Diaper Rash

Diaper Rash is a topic covered in the 5-Minute Emergency Consult.

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  • Very common dermatologic disorder of infancy
  • Most common in 1st month of life and again at 12–24 mo
  • Incidence in adult incontinent patients is reported from 5.7% to more than 42% and appears to be strongly associated with age
  • Primary irritant/contact dermatitis:
    • Outer skin layers are broken down, leading to inflammation, impairment of normal skin microflora, and loss of protective barrier function.
    • Increased skin moisture encourages growth of microorganisms on the surface of the skin.
    • Secondary fungal or bacterial infection can cause more severe forms of diaper dermatitis.
  • Also known as irritant diaper dermatitis


  • Irritants:
    • Moisture:
      • Prolonged overhydration owing to infrequent diaper changes, poorly absorbing diapers or cloth diapers, urinary or faecal incontinence in adults
    • Friction:
      • Diaper rubbing on skin or loose-fitting diaper
    • Chemicals:
      • Prolonged exposure to stool enzymes and urine
      • Scents or moisturizers in wipes or soap
      • Diaper material or adhesive used to hold diaper in place
  • Infection:
    • Candida albicans:
      • Isolated in up to 80% of infants
      • Overgrowth common after systemic antibiotic use
    • Bacterial
    • Often complication of other causes of dermatitis:
      • Staphylococcus aureus, Streptococcus, Escherichia coli are common; Peptostreptococcus and Bacteroides may also be encountered.
  • Seborrheic diaper dermatitis
  • Atopic diaper dermatitis (contact dermatitis)
  • Risk factors:
    • Oral thrush
    • Number of previous episodes of diaper rash
    • Duration of use of diapers
    • Diarrhea

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