Change the diaper as soon as it is wet or soiled to avoid rash. Photo designed by Freepik.

ONE of the most common skin problems that affects babies is diaper rash. The skin rash usually affects babies between four and 15 months old, and those who have an underlying skin condition such as eczema are prone to this.

Diaper rash accounts for about 20 per cent of all childhood visits to the dermatologist. In mild cases, the skin turns red. In severe cases, there may be painful, open sores.

UM Specialist Centre consultant paediatrician Associate Professor Dr Choo Yao Mun says diaper rash, also called diaper dermatitis, is normally categorised as red and raw-looking skin in the diaper area, and can be spotty in appearance.

He says it can be caused by excessive hydration from water in urine and stool due to infrequent diaper changes, and skin trauma caused by friction between the diaper and skin. Diapers that rub against the skin or fit too tightly can also cause irritation.

Other reasons include the presence of irritants; ammonia produced from urine or faeces, soap and detergent left over on skin, fragrance in wipes and napkin powders; fungal infections such as candida albicans (a fungus that grows in warm, moist places) and the use of antibiotics.

“As a result of serious diaper rash, some babies experience severe skin infection that can lead to fever and painful, ulcerated skin. While most cases of diaper rash are mild and can be treated easily, if left untreated, it can lead to severe skin infections by bacteria such as Staphylococcus and Streptococcus, as well as fungal infections like candida.

“To prevent a serious infection, parents should seek medical help when they notice pimples or small ulcers, if the rash bleeds or oozes fluid, if the baby has a fever or if the rash spreads to other areas such as the arms, face or scalp.”

In recent years, the occurence and severity of irritant and allergic contact dermatitis have decreased due to the availability of hypoallergenic, fast-absorbing disposable diapers.

“Fast-absorbing diapers help by absorbing moisture that would otherwise stay on baby’s skin.


To avoid and treat diaper rash, Dr Choo suggests a simple ABCDE approach :

• Air:

Leave the nappy off as much as possible and expose the diaper area frequently to air as.

• Barrier:

Use barrier creams that contain zinc oxide and petrolatum.

• Cleansing:

Using baby wipes on your baby’s skin is as effective as using cotton wool and water.

• Diapering:

Change the nappy as often as you can as soon as it is wet or soiled.

• Education:

Parents should wash their hands before and after every diaper change.

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