Diaper dermatitis
The content of the article:
- Causes and risk factors
- Disease symptoms
- Diagnostics
- Diaper dermatitis treatment
- Potential consequences and complications
- Forecast
- Prevention
Diaper dermatitis is an inflammation of limited areas of the skin caused by mechanical, physical, microbial or chemical factors. The disease in most cases affects children in the first year of life. According to statistics, it is diagnosed in 60-65% of infants. The incidence rate is slightly higher among bottle-fed babies.
Much less often, diaper dermatitis develops in adults. In this case, the disease affects bedridden patients who do not control the processes of urination and defecation, with inadequate hygienic care for them. The appearance of diaper dermatitis in bedridden patients significantly increases the risk of pressure ulcers.
Diaper dermatitis occurs in about 60% of infants
Causes and risk factors
In children of the first year of life, the skin is very delicate and thin. It has the ability to easily absorb substances that fall on its surface. Its protective and barrier functions are underdeveloped. All these age characteristics create the prerequisites for the development of diaper dermatitis in children.
Various factors can provoke the development of the disease:
- mechanical - rubbing against the delicate skin of a baby diapers made of coarse material or clothing seams;
- chemical - prolonged contact of the child's skin with feces or urine;
- physical - increased skin moisture or overheating of the child.
Also, the reason for the development of diaper dermatitis can be poor rinsing of diapers and baby clothes after washing with laundry soap or synthetic detergent, poor-quality diapers and improper use of baby cosmetics (soap, cream, powder).
Diaper dermatitis in adults, as mentioned above, affects bedridden patients. The elderly are more susceptible to the development of the disease. This is due to the fact that they have reduced epidermal regenerative capacity (regeneration). Another risk factor for developing diaper dermatitis in adults is the prescription of digestive enzymes. The fact is that an excess of these enzymes, together with feces, gets on the skin and enhances the phenomenon of maceration.
Disease symptoms
Diaper dermatitis most often affects the skin of the groin folds and perineum, as well as the fold between the buttocks. Somewhat less often, the lesion is localized in the armpits or behind the ears.
The clinical symptoms of diaper dermatitis depend on the severity of the disease. With a mild degree, an edematous hyperemic (reddened) area appears on the skin. Its surface is hotter to the touch than the surrounding healthy skin.
In the absence of the necessary treatment, the symptoms of the disease progress. As a result, the redness of the affected area of the skin becomes brighter, and erosions and cracks appear on its surface, and separate small pustules appear. Touching this area is painful, children react to them with a cry.
Diaper dermatitis stages
Severe diaper dermatitis is characterized by an increase in the surface area of erosion and cracks. The surface of the affected skin begins to become very wet. Often there is a detachment of the affected epidermis, which leads to the formation of poorly healing ulcers.
Skin lesions with diaper dermatitis are accompanied by itching and burning, which causes tearfulness, poor sleep and decreased appetite in children. In adults, severe itching worsens the patient's mental state, causes insomnia, and becomes the cause of a depressive state.
Diagnostics
The diagnosis of diaper dermatitis is usually not difficult and is based on a characteristic clinical picture. In most cases, the disease does not require any laboratory or instrumental diagnostic methods.
If the traditional treatment of diaper dermatitis does not lead to an improvement in the condition of the affected skin, then in this case it is possible to suspect the presence of fungal dermatitis in the child caused by infection with Candida albicans. To confirm the diagnosis, a bacteriological study is performed.
Diaper dermatitis treatment
Diaper dermatitis treatment begins with proper hygienic care for the patient's skin. After each urination and defecation, washing is performed. Then, with gentle blotting movements, the skin is dried and anti-inflammatory ointments or creams are applied to it, which include zinc oxide, dexpanthenol or other active substances.
In the treatment of diaper dermatitis, air baths are widely used, which contribute to better aeration of the affected surface and its drying. Also shown are medicinal baths with decoctions of medicinal plants with disinfecting and tanning properties (oak bark, chamomile). In the absence of signs of infection, physiotherapy methods, in particular phototherapy, can be used.
Air baths for diaper dermatitis promote better healing of the affected surface
Treatment of diaper dermatitis, complicated by the addition of a secondary fungal or bacterial infection, requires topical application of antifungal or antibacterial agents, respectively.
It must be remembered that diaper dermatitis is not an allergic disease, therefore antihistamines and corticosteroids are not used to treat it.
Potential consequences and complications
Damage to the surface of the skin against the background of diaper dermatitis becomes the entrance gate for a secondary infection, the addition of which is manifested by the formation of pustules and a worsening of the course of the disease.
Forecast
The prognosis for diaper dermatitis is favorable. Timely started treatment leads to a rapid improvement in the condition of the skin and complete recovery of the patient.
Prevention
Prevention of the development of diaper dermatitis consists in careful and proper care of the skin of children and bedridden patients and includes the following measures:
- refusal to use baby powder and talcum powder;
- washing away after each urination and bowel movement;
- use of special children's cosmetics (oil, soap, cream, lotion) for skin treatment;
- correct selection of diapers in size;
- prevention of friction of the skin with coarse seams and folds of clothes, diapers;
- application of a special barrier cream under the diaper, which must be applied to the panties area with each diaper change.
To prevent diaper dermatitis, it is important to change diapers regularly (at least 7-8 times a day). They should be changed in the morning, as soon as the baby wakes up, then after each feeding and always before bedtime. If the baby is restless, then the diaper should also be replaced.
Prevention of diaper dermatitis consists in maintaining hygiene and changing diapers frequently
In children, the prevention of diaper dermatitis, if necessary, may include the appointment of vitamin D. A lack of this vitamin leads to the development of rickets, manifested by a violation of the formation of bone tissue, and in addition, accompanied by increased sweating and a violation of the structure of the skin.
Modern disposable three-layer diapers not only absorb moisture well, but also know how to "breathe", that is, they have the ability not to disrupt the process of air exchange, therefore, when using them, the risk of developing diaper dermatitis is significantly reduced.
When choosing diapers, the gender of the child should be taken into account. In boys, when urinating, most of the urine is fixed in the front of the product, in girls, in the back or central. Therefore, different diapers for girls and boys are a hygienic necessity, and not a marketing ploy of companies.
Nowadays, there are even baby diapers on sale that can absorb not only urine, but also feces. The upper hydrophobic layer of these diapers has large pores arranged like a honeycomb. The inner layer includes specially treated cellulose fibers, due to which its absorbency is significantly enhanced.
Leading diaper manufacturers include in their products a special layer of Aloe barbadensis lotion, which has excellent moisturizing, anti-inflammatory, regenerative properties.
Another advantage of modern disposable diapers is their extra soft surface. This is important, because in children of the first year of life, the skin is the most developed and largest sensory organ, therefore the softness of linen and diapers touching it not only reduces the risk of developing diaper dermatitis, but also affects the general condition of children, contributes to their correct emotional development …
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Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
