Types of Diaper Rash: Symptoms and Treatment

Diaper rash is one of the most common dermatological problems in babies. Although it doesn't usually cause complications, it's very bothersome. Today we'll tell you about the different types of diaper rash, their symptoms, and how to treat them.

Written and verified by the dermatologist Maria del Carmen Hernandez.

Last update: 11 June, 2022

Diaper rash is the most common skin disorder in young infants. There are different types of diaper rash, which is usually a mild, self-limiting condition that requires minimal intervention. In most cases, it occurs on the buttocks and genital area. However, it can also appear on the lower abdomen and upper thighs due to contact with irritants.

According to information in Pediatric Dermatology, this condition is the result of friction, over-hydration of the skin, and alterations in skin pH, among others. In addition, it’s more prevalent during the baby’s first year of life. So, what types of diaper rash are there? And what are the symptoms? How can you treat it?

Symptoms of diaper rash

Diaper rash is an inflammatory reaction of the skin around the diaper area. Keep in mind that babies have thinner skin, which produces less secretion and makes them more susceptible to infection or irritation. Even so, the most important factor in this condition is the occlusion of the skin by the diaper.

Symptomatology depends on the seriousness and the time of evolution of dermatitis. According to information compiled by the Spanish Society of Outpatient Pediatrics and Primary Care some of the clinical manifestations are the following

• Itching of variable intensity
• Subtle redness in mild cases
• Intense inflammation (there may even be bleeding in severe cases)
• Alterations in the baby’s mood due to the significant irritation in the area around the diaper

What are the causes?

Diaper rash is the result of a combination of multiple factors. These include increased moisture, prolonged contact with urine or feces, and other irritants such as detergents.

The second most common cause of diaper dermatitis is infection. In particular, fungal infection, especially Candida albicans, is the most common infectious cause. Similarly, other mycoses can be associated with diaper dermatitis, such as

• Infection by dermatophytosis
• The exacerbation of Malassezia seborrheic dermatitis
• Pseudomycosis conditions such as erythrasma

Types of diaper rash

Diaper rash is any skin condition that occurs in the area that comes in contact with the diaper. In turn, this inflammation can be the result of various factors. In this sense, we can categorize them as follows:

Irritative contact dermatitis

Irritative contact dermatitis is the most common type of diaper dermatitis. Its appearance is related to skin contact with feces and urine that accumulate in the diaper. However, the folds in the groin are usually healthy, without alterations, because they have less contact with irritating agents.

To prevent this from happening, studies by AEPED recommend keeping the area clean and dry at all times. What’s more, you should change your child’s diaper repeatedly throughout the day.

Candidiasis of the diaper

Diaper rash is a yeast infection that occurs due to the overdevelopment of a type of fungus that normally lives in the digestive microbiota. The signs that characterize it are the following:

• Very red stains
• Shiny injured skin
• Clearly defined lesions
• Sores
• Compromised groin folds

Dermatitis by bacteria

In a few cases, bacterial dermatitis, also known as impetigo, is observed. However, staphylococcus and streptococcus often cause a diaper rash or worsen an existing one. A characteristic sign of streptococcal infection is bright red skin around the anus.

Allergic dermatitis

Babies with sensitive skin may develop some type of allergic reaction to a particular component of the diapers or creams. The most common allergens include the following:

• Elastics or dyes in the diaper
• Perfumes
• Preservatives in hygiene products

Is it possible to prevent diaper rash?

The treatment of diaper rash has two main objectives. First, to heal the damaged skin and, second, to prevent the recurrence of the rash. With that in mind, below are some helpful strategies to meet these goals.

• Good hygiene is essential to maintaining skin integrity and preventing further degradation. You can reduce exposure to irritants such as urine and feces with frequent diaper changes and super absorbent diapers that help reduce skin over-hydration.
• Also, always be sure to wash and clean the diaper area with soap-free cleanser and water.
• Finally, contrary to what many think, Pediatric Dermatology studies show that baby wipes don’t cause any damage to the skin. In addition, the new formulations of this product, which include pH buffers, help balance the alkaline pH of the urine and prevent skin damage.

Treatment of diaper rash

Remember that, whatever the type of infection in the diaper area, it requires diagnosis and treatment by the pediatrician or dermatologist. Once a doctor determines the type of diaper rash that’s affecting your child and its distribution, they’ll determine the cause and establish therapeutic options.

In the case of irritative contact dermatitis, you should practice proper hygiene and also leave your child diaper-free for a few minutes afterward. Finally, apply a lasser paste based preparation on the area before completing the diaper change.

If you’re dealing with a yeast infection, then you’ll need to apply a topical ointment with imidazolics.

Note: The use of corticoid creams in the diaper area is completely contraindicated.

When to consult a physician?

If the baby’s diaper rash doesn’t go away with the above measures, you should consult with a doctor so that he or she can prescribe the right medication. What’s more, in the case of suppuration, sores, fever or any other clinical manifestation of a complication, you should see a doctor right away.

In most cases, these types of dermatological problems improve with basic care, such as avoiding the use of irritants and ensuring good hygiene. Even so, it’s best to inform your pediatrician about the symptoms.