Diaper Rash Medication

  • Author: Rania Dib, MD; Chief Editor: Richard G Bachur, MD   more...
 
Updated: May 15, 2012
 

Medication Summary

Medical treatment of diaper rash primarily involves topical corticosteroids to reduce the inflammatory response in irritated areas of skin and antifungal or antibiotic agents to treat secondary infections.

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Corticosteroid, topical

Class Summary

Suppresses inflammation and itching.

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Hydrocortisone topical (Cortizone, Westcort, Dermacort)

 

Adrenocorticosteroid derivative suitable for application to skin or external mucous membranes. Considered lowest potency, but safest topical steroid. It has mineralocorticoid and glucocorticoid effects resulting in anti-inflammatory activity.

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Antifungal agents

Class Summary

For use in candidal diaper dermatitis. Binds to sterols in fungal cell membrane allowing for leakage of cellular contents. Oral antifungals are indicated if coexisting thrush is found.

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Nystatin (Mycostatin, Nilstat)

 

Fungicidal and fungistatic antibiotic obtained from Streptomyces noursei. Effective against various yeasts and yeastlike fungi. Changes permeability of fungal cell membrane after binding to cell membrane sterols, causing cellular contents to leak. Drug is not significantly absorbed from the GI tract.

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Clotrimazole topical (Lotrimin, Mycelex)

 

Broad-spectrum antifungal agent that binds to phospholipids in the fungal cell membrane altering cell wall permeability resulting in a loss of essential intracellular elements.

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Miconazole topical (Monistat)

 

Damages fungal cell wall membrane by inhibiting biosynthesis of ergosterol. Membrane permeability is increased causing nutrients to leak out, resulting in fungal cell death.

Lotion is preferred in intertriginous areas. If cream is used, apply sparingly to avoid maceration effects.

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Ketoconazole topical (Nizoral)

 

Imidazole broad-spectrum antifungal agent. Inhibits synthesis of ergosterol, causing cellular components to leak, resulting in fungal cell death.

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Antibiotics, topical

Class Summary

Used in treating mild bacterial superimposed infections.

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Bacitracin (Baciguent)

 

Prevents transfer of mucopeptides into growing cell wall, inhibiting bacterial growth.

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Antibiotics, oral

Class Summary

Used in treating more aggressive bacterial superimposed infections.

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Amoxicillin and clavulanate (Augmentin)

 

Drug combination treats bacteria resistant to beta-lactam antibiotics.

Indicated for skin and skin structure infections caused by beta-lactamase-producing strains of Staphylococcus aureus. For children > 3 months, base dosing protocol on amoxicillin content; because of different amoxicillin/clavulanic acid ratios in 250-mg tab (250/125) vs 250-mg chewable tab (250/62.5), do not use 250-mg tab until child weighs >40 kg.

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Contributor Information and Disclosures
Author

Rania Dib, MD  Pediatric Senior Specialist, Procare Riaya Hospital, Al Khobar, Saudia Arabia

Disclosure: Nothing to disclose.

Coauthor(s)

A Antoine Kazzi  MD, Deputy Chief of Staff, American University of Beirut Medical Center; Associate Professor, Department of Emergency Medicine, American University of Beirut, Lebanon

A Antoine Kazzi is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Jerry Balentine, DO  Professor of Emergency Medicine, New York College of Osteopathic Medicine; Executive Vice President, Chief Medical Officer, Attending Physician in Department of Emergency Medicine, St Barnabas Hospital

Jerry Balentine, DO is a member of the following medical societies: American College of Emergency Physicians, American College of Osteopathic Emergency Physicians, American College of Physician Executives, American Osteopathic Association, and New York Academy of Medicine

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Wayne Wolfram, MD, MPH  Associate Professor, Department of Emergency Medicine, Mercy St Vincent Medical Center

Wayne Wolfram, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American Academy of Pediatrics, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Richard G Bachur, MD  Associate Professor of Pediatrics, Harvard Medical School; Associate Chief and Fellowship Director, Attending Physician, Division of Emergency Medicine, Children's Hospital of Boston

Richard G Bachur, MD is a member of the following medical societies: American Academy of Pediatrics, Society for Academic Emergency Medicine, and Society for Pediatric Research

Disclosure: Nothing to disclose.

References

  1. Davis JA, Leyden JJ, Grove GL, Raynor WJ. Comparison of disposable diapers with fluff absorbent and fluff plus absorbent polymers: effects on skin hydration, skin pH, and diaper dermatitis. Pediatr Dermatol. Jun 1989;6(2):102-8. [Medline].

  2. Prasad HR, Srivastava P, Verma KK. Diapers and skin care: merits and demerits. Indian J Pediatr. Oct 2004;71(10):907-8. [Medline].

  3. Prasad HR, Srivastava P, Verma KK. Diaper dermatitis--an overview. Indian J Pediatr. Aug 2003;70(8):635-7. [Medline].

  4. Wilson PA, Dallas MJ. Diaper performance: maintenance of healthy skin. Pediatr Dermatol. Sep 1990;7(3):179-84. [Medline].

  5. Adam R. Skin care of the diaper area. Pediatr Dermatol. Jul-Aug 2008;25(4):427-33. [Medline].

  6. Korting HC, Braun-Falco O. The effect of detergents on skin pH and its consequences. Clin Dermatol. Jan-Feb 1996;14(1):23-7. [Medline].

  7. Walsh SS, Robson WJ. Granuloma gluteale infantum: an unusual complication of napkin dermatitis. Arch Emerg Med. Jun 1988;5(2):113-5. [Medline].

  8. Alberta L, Sweeney SM, Wiss K. Diaper dye dermatitis. Pediatrics. Sep 2005;116(3):e450-2. [Medline].

  9. Longhi F, Carlucci G, Bellucci R, di Girolamo R, Palumbo G, Amerio P. Diaper dermatitis: a study of contributing factors. Contact Dermatitis. Apr 1992;26(4):248-52. [Medline].

  10. Borkowski S. Diaper rash care and management. Pediatr Nurs. Nov-Dec 2004;30(6):467-70. [Medline].

  11. Atherton DJ. A review of the pathophysiology, prevention and treatment of irritant diaper dermatitis. Curr Med Res Opin. May 2004;20(5):645-9. [Medline].

  12. Nield LS, Kamat D. Prevention, diagnosis, and management of diaper dermatitis. Clin Pediatr (Phila). Jul 2007;46(6):480-6. [Medline].

  13. Baer EL, Davies MW, Easterbrook KJ. Disposable nappies for preventing napkin dermatitis in infants. Cochrane Database Syst Rev. Jul 19 2006;CD004262. [Medline].

  14. Davies MW, Dore AJ, Perissinotto KL. Topical vitamin A, or its derivatives, for treating and preventing napkin dermatitis in infants. Cochrane Database Syst Rev. Oct 19 2005;CD004300. [Medline].

  15. Ehretsmann C, Schaefer P, Adam R. Cutaneous tolerance of baby wipes by infants with atopic dermatitis, and comparison of the mildness of baby wipe and water in infant skin. J Eur Acad Dermatol Venereol. Sep 2001;15 Suppl 1:16-21. [Medline].

  16. Gallup E, Plott T. A multicenter, open-label study to assess the safety and efficacy of ciclopirox topical suspension 0.77% in the treatment of diaper dermatitis due to Candida albicans. J Drugs Dermatol. Jan-Feb 2005;4(1):29-34. [Medline].

  17. Adalat S, Wall D, Goodyear H. Diaper dermatitis-frequency and contributory factors in hospital attending children. Pediatr Dermatol. Sep-Oct 2007;24(5):483-8. [Medline].

  18. Atherton D. Maintaining healthy skin in infancy using prevention of irritant napkin dermatitis as a model. Community Pract. Jul 2005;78(7):255-7. [Medline].

  19. Atherton D, Mills K. What can be done to keep babies' skin healthy?. RCM Midwives. Jul 2004;7(7):288-90. [Medline].

  20. Berg RW. Etiology and pathophysiology of diaper dermatitis. Adv Dermatol. 1988;3:75-98. [Medline].

  21. Berg RW, Buckingham KW, Stewart RL. Etiologic factors in diaper dermatitis: the role of urine. Pediatr Dermatol. Feb 1986;3(2):102-6. [Medline].

  22. Brook I. Microbiology of secondarily infected diaper dermatitis. Int J Dermatol. Oct 1992;31(10):700-2. [Medline].

  23. Buckingham KW, Berg RW. Etiologic factors in diaper dermatitis: the role of feces. Pediatr Dermatol. Feb 1986;3(2):107-12. [Medline].

  24. Heimall LM, Storey B, Stellar JJ, Davis KF. Beginning at the bottom: evidence-based care of diaper dermatitis. MCN Am J Matern Child Nurs. Jan-Feb 2012;37(1):10-6. [Medline].

  25. Herbert J. The prevention and treatment of nappy rash. Some fresh insights into an old problem. Prof Care Mother Child. 1997;7(3):67-70. [Medline].

  26. Honda M. Differential diagnosis of unusual skin diseases in infants. Pediatrician. 1987;14 Suppl 1:15-7. [Medline].

  27. Janniger CK, Thomas I. Diaper dermatitis: an approach to prevention employing effective diaper care. Cutis. Sep 1993;52(3):153-5. [Medline].

  28. Jordan WE, Lawson KD, Berg RW, Franxman JJ, Marrer AM. Diaper dermatitis: frequency and severity among a general infant population. Pediatr Dermatol. Jun 1986;3(3):198-207. [Medline].

  29. Lin RL, Tinkle LL, Janniger CK. Skin care of the healthy newborn. Cutis. Jan 2005;75(1):25-30. [Medline].

  30. Obalek S, Janniger C, Jablonska S, Favre M, Orth G. Sporadic cases of Heck disease in two Polish girls: association with human papillomavirus type 13. Pediatr Dermatol. Sep 1993;10(3):240-4. [Medline].

  31. Rasmussen JE. Classification of diaper dermatitis: an overview. Pediatrician. 1987;14 Suppl 1:6-10. [Medline].

  32. Scheinfeld N. Diaper dermatitis: a review and brief survey of eruptions of the diaper area. Am J Clin Dermatol. 2005;6(5):273-81. [Medline].

  33. Singalavanija S, Frieden IJ. Diaper dermatitis. Pediatr Rev. Apr 1995;16(4):142-7. [Medline].

  34. Singleton JK. Pediatric dermatoses: three common skin disruptions in infancy. Nurse Pract. Jun 1997;22(6):32-3, 37, 43-4 passim. [Medline].

  35. Sires UI, Mallory SB. Diaper dermatitis. How to treat and prevent. Postgrad Med. Dec 1995;98(6):79-84, 86. [Medline].

  36. Zimmerer RE, Lawson KD, Calvert CJ. The effects of wearing diapers on skin. Pediatr Dermatol. Feb 1986;3(2):95-101. [Medline].

 
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Diaper rash.
Diaper rash.
Diaper rash.
Diaper rash pathophysiology scheme.
Table. Skin Care Ingredients Found in Diaper Rash Creams, Ointments, and Pastes
Several products are available for the care, management, and maintenance of skin integrity. The following are examples of ingredients frequently found in skin care products.
PetrolatumSkin protectant, water repellant, a barrier
Zinc oxideSkin protectant, soothes irritated skin
DimethiconeSkin protectant
Vitamins A and DSkin conditioner
KarayaViscosity modifier and absorbs moisture
Mineral oil, lanolin, glycerinEmollient, softens and soothes irritated skin, a lubricant



Humectant, hygroscopic (brings water to the surface of the skin producing a moisturizing effect)



Vitamin E acetateSkin conditioner
Isopropyl palmitateSkin conditioner
Purified waterDiluent
Chloroxylenol (PCMX)Antimicrobial, kills or inhibits bacteria
Isopropyl alcoholAntimicrobial
Miconazole nitrateAntifungal
Carboxymethylcellulose sodiumViscosity modifier
Methyl glucose dioleateEmulsifier, added to water-oil preparations to prevent the oil from separating from the water
Stearate acidEmulsifier
ButylparabenPreservative, prevents breakdown of product and destroys or prevents growth of bacteria
MethylparabenPreservative
TriethanolaminepH adjuster (normal pH of skin is 4.5-5.5)
Aminomethyl propanolpH adjuster
Cetyl alcoholEmollient and thickening agent
Adapted from Pediatr Nurs. 2004 Nov-Dec; 30(6): 467-70.[10]
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