Diaper Rash

Topic Overview

Diaper rash (diaper dermatitis) is a skin problem caused by the skin staying wet, rubbing from the diaper, and contact with chemicals in the urine and stool. The skin may look red, raw, scalded, or burned. While a diaper rash is uncomfortable, generally it is not a serious problem.

Diaper rash is the most common skin problem in babies and young children, but it can occur at any age if diapers or incontinence briefs are worn. Diaper rash occurs most often in babies between the ages of 9 and 12 months. It often occurs in babies who sleep for many hours without waking so the wet diaper is on them longer.

An adult may develop a rash in the genital area if he or she cannot wash the genital area well, such as while on a long backpacking trip. If an adult does not have complete bowel or bladder control (incontinence), he or she may use incontinence briefs. These briefs can cause skin irritation or a person may be allergic to the perfumes in the material. This type of rash is very similar to a baby's diaper rash. Home treatment measures may help the rash go away.

The skin may blister or peel in severe cases of diaper rash, leaving raw areas that may bleed or ooze fluid. A diaper rash that becomes raw, oozes fluid, or bleeds is harder to treat. Fungal or bacterial infections may be the cause of a severe diaper rash.

The most common causes of diaper rash include:

• Not changing a wet or dirty diaper often enough. The skin becomes irritated from contact with urine and stool, particularly when diarrhea is present.
• Babies starting to eat solid foods. This may change their stools and make diaper rash worse.
• Rubbing of the skin by a diaper or incontinence brief. The irritated area may include the thighs, genitals, buttocks, or belly area.
• A skin reaction to perfumes in disposable diapers or incontinence briefs, to chemicals in skin-cleaning "diaper wipes," or to the detergents or fabric softeners used to clean cloth diapers.

A diaper rash may also be a sign of abuse or neglect.

• Neglect occurs when a caregiver does not treat a diaper rash at the time treatment is needed.
• Abuse occurs when a caregiver purposely does not treat a diaper rash because of anger directed at the child or vulnerable adult.

Sometimes a diaper rash may occur with other skin problems, such as psoriasis, atopic dermatitis, or seborrhea. The rash may be red and oozing. A crust may form, and there will often be similar patches of rash on other parts of the body.

Most diaper rashes last about 24 hours and can be treated at home. The rash clears up when the diapers are changed more often, careful washing and cleaning of the skin is done, or nonprescription ointments are put on the area. Treatment for diaper rash is the same for both children and adults.

Use the Check Your Symptoms section to decide if and when you should see a doctor.

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Author:	Jan Nissl, RN, BS	Last Updated: August 1, 2008
Medical Review:	Michael J. Sexton, MD - Pediatrics H. Michael O'Connor, MD - Emergency Medicine Alexander H. Murray, MD, FRCPC - Dermatology Kathleen Romito, MD - Family Medicine
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