There are many alternatives and products available in the management of diaper rash (DR). The differences may cause confusion to nurses. These options may reflect unfamiliarity of the products and ingredients, practitioner preference, availability, cost, and family customs and traditions. What may work for one child may not work for another. This article will give a brief review of diaper rash, skin care products and ingredients, and alternatives in care.
Diaper rash (DR) or diaper dermatitis is one of the most common skin disorders in infants and toddlers (Liptak, 2001). Diaper rash may occur at any time, to any child, and to the most meticulous parent, but it typically tends to wax and wane, and occurs most frequently between 9 and 12 months of age (Van Onselen, 1999; Jorden, Larson, Berg, Frandman, & Marrer, 1986). The etiology is multifocal and a diaper rash may present in various conditions in the pediatric community. The majority of cases are mild to moderately severe and subject to individual interpretation. Diaper dermatitis usually occurs as a primary reaction to irritation by urine, feces, moisture, or friction (Van Onselen, 1999; Berg, Buckingham, & Stewart, 1986; Zimmerer, Lawson, & Calvert, 1986; Buckingham & Berg, 1986). Care and management of diaper dermatitis can present a challenge for pediatric nurses and care providers. To identify the cause, an assessment and accurate history are necessary. A description of the rash must be documented along with continued assessment, evaluation, and the outcome of treatment.
There are many alternatives and products available in the management of DR, which may sometimes confuse the nurse. These options may reflect unfamiliarity of the products and ingredients, practitioner preference, availability, cost, and family customs and traditions. What may work for one child may not work for another. A brief review of diaper rash, skin care products and ingredients, and alternatives in care will be presented.
Common Causes of Diaper Dermatatis
One of the most common types of diaper dermatitis is irritant contact dermatitis. Distribution patterns may vary, but irritative dermatitis typically involves the convex surfaces where the skin is in greatest contact with the diaper. Irritative dermatitis usually spares the inquinal folds, and may be mild red, shiny, and with or without papules (elevated solid lesions varying in color) (Liptak, 2001; Wysocki & Bryant, 1992). Scaling may also be present.
The second most common pattern of diaper dermatitis is usually classified as candidal dermatitis. This pattern involves the skin folds and spares the convex surfaces. Rashes in the perineal area may be the result of diarrhea, moisture, and a secondary candida infection, which is the most common complication of irritant diaper dermatitis. The rash is bright red, denuded (red, raw, weepy skin) containing macules (flat, discolored lesions) or papules with satellite lesions, which can be inflamed and painful (Liptak, 2001; Wysocki & Bryant, 1992). A diaper rash presenting more than 72 hours will usually have a cadida infection. This yeast infection produces a protease that penetrates the skin and can cause a primary or secondary...
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