Nappy rash is the most common inflammatory dermatosis among babies. In fact, it is estimated that this skin condition affects between 7% and 35% of infants in the first years of their life.
Nappy rash affects both sexes equally and it tends to occur between 6 and 12 months of age.
Why does nappy rash occur?
Newborn skin is more susceptible to external irritants. The most important thing in caring for it is maintaining skin integrity, hygiene (with special attention to the genital and nappy areas) and the proper use of soap and emollients.
Moisture, occlusion, maceration, contact with urine and/or faeces, produce an irritant dermatitis in the nappy area, also known as nappy rash.
The inguinal areas and the intergluteal and genital folds are particularly susceptible to irritating, flaking, and exudative conditions, such as irritative or allergic nappy rash or vulvitis or vulvovaginitis in girls.
The nappy occludes the skin, leading to maceration and predisposition to infection and inflammation. The pH of the skin increases when the urine mixes with the faeces, which also contributes to a loss of the epidermal barrier. This explains why the incidence of nappy rash is three to four times higher in children with diarrhoea.
How does nappy rash manifest?
The diagnosis of nappy dermatitis is usually made when there are changes in the colouration of the skin (macules) and the appearance of red and inflamed plaques in that part of the body. In addition, the presence of exudates and ulcerative lesions is very common.
Nappy area dermatitis may simply be irritation from contact with the nappy or may be complicated by a candida superinfection. In cases of severe nappy dermatitis, crusting, thickening of the dermis (lichenification), fissures and scarring may also be seen.
With the onset of the first symptoms of nappy rash, the guidelines to follow should be as follows:
- Bathe the baby every day. It is recommended to bathe the baby every day until the rash disappears, using warm water and a neutral, fragrance-free and hypoallergenic soap. Then be sure to dry the area well by patting and not rubbing. It is advisable to avoid excessive cleaning with baby wipes.
- Keep the nappy area clean and dry. It is important to change the nappy frequently to decrease moisture in the nappy area. Short periods without a nappy are also advised. The application of a protective product that isolates the skin from contact with the nappy, such as, for example, a water-based paste with zinc oxide; this is a good preventive measure, although its use is not recommended if there are erosions on the skin.
- Keep the nappy area ventilated. The nappy should be large enough to allow ventilation to the parts of the body it covers, as well as to ensure as little friction as possible with the skin.
- Combat exudation. The exudation of liquid is one of the main symptoms of nappy rash. To combat it, it is necessary to resort to formulas with drying and astringent active ingredients. This way, the topical anti-inflammatory products that are then applied will be absorbed easier. Finally, you have to apply a nappy rash cream that works as a barrier and prevents the appearance of new bouts of inflammation.