological secretions. But if you change diapers rarely, then the development of diaper dermatitis in children will be difficult to avoid.

Symptoms

How does this disease manifest itself? Main features:

• redness of the skin in the groin and upper thighs;
• the formation of small bubbles filled with liquid;
• peeling.

At the initial stage of diaper dermatitis, the areas of redness are small. But if timely treatment measures are not taken, the inflammation spreads and can cover large areas of the skin. In severe cases of the disease, the appearance of:

• swelling;
• ulcers;
• infiltrates.

If the disease is complicated by an associated yeast infection, then specific symptoms appear. The affected skin with fungal dermatitis becomes bright red, and a white coating appears on the surface.

Children receiving adapted milk formulas are more susceptible to diaper dermatitis. In this case, inflammation develops in the anus. This is due to the alkaline environment of feces. Breastfed babies do not have this problem.

Dermatitis caused by mechanical causes most often develops on the lower abdomen, upper legs and axillary folds. This is caused by rubbing with improperly chosen clothes and diapers.

Diagnostics

Before starting treatment for diaper dermatitis, it is necessary to correctly diagnose it. Usually, for diagnosis it is enough to perform an examination and collect an anamnesis. It is necessary to exclude allergic dermatitis, which may develop due to the use of a new brand of diapers or other hygiene products. During the diagnostic process, the stage of development of diaper rash is also determined:

• with a mild degree of damage, slight redness of the skin is observed, which quickly disappears subject to hygiene rules and the use of special products;
• in moderate cases, the affected skin acquires a crimson tint, and blisters and pustules may appear on it;
• with severe damage, large weeping areas are observed; as a rule, the course of the disease is complicated by secondary infections, most often fungal.

Treatment

Parents often wonder how to treat diaper dermatitis? First of all, you need to provide good hygienic care for your child's skin. In addition, it is necessary to take measures to stop the inflammatory process.

What can't you do?

Parents should remember that if you have dermatitis, you should not do the following:

• wash affected areas with soap and bathing gels;
• wipe them with alcohol-containing antiseptics or hydrogen peroxide;
• Do not rub the skin to try to remove plaque;
• lubricate the affected areas with brilliant green or sprinkle with baby powder;
• You should not use a solution of potassium permanganate for washing;
• If the affected skin is covered with crusts, then under no circumstances rip them off, this will lead to additional infection.

Such actions will cause pain to the baby and may also cause additional skin irritation.

Proper care

It is very important to provide proper care for newborns. This will avoid the development of diaper dermatitis. And if the disease has already manifested itself, then proper care will become one of the important components of treatment. Recommendations:

• change your child's diapers more often, do not wait until he is full;
• after defecation, changing the diaper is mandatory, and the baby must be washed with warm water and baby foam for bathing;

• Be sure to periodically give your baby air baths, leaving him without diapers or diapers. This allows the skin to “breathe”;
• To wash rompers and diapers, use baby soap or special powders for washing baby clothes;
• If there is slight redness, lubricate the skin with creams for children or.

These simple baby care measures are often enough to cure mild diaper dermatitis.

Medicines

How to treat diaper dermatitis with moderate and severe damage to the skin? In this case, you cannot do without the use of medications. What ointment for diaper dermatitis can be used in treatment? A pediatrician should prescribe ointments for the treatment of the inflammatory process, since individual indications must be taken into account when prescribing.

• In the absence of signs of associated infections, ointments with wound healing properties are prescribed. Most often, ointments containing dexpanthenol are prescribed, for example, Bepanten or D-panthenol. The use of these creams stimulates regeneration, so all wounds heal faster.

Advice! You can use ointments with dexpanthenol not only if diaper dermatitis is being treated, but also to prevent this disease.

• Fungal diaper dermatitis is treated using creams containing antifungal additives. To treat children, they use creams containing clotrimazole; these products not only successfully cure yeast infections, but are also completely safe.
• If there are weeping areas, it is advisable to use creams containing zinc oxide. They dry well and promote faster healing of damage.
• If there are pustules on the skin, then ointments are used that treat bacterial infections, for example, tetracycline or erythromycin.

So, diaper dermatitis in newborns is most often caused by improperly organized care for the baby. If you notice signs of inflammation on the skin, you should not delay treatment. With a mild degree of damage, the disease is cured quickly enough.

Diaper dermatitis in infants is a phenomenon that young parents often encounter. The delicate epidermis of a newborn is sensitive to various inflammations. This often causes: streptoderma, rash, skin irritation. It is important for parents to promptly notice the pathology of the skin under the diaper in order to prevent the development of complications in the inflammatory process.

Diaper dermatitis (what it looks like, symptoms)

Dermatitis often appears in children under one year of age in conditions of excessive humidity and inaccessibility of air. Therefore, it appears under diapers, where a certain chemical reaction of microorganisms takes place. Most often, a child who is kept on artificial feeding suffers.

The photo of diaper dermatitis in children shows that a skin infection may appear:

• on the genitals;
• in the anal area;
• in the groin;
• lower abdomen;
• on the hips.

Diaper dermatitis develops in a child when the skin comes into contact with a dirty diaper for a long time. The combination of urine and feces causes active proliferation of the fungus. The occurrence of skin inflammation is also facilitated by contents getting on the neck when the baby frequently burps. This mass gets under the diaper or clothing, causing irritation on the skin.

The main symptoms of inflammation include:

• redness of baby skin;
• intertrigo;
• erosion;
• wounds;
• crusts.

When the skin is affected, a child becomes very restless, as he is tormented by itching. There are times when the temperature rises. The baby constantly cries, cannot sleep peacefully, and loses his appetite. Similar symptoms occur with psoriasis, in which case it is an excellent choice for its treatment.

This is what the symptoms of diaper dermatitis in children look like in the photo, so treatment should begin as quickly as possible.

How and with what to treat a child

At the first symptoms of a skin rash in a newborn, parents should contact their pediatrician. He first examines the child visually. And then he can refer you to a dermatologist, immunologist, allergist or gastroenterologist.

The doctor carries out other diagnostic methods only when the disease lasts more than three days. The specialist takes a smear from the affected area of ​​the skin to determine the microflora present and understand where the dermatitis comes from and whether it is another disease.

Having studied the symptoms of diaper dermatitis in children, the pediatrician prescribes effective treatment and monitors the result.

Diaper dermatitis in a child can be cured using several methods:

• using healing creams and ointments;
• diet;
• folk remedies;
• prevention.

Therapeutic manipulations are all carried out in conjunction with compliance with the principles of hygiene and attentive care of the child.

Medicines (ointments and creams)

Exposure to constant rubbing of diapers against wet areas provokes the development of diaper dermatitis. The best therapy is medicinal ointments. These are products based on zinc oxide with a tightening effect, dry and block the negative effects of secretions in young children.

The best of them are:

• Zinc ointment;
• Desitin;
• Valiskin;
• Tsindol.

Antimicrobials protect and moisturize the skin. This group of medications includes:

• Drapolene;
• Etonium;
• Bepanten.

Ointments and creams actively influence the healing process and relieve inflammation.

Diaper dermatitis can be caused by a fungal infection called Candida. The development of infection is influenced by weak thermoregulation, imperfect immunity, and the use of antibiotics.

Fungal diaper dermatitis is treated with antifungal agents:

• baby powder with nystatin;
• Amphotericin B;
• Clotrimazole.

To carry out drug therapy, a number of actions should be taken:

1. After emptying, remove the diaper.
2. Rinse your baby's skin well without rubbing it.
3. Arrange air baths for a few minutes.
4. Apply medicated cream or ointment to the affected areas.

Hygienic means when bathing should only be: warm water and hypoallergenic soap.

Traditional methods

Alternative therapy suggests quickly getting rid of diaper dermatitis by bathing in medicinal decoctions once a day. Such procedures have a soothing effect on the skin and reduce pain.


You can prepare herbal infusions:

• from a series;
• dried calendula flowers;
• chamomile inflorescences;
• St. John's wort;
• celandine.

To do this, take 2 large spoons of dry herbs per glass of boiled water. Brew them for half an hour. And then add the broth to the bath. Plants have antiseptic and soothing properties.

The disease can be cured with frequent air baths. It is recommended to perform them all the time when changing a diaper.

If you don’t have a suitable cream or ointment at home, a starch recipe can help. Grind it with streptocide tablets, taking the ingredients in equal portions. Apply it to the buttocks, groin folds and other affected areas of the body. Homemade powder will help to better dry the epidermis and remove inflammation. You should monitor irritants and change diapers more often. You can find out how to treat contact dermatitis at home by clicking on the link.

Nutrition and diet

With diaper dermatitis, parents should reconsider the child's nutritional habits. First of all, it is recommended to temporarily stop giving your baby complementary foods in the form of fermented milk products, fruits and sour juices. This will reduce the acidity of the stool, which causes skin irritation.

With such a disease, you should not neglect your diet:

• eliminate foods that cause allergies;
• do not give yoghurts, kefir;
• provide the body with necessary vitamins.

It is important not to deny your baby breastfeeding. It is what forms the baby’s immune system. Dermatosis in newborns can appear after improper intake of solid foods.

Quick treatment of children from Komarovsky

Komarovsky will help you quickly cure diaper dermatitis with his simple and effective rules. The pediatrician suggests approaching this problem with comprehensive measures.

It is necessary to treat in such a way that the skin comes into contact with air as much as possible. The humidity and temperature in the room should be optimal for the child's body.

If this does not help, medications can be used. However, parents should remember that only those medications that are approved for children under 1 year of age are used for infants.

If your child has allergies, you must be sure to familiarize yourself with the contents of the medicine so as not to cause an allergic effect.

In advanced cases, the famous doctor Komarovsky recommends using lotions and wet-dry dressings. Anti-inflammatory hormones can be applied to skin wounds.

Stages and types of disease

Diaper dermatitis has three stages.

The disease is local in nature, so inflammation occurs in separate areas, most often in the diaper area. From this, the disease is divided into types:

• bacterial;
• seborrheic;
• fungal;
• regional;
• candida;
• staphylococcal impetigo.

Only a doctor can establish an accurate diagnosis of the type of diaper dermatitis by conducting the necessary laboratory tests.

Fungal

Fungal dermatitis is an infectious disease of mycotic etiology. It usually forms under diapers in the form of pustules and swelling. Poor or inadequate nutrition and poor hygiene contribute to the presence of dermatitis.

The danger of this type of infection lies in the toxic and sensitizing properties of fungi on the child’s body. If a specialist has diagnosed a fungal diaper infection, he will immediately prescribe treatment methods with drugs with antifungal and antimicrobial functionality.

Candida

Candidiasis diaper dermatitis matures under the influence of taking antibiotics. The affected areas of the skin may be bright red in color and with many small rashes. Inflammation occurs under the diaper in the groin area and on the buttocks.

A favorable environment for candidiasis is provided by:

• antibiotics;
• elevated temperature;
• prolonged skin contact with a dirty diaper.

If inflammation is left untreated, abrasions, peeling and blisters will appear over time. After urination, pain appears and the child begins to cry.

Prevention

The best treatment for diaper dermatitis in newborns is compliance with preventive measures. Daily and careful child care will guarantee his health.


A number of preventive measures help avoid skin problems:

• keep skin dry and clean;
• change diapers on time;
• Wash your child’s problem areas more often;
• take into account the characteristics of the skin;
• do not rush to give the child a new diaper, let him take air baths;
• Choose diapers of the appropriate size and gender of the child.

The famous children's doctor Komarovsky has his own opinion about the treatment of skin diseases.

Komarovsky's opinion

Diaper dermatitis is associated with the word diaper. This means that all the problems are associated with urine-soaked diapers, which now replace the diaper, and body contact with them. Even with the most caring parents, a child can wake up the next morning with redness on his bottom. In such cases, there is no need to despair. The most effective treatment is an air bath. Leave the baby without a diaper for 30 minutes. Baby skin regenerates very quickly. It just takes two days and the problems will disappear. The main thing parents should pay attention to is that skin irritation can be dry and wet. Wet damage should be treated with products with drying effects, and dry damage with moisturizing effects.

Parents often encounter diaper dermatitis. You should pay attention to the symptoms in time and consult a doctor so as not to worsen the situation. Proper care and simple hygiene rules will help you quickly cope with signs of inflammation and prevent the occurrence of complications on delicate skin.

Diaper dermatitis (ND) in newborns is a periodic inflammation of the skin in the buttocks and inner thighs under the influence of a number of factors:

• Mechanical - friction of the skin against the fabric of a diaper, gauze or diaper
• Chemical – ammonia, fatty acid salts, digestive enzymes
• Physical factors– increased humidity and temperature
• Microbial factors— Escherichia coli and other pathogenic and opportunistic microorganisms

Causes of PD

The main reason for the development of PD in infants is a violation of hygiene rules. If the diaper is not changed in a timely manner, as well as the use of diapers and gauze, which is generally unacceptable, the impact of the above factors occurs and the risk of inflammation increases.

Microbial flora, in particular fungi of the genus Candida, may also play a role. At the same time, PD is not skin candidiasis, however, a fungal infection can aggravate the course of the disease or contribute to its early appearance in conditions of poor hygiene in the child.

It can also be noted that some children are more susceptible to PD, among them children prone to allergies, with impaired water-salt metabolism, with atopic dermatitis, with immunodeficiency, children with unstable stools or with high levels of ammonia in the urine. Artificial feeding may also be one of the factors influencing the development of the disease.

A few words about diapers

Many mothers are faced with assurances from relatives that wearing diapers is harmful. Nothing like this! Diaper dermatitis in children who wear diapers is ten times less common than in children who are simply swaddled or have gauze diapers tied on them. If you follow preventive measures and use modern diapers correctly, the risk of this disease is minimal. You should also not stop using diapers early, as you develop incorrect hygiene habits. Before one and a half years, there is no point in stopping their use; you can learn more about this in articles related to potty training.

Features of the skin in young children.

• The skin of a child at this age is still immature: the epidermis is very thin and easily injured, there is still little connective tissue in the dermis, and the basement membrane is very fragile.
• A child's skin contains little water.
• The skin is easily injured.
• Imperfect functioning of the immune system.
• Poor thermoregulation.

All these features contribute to the development of PD.

Symptoms of diaper dermatitis

The prevalence of the disease varies from 30 to 50% according to various sources. More common in girls than boys. The process can be local, the affected area can be small and manifest itself as slight redness on the skin, or there can be deep skin damage with infiltration.

The main symptoms of PD are:

• Hyperemia (redness) of the skin in the area of ​​the buttocks, perineum and inguinal folds; there may be small blisters filled with liquid or in this area. In the initial stages, hyperemia can be very limited; with time and progression of the disease, the area and depth of the lesion increases.
• In severe cases, ulcers appear in the affected area, swelling, ulcerations, and tissue infiltration.
• The child becomes restless, cries, sleeps poorly, and appetite may decrease.

Children who are bottle-fed often have PD localized around the anus, since the stool of such children is alkaline, unlike breastfed children.

If mechanical factors predominate, redness appears first in the area of ​​closest contact with the edges of the diaper, which can happen if the diaper size is incorrectly selected. Redness appears in the area of ​​the groin folds, buttock folds and lower abdomen. When other factors are added, hyperemia intensifies.

Diaper dermatitis, complicated by candidiasis, manifests itself as bright red areas localized in the area of ​​folds with whitish ulcers. If PD does not go away with treatment within three days, then it is likely that a fungal infection has occurred.

What does diaper dermatitis look like (Fig. 1) and complicated by candidiasis (Fig. 2)

In what cases is it necessary to interrupt treatment of diaper dermatitis at home and consult a doctor:

Diagnostics

To diagnose this disease, as a rule, examination and history taking are sufficient. Diaper dermatitis can be differentiated from allergic rashes (see), which usually appear after changing baby care hygiene products (diaper wipes, soap, bathing foam, cream), as well as. You should know that.

Treatment

An important question is how and with what to treat PD at home. Treatment includes several simple points.

Proper hygiene care

• After the baby has emptied his bowels or bladder, the diaper must be removed.
• Rinse the perineum, buttocks, and thighs under warm running water, paying special attention to the folds.
• When it comes to cosmetic hygiene products, it is permissible to use hypoallergenic baby soap, but you can get by with plain water. It is not recommended to use other products (foam, liquid soap, gel).
• Dry the baby's skin by gently patting it with a soft towel. Do not rub your skin with a towel under any circumstances.
• Apply a thin layer of a special cream to the affected areas (more about them below).
• Leave the child to take an air bath for 20-30 minutes, if possible.

These manipulations must be performed every time you change the diaper.

Use of ointments

• The best among them are ointments containing zinc oxide. These include "Desitin". Such ointments have a “tightening” effect and reduce the harmful effects of mucus and other secretions of the child.
• Antimicrobial ointments, for example, "Drapolen" have an antiseptic effect, perform a protective and moisturizing function.
• Ointments containing dexpanthenol, for example, "Bepanten" (Panthenol, Pantoderm) stimulate the healing process and reduce skin inflammation.
• Antifungal ointments are used for complications of candida infection; they are prescribed only by a doctor.
• In case of severe inflammation, ointments with corticosteroids can be prescribed and they are also prescribed only by a pediatrician.

Never use cream and powder at the same time, as this will result in the formation of small lumps that can injure the baby’s skin!

Prevention

• Avoid using powder altogether.
• If necessary, use creams under the diaper; you can often even use a cream with dexpanthenol for prevention.
• The diaper should be changed after each bowel or bladder movement, that is, on average at least 8 times a day.
• Refusal of diapers and gauze diapers.
• Consider the sex of the child when choosing diapers, since in this case the best absorption occurs in different areas of the diaper, depending on the sex of the child.
• Daily intake of vitamin D in a prophylactic dose from the age of 3 weeks to 3 years (see). When vitamin D levels decrease, immunity decreases and sweating increases, which can cause, among other things, diaper dermatitis.

Diaper rash bothers babies from birth. Mild irritation on the skin can develop into diaper dermatitis, which can turn into a fungal form within 3-4 days. However, this can be avoided by intervening at the right time and providing the necessary care for the child and treatment related to the elimination of the microbial process.

What is diaper dermatitis

Diaper dermatitis is popularly called diaper rash or diaper rash. Although, according to Dr. Komarovsky, it is the use of diapers that reduces the likelihood of this pathology. Diaper dermatitis is an inflammation of the baby's skin caused by environmental influences. Impacts may be:

Unfortunately, skin lesions of this kind in babies are not so rare.

According to statistics, 35–50% of children under the age of 1 year are susceptible to the disease. Girls are more often affected.

Types of diaper dermatitis

Diaper dermatitis can be:

1. Bacterial. The cause of infection may be intestinal enzymes in the stool. The causative agents are staphylococci and streptococci.
2. Gribkov. Irritation and damage to the surface of the skin create conditions for fungi from the external environment to enter the epithelium, which has lost its protective properties. Diaper fungal dermatitis is mostly candidiasis, its causative agent is the yeast fungus Candida albicans. The cause of infection is associated with contact of the damaged area of ​​skin with feces on the diaper. The fungus cannot penetrate if the integrity of the skin is not broken. Damage to the epidermis that provokes penetration of the pathogen: peeling, cracks, abrasions. The danger of fungal infection is due to the fact that it first affects the surface of the dermis, but without being stopped, it is able to penetrate into the deeper layers, destroying skin fiber.

One of the main factors in the effective treatment of fungal dermatitis is the use of ointment in the initial stages to avoid destruction of the skin at a structural level.

Symptoms

The main symptoms of diaper dermatitis are:

• redness;
• rashes;

Inflammation can manifest itself in varying degrees:

• mild - slight redness, rash, skin peeling on the child’s buttocks and genitals;

  Diaper rash on the butt with slight redness is a mild stage of diaper dermatitis, the development of which can be stopped by using a medicinal product

• moderate degree is a complication of mild due to prolonged exposure to the causes of irritation and lack of timely treatment. Characterized by infection with candida bacteria or fungi. The skin reaction is associated with tissue damage;

  With moderate diaper dermatitis, widespread irritation and peeling of the skin is noticeable

• severe (acute) degree is characterized by the presence of a rash, severe redness, erosions, ulcers, swelling and ulcers.

  Bright red skin color is associated with the presence of long-term inflammation of a fungal nature

Causes and development factors

It is important to understand exactly what factors contribute to the worsening of the child’s skin condition in order to prevent complications and stop the development of pathological processes in time. The epidermis of infants is thin and vulnerable, the immunity and thermoregulation of the skin are imperfect. The skin acquires protective properties only by the second year of the baby’s life.

Due to the introduction of complementary foods, the composition of feces changes, and this can provoke an unexpected skin reaction, the care of which must be special. And also one of the risk factors is the predisposition of close relatives to skin diseases.

Child care mistakes:

• violation of temperature conditions and skin ventilation;
• use of gauze, diapers;
• rare diaper changes;
• tight diaper.

Diagnostics

The main way to make a diagnosis is a visual examination by a pediatrician. The doctor makes an assumption about the degree of development of the disease based on the condition of the skin. Mild forms, such as redness and diaper rash, do not require laboratory testing. If visually the skin has undergone significant changes, and the doctor detects signs characteristic of a moderate or severe degree of the disease, then tests are prescribed to determine the type of dermatitis.

Types of analyzes

To identify pathogenic bacteria, the doctor prescribes a general blood test, urine and feces examination for the presence of staphylococci and streptococci.

Mycological analysis is a scraping of the affected area of ​​skin in order to identify the type of pathogen. The most common are Candida fungi, but analysis may show the presence of other forms - dermatophytes and trichophytes. Determining the type of infection allows you to choose the right drugs to neutralize it.

Differential diagnosis is designed to distinguish diaper dermatitis from diseases that have similar symptoms:

• psoriasis;
• atopic dermatitis;
• seborrhea;
• reactions to substances used to treat the skin.

The main distinguishing feature of diaper dermatitis is the localization of irritation on the buttocks and groin. Other types of skin diseases spread, in addition to these areas, to the face and head.

Treatment

Therapeutic measures are related to ensuring proper care of the baby’s skin and the use of medications.

Skin care features:

1. Buttock hygiene. Maintain dryness and cleanliness, in order to avoid complications, avoid contact with feces, so it is recommended that a baby with dermatitis stay in the air without a diaper.
2. Frequent diaper changes.
3. Washing your butt with cotton balls soaked in warm water.
4. Using baby powder, which has a beneficial effect.
5. Using solutions of furatsilin and fucorcin to treat the butt after washing.

The development of pathology can be prevented by using anti-inflammatory drugs when the first microdamage to the epithelium is detected. When treating fungal dermatitis, it is important to start with the use of antibacterial ointments; other means, such as baths and creams, may not have any effect. The drug is used until there is a significant visual change in the skin. After the main redness and rash has gone away, you can switch to creams with panthenol and folk remedies.

Drug therapy: drug table

Pharmacy products - photo gallery

The convenience of applying Panthenol spray consists of spraying directly onto the affected area, which allows you not to touch sensitive skin with your hands. Bepanten cream is a popular product, its price in pharmacies is about 377 rubles. Zinc ointment is an anti-inflammatory and drying agent, and is an inexpensive drug.
Desitin cream is recommended for use at the initial stage of irritation. Emolium is an expensive product, the peculiarity of which is the presence of exotic herbal ingredients in it, which makes the drug ideal for regular use. Levomekol ointment for the treatment of bacterial dermatitis is an inexpensive product, costing about 130 rubles
Advantan ointment contains a hormone that helps stop the inflammatory process. An inexpensive universal drug Clotrimazole is suitable for the treatment of all types of dermatitis, approved for use in infants

Treatment with folk remedies

After fungal dermatitis has been treated with special ointments, and the main symptoms, such as itching and redness, have gone away, the skin needs additional treatment. Folk remedies can only be used as auxiliary methods of therapy.

Folk recipes: table

Duration of treatment, possible complications

The duration of treatment is directly related to the correct diagnosis. With the right means, an improvement can be detected within 2-3 days; if the dermatitis does not go away for a week, two or a month, this means that the drug used does not contain exactly those components that suppress the activity of the pathogen; scraping was not carried out to determine the type of fungus . If the provocateur is not detected, a broad-spectrum ointment is prescribed, active against both bacteria and fungi. If the disease lasts 3–4 days and there is no improvement, complications such as:

• abscess;
• formation of infiltrates on the skin;
• temperature increase.

At the first signs of deterioration of the skin condition, a doctor should be called to your home within 3-4 days after starting treatment.

Bathing for dermatitis

Bathing is a useful hygienic procedure for dermatitis, which helps not only to cleanse the skin, but also has a beneficial effect on the nervous system, because against the background of the disease the baby becomes more restless. You can bathe your child once a day before bedtime.

An infusion of herbs, when added to water, not only has a beneficial effect on the skin, but also has a calming effect on the nervous system.

Features of the procedure:

1. Boil the water.
2. Pour boiled water into the bath and add a previously prepared infusion of chamomile, string or celandine herbs.
3. Measure the water temperature with a thermometer. It should be approximately 37 degrees.
4. Bath your child for 10–20 minutes.
5. When treating dermatitis, do not use shampoo or soap for bathing; you can use special emulsions that are allowed for children from birth.
6. After bathing, pat your body dry with a towel and apply medicinal ointment or cream.

Bathing emulsions: table

Prevention

To avoid the development of skin dermatitis, you must:

• change diapers once every 3 hours;
• after each act of defecation, wipe the butt not with a napkin, but wash it with warm water and soap;
• more often allow the child to lie on an oilcloth with a special diaper placed on it without a diaper; staying in the air during an exacerbation helps to avoid the risk of the spread of germs;
• use a barrier cream, for example, Bepanten;
• stop using gauze diapers.