Sections

Diaper Rash

Medication

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.

Class Summary

Suppresses inflammation and itching.

Hydrocortisone topical (Cortizone, Westcort, Dermacort)

View full drug information

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.

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.

Nystatin (Mycostatin, Nilstat)

View full drug information

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.

Clotrimazole topical (Lotrimin, Mycelex)

View full drug information

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.

Miconazole topical (Monistat)

View full drug information

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.

Ketoconazole topical (Nizoral)

View full drug information

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

Class Summary

Used in treating mild bacterial superimposed infections.

Bacitracin (Baciguent)

View full drug information

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

Class Summary

Used in treating more aggressive bacterial superimposed infections.

Amoxicillin and clavulanate (Augmentin)

View full drug information

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.

Follow-up

Fölster-Holst R. Differential diagnoses of diaper dermatitis. Pediatr Dermatol. 2018 Mar. 35 Suppl 1:s10-s18. [QxMD MEDLINE Link].
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. 1989 Jun. 6(2):102-8. [QxMD MEDLINE Link].
Prasad HR, Srivastava P, Verma KK. Diapers and skin care: merits and demerits. Indian J Pediatr. 2004 Oct. 71(10):907-8. [QxMD MEDLINE Link].
Prasad HR, Srivastava P, Verma KK. Diaper dermatitis--an overview. Indian J Pediatr. 2003 Aug. 70(8):635-7. [QxMD MEDLINE Link].
Wilson PA, Dallas MJ. Diaper performance: maintenance of healthy skin. Pediatr Dermatol. 1990 Sep. 7(3):179-84. [QxMD MEDLINE Link].
Adam R. Skin care of the diaper area. Pediatr Dermatol. 2008 Jul-Aug. 25(4):427-33. [QxMD MEDLINE Link].
Korting HC, Braun-Falco O. The effect of detergents on skin pH and its consequences. Clin Dermatol. 1996 Jan-Feb. 14(1):23-7. [QxMD MEDLINE Link].
Yonezawa K, Haruna M, Shiraishi M, Matsuzaki M, Sanada H. Relationship between skin barrier function in early neonates and diaper dermatitis during the first month of life: a prospective observational study. Pediatr Dermatol. 2014 Nov-Dec. 31 (6):692-7. [QxMD MEDLINE Link].
Ersoy-Evans S, Akinci H, Dogan S, Atakan N. Diaper Dermatitis: A Review of 63 Children. Pediatr Dermatol. 2016 May. 33 (3):332-6. [QxMD MEDLINE Link].
Walsh SS, Robson WJ. Granuloma gluteale infantum: an unusual complication of napkin dermatitis. Arch Emerg Med. 1988 Jun. 5(2):113-5. [QxMD MEDLINE Link].
Cohen B. Differential Diagnosis of Diaper Dermatitis. Clin Pediatr (Phila). 2017 May. 56 (5_suppl):16S-22S. [QxMD MEDLINE Link].
Ersoy-Evans S, Akıncı H, Doğan S, Atakan N. Diaper Dermatitis: A Review of 63 Children. Pediatr Dermatol. 2016 May. 33 (3):332-6. [QxMD MEDLINE Link].
Alberta L, Sweeney SM, Wiss K. Diaper dye dermatitis. Pediatrics. 2005 Sep. 116(3):e450-2. [QxMD MEDLINE Link].
Longhi F, Carlucci G, Bellucci R, di Girolamo R, Palumbo G, Amerio P. Diaper dermatitis: a study of contributing factors. Contact Dermatitis. 1992 Apr. 26(4):248-52. [QxMD MEDLINE Link].
Adalat S, Wall D, Goodyear H. Diaper dermatitis-frequency and contributory factors in hospital attending children. Pediatr Dermatol. 2007 Sep-Oct. 24(5):483-8. [QxMD MEDLINE Link].
Borkowski S. Diaper rash care and management. Pediatr Nurs. 2004 Nov-Dec. 30(6):467-70. [QxMD MEDLINE Link].
Atherton DJ. A review of the pathophysiology, prevention and treatment of irritant diaper dermatitis. Curr Med Res Opin. 2004 May. 20(5):645-9. [QxMD MEDLINE Link].
Nield LS, Kamat D. Prevention, diagnosis, and management of diaper dermatitis. Clin Pediatr (Phila). 2007 Jul. 46(6):480-6. [QxMD MEDLINE Link].
Baer EL, Davies MW, Easterbrook KJ. Disposable nappies for preventing napkin dermatitis in infants. Cochrane Database Syst Rev. 2006 Jul 19. CD004262. [QxMD MEDLINE Link].
Blume-Peytavi U, Hauser M, Lünnemann L, Stamatas GN, Kottner J, Garcia Bartels N. Prevention of diaper dermatitis in infants--a literature review. Pediatr Dermatol. 2014 Jul-Aug. 31 (4):413-29. [QxMD MEDLINE Link].
Davies MW, Dore AJ, Perissinotto KL. Topical vitamin A, or its derivatives, for treating and preventing napkin dermatitis in infants. Cochrane Database Syst Rev. 2005 Oct 19. CD004300. [QxMD MEDLINE Link].
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. 2001 Sep. 15 Suppl 1:16-21. [QxMD MEDLINE Link].
Benitez Ojeda AB, Mendez MD. Diaper Dermatitis. 2021 Jan. [QxMD MEDLINE Link]. [Full Text].
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. 2005 Jan-Feb. 4(1):29-34. [QxMD MEDLINE Link].
Bonifaz A, Tirado-Sánchez A, Graniel MJ, Mena C, Valencia A, Ponce-Olivera RM. The efficacy and safety of sertaconazole cream (2 %) in diaper dermatitis candidiasis. Mycopathologia. 2013 Apr. 175(3-4):249-54. [QxMD MEDLINE Link]. [Full Text].
Blume-Peytavi U, Kanti V. Prevention and treatment of diaper dermatitis. Pediatr Dermatol. 2018 Mar. 35 Suppl 1:s19-s23. [QxMD MEDLINE Link].

Media Gallery

Diaper rash.
Diaper rash.
Diaper rash.
Diaper rash pathophysiology scheme.

of 4

Table. Skin Care Ingredients Found in Diaper Rash Creams, Ointments, and Pastes

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.
Petrolatum	Skin protectant, water repellant, a barrier
Zinc oxide	Skin protectant, soothes irritated skin
Dimethicone	Skin protectant
Vitamins A and D	Skin conditioner
Karaya	Viscosity modifier and absorbs moisture
Mineral oil, lanolin, glycerin	Emollient, softens and soothes irritated skin, a lubricant Humectant, hygroscopic (brings water to the surface of the skin producing a moisturizing effect)
Vitamin E acetate	Skin conditioner
Isopropyl palmitate	Skin conditioner
Purified water	Diluent
Chloroxylenol (PCMX)	Antimicrobial, kills or inhibits bacteria
Isopropyl alcohol	Antimicrobial
Miconazole nitrate	Antifungal
Carboxymethylcellulose sodium	Viscosity modifier
Methyl glucose dioleate	Emulsifier, added to water-oil preparations to prevent the oil from separating from the water
Stearate acid	Emulsifier
Butylparaben	Preservative, prevents breakdown of product and destroys or prevents growth of bacteria
Methylparaben	Preservative
Triethanolamine	pH adjuster (normal pH of skin is 4.5-5.5)
Aminomethyl propanol	pH adjuster
Cetyl alcohol	Emollient and thickening agent
Adapted from Pediatr Nurs. 2004 Nov-Dec; 30(6): 467-70.^[16]

Back to List

Diaper Rash Medication

Medication Summary

Corticosteroid, topical

Class Summary

Hydrocortisone topical (Cortizone, Westcort, Dermacort)

Hydrocortisone topical (Cortizone, Westcort, Dermacort)

Antifungal agents