The skin of newborns and infants is very delicate. The structure of the skin of an infant and an adult has a number of significant differences, the epidermis in babies is much thinner, which explains the need for careful care of newborns and infants. The connection between the cells of the stratum corneum is weak, the horny plates are easily rejected, and the exfoliation process occurs 4-5 times faster than in adults. These features contribute to the disruption of the barrier function of the skin and the development of diaper rash.
Diaper rash, or diaper dermatitis, is manifested by inflammatory changes in the skin in infants due to occlusion of the skin by diapers and exposure to irritants. Diaper rash is common in infants, but the peak incidence occurs between the ages of 9 and 12 months, regardless of the child's gender. With proper treatment and elimination of triggers, diaper rash quickly regresses.
Diaper rash can be divided into two main groups based on the cause:
1. Skin inflammation that occurs when a child's skin comes into contact with wet, soiled diapers.
2. Skin inflammation not directly related to diaper use.
The first group includes irritant dermatitis caused by exposure to irritants, candidiasis, contact dermatitis, and contact allergic dermatitis. This condition is more often observed in children with dyspeptic symptoms and dysbiosis due to previous systemic antibacterial therapy.
Irritant dermatitis.Irritant dermatitis (or "classic" diaper dermatitis, or poor care disease) is characterized by redness and inflammation of the skin. This type of diaper dermatitis is most common in pediatric practice. In mild cases, skin lesions are limited to areas of redness, while in severe cases, erosions and severe inflammation occur. Dermatitis is promoted by poor care (infrequent diaper and nappies changes, failure to use barrier creams with each diaper change), the use of waterproof underwear, and frequent loose stools in the child.
Candidosis. With prolonged inflammatory dermatosis, a secondary infection often occurs, characterized by crimson-red spots with clear borders, erosions with an edge of exfoliated epidermis, and isolated vesicular elements on healthy skin. Blisters with flaccid caps quickly burst, leaving behind "varnished" erosions. Candidiasis in young children can also develop primarily on unchanged skin due to previous antibiotic therapy.
Contact allergic dermatitis.Inflammation in the diaper area can also develop even with good skin care. For example, with allergic contact dermatitis, a child may develop an individual reaction to diapers. Clinically, this condition is characterized by reddening of the skin, with clear boundaries and not extending beyond the diapers. If allergic dermatitis develops, diapers should be replaced with hypoallergenic ones or abandoned completely.
Simple contact dermatitis. Dermatitis often develops in infants due to the use of cleansers and disinfectants (alcohols, antiseptics) in excessive "adult" concentrations. In these cases, simple contact dermatitis develops, which is essentially a chemical burn. This dermatitis is distinguished by clear boundaries of the lesion, precisely corresponding to the places where the chemical was applied, swelling, bright red erythema, and, in severe cases, the presence of blisters and erosions, and severe pain. Contact dermatitis ends with the appearance of large scales.
Now let's focus on the second group of diseases. Some skin diseases can also appear in children in the diaper area, but their appearance is not directly related to their use. An important difference between such conditions is the presence of rashes in other localizations. Changes can be observed with seborrheic dermatitis, pyoderma, psoriasis, scabies, etc.
Seborrheic dermatitis. Seborrheic dermatitis in infants is characterized by the appearance of bright pink erythema lesions covered with yellowish greasy scales. The rash is mainly localized on the skin of the scalp, face (eyebrows, nasolabial folds), neck and other skin folds (for example, armpits, thigh folds, elbows and in the popliteal fossa).
Bacterial infection. This is a disease that develops in young children when a streptococcal infection is added with poor care. It is characterized by the appearance of small (about 1-2 millimeters) elevated foci of a bluish-red color. Subjectively, the baby may be bothered by itching or soreness.
Psoriasis is a chronic skin disease characterized by the appearance of infiltrated foci of erythema of a bright pink color, covered with silvery-white scales. When the rash is localized in the diaper area, silvery-white scales may be absent, making this condition similar to diaper dermatitis and anogenital candidiasis.
Scabies is a contagious parasitic skin disease caused by the scabies mite. It is characterized by the sudden appearance of bright red lesions, papules, vesicles, and pustules localized on the skin of the abdomen, palmar surfaces of the hands, plantar surfaces of the feet, armpits, and genitals. Subjectively, intense itching is bothersome, intensifying in the evening and at night. Scabies often affects several family members at the same time.
If any of these diseases occur or are suspected, you must consult a doctor.
Prevention
Prevention of diaper dermatitis is to follow these recommendations:- Do not use regular soaps to cleanse the skin
- Use hypoallergenic diapers
- Dry the folds after washing
- Be sure to apply protective emollients to dry skin with each diaper change
Care tips are presented in the ABCDE recommendations, which reflect a comprehensive approach to the prevention of diaper rash.
- A (air) - reduce skin contact with urine and feces, that is, allow the child to periodically do without a diaper, allowing the skin to be exposed directly to air.
- B (barrier) - use Zinc oxide or petroleum jelly creams are used under diapers. Barrier products create a protective lipid film that prevents irritants from reaching the skin while allowing the skin to heal underneath the cream. C (cleansing) — gentle cleansing with water or wet wipes specifically recommended for small children (free of alcohol and fragrances) at each diaper change. It is important to avoid vigorous rubbing of the skin. D (diapering) — choosing disposable diapers over cloth diapers. The diaper should be changed at least every 1-3 hours during the day and once during the night, as well as in case of severe soiling.
- E (education) - providing parents with information on the use of diapers, hygiene and basic skin care methods.
LIBREDERM Baby Collection: therapeutic cosmetics from the first days of life
Children's cosmetics are specially developed products for the care of children from newborn age. Such products contain gentle components that provide gentle but high-quality cleansing, and also act on the causes of increased skin sensitivity, enhancing the effectiveness of self-defense mechanisms.Cleansing
For cleansing babies, it is recommended to use cleansing wipes (alcohol-free) from the Baby LIBREDERM line. They contain: 100% hypoallergenic cellulose; Cotton extract (a natural ingredient with nourishing, softening, and protective properties) and panthenol (has a moisturizing, softening effect, accelerates skin regeneration, eliminating redness, dryness, and discomfort). These cleansing wipes are suitable for daily hygiene from the first day of life.Care
The use of barrier products is an important step in the treatment and prevention of diaper rash. Barrier products should be applied in a thick layer to the skin after cleansing at each diaper change. There is no need to completely rinse the barrier products off the skin at each diaper change. Diaper products should not contain preservatives, fragrances, or other additives. Diaper cream from the Baby line by LIBREDERM is suitable for the sensitive skin of babies from the first day of life. When applied, it forms a breathable barrier that prevents contact with moisture, which can cause skin irritation. Contains: cotton extract (a natural component with protective and regenerating properties); highly purified lanolin (guarantees a high degree of protection and hydration for the skin); shea butter (softens and soothes irritated skin); bisabolol and dipotassium glycyrrhizinate (effective anti-inflammatory ingredients).
Newborn skin differs significantly from adult skin and has many signs of anatomical and functional immaturity (thinness of the superficial layers of the skin, tendency to maceration). Almost every infant experiences diaper rash. Basic skin care of the anogenital area is essential for the treatment and prevention of diaper rash. LIBREDERM's cleansing and barrier diaper products have a proven safety profile and can be used to prevent and treat diaper rash.