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|||The nappy area needs to be kept as dry as possible|
|||Change nappies often|
|||Mild redness of the skin often settles if no nappy is worn|
|||A child without a nappy should not be left lying in urine or faeces|
|||Plastic overpants should not be used if nappies cannot be changed regularly|
|||The nappy area can be cleaned with warm water or a moisturising cream such as sorbolene or aqueous cream|
|||At each nappy change a water repellent moisturiser such as zinc and castor oil cream or vaseline can be applied as a barrier|
|||Avoid the use of soap on the skin|
|||Add a small amount of unperfumed bath oil to the bath|
|||Avoid adding antiseptics and other chemicals to the nappy rinse|
what is it?
where does it occur?
Clearly nappy rashes occur in the area where the nappy is being worn, i.e. in the groin, on the buttocks and on the thighs. The rash occurs only at points of direct contact of the nappy with the skin.
there can be associated rashes away from the areas where the nappy is being
worn. This may indicate that there is some other disease such as eczema, which
is part of the underlying problem that makes the baby have a tendency to nappy
what causes it?
The primary cause is the presence of a wet or dirty nappy in contact with the childs skin. The moisture, plus the friction of the nappy against the skin irritates it and causes the inflammation. This is more likely to happen if a child has sensitive skin already, e.g. it has a tendency to eczema.
the surface of the skin is affected and inflamed secondary infection with bacteria
and thrush (candida) can also play a part. The use of irritants such as soap
and alcohol based nappy wipes can also keep it going or make it worse. The longer
wet nappies are left on the skin between nappy changes, the greater are the
chances of a nappy rash occurring.
how is it treated?
If the nappy is not in contact with the skin, the rash should not occur. Leaving the nappy off when possible will help clear the rash. However it is not practical to leave a child without nappies all the time. Therefore, nappy changes should be as frequent as possible. If the child is left without a nappy, it should not be left lying in urine or faeces. Plastic overpants should not be used if the nappies cannot be changed regularly.
High quality absorbent nappies are the ideal. Cloth nappies should be adequately washed and rinsed. If chemicals such as antiseptics and biological detergents are used they should be thoroughly rinsed out. Fabric conditioners should be avoided when washing nappies.
When the nappy is changed, the skin can be cleaned with warm water or a moisturising cream such as sorbolene or aqueous cream. Soap should be avoided as it will further irritate the inflammation or alter the skin barrier creating a tendency towards inflammation if it hasnt occurred already. Once the nappy area has been cleaned, the skin should be gently patted dry rather than rubbed, and then a water repellent moisturiser such as zinc and castor oil cream or Vaseline can be applied.
If a mild
nappy rash does not settle with simple treatment, or if it becomes severe, then
a doctors advice may be necessary to determine whether cortisone creams
or anticandida treatments are necessary. The doctor may also determine whether
there is an underlying tendency to eczema which is causing the child to develop
the nappy rash. Any eczema will need to be treated and measures taken to prevent
its return in the long term.
Maternal and Child Health nurse.
Your family doctor.
© 2002, Department of Dermatology, St. Vincents Hospital Melbourne, Victoria Parade, Fitzroy, Victoria 3065 Australia.