Diaper Rash Flashcards
What skin conditions can diaper rashes be classified under?
Irritant contact dermatitis
Are the skin folds affected in diaper rash?
These regions are spared
What causes or is a risk factor for diaper rash?
Fecal/urine contact: diarrhea caused by viral gastroenteritis (stomach flu) causes harsh GI enzymes in poop
Chemical residue (laundry detergents, but really only if using cloth diapers)
Chafing
Antibiotic use
A diet consisting of formula can be worse compared to breast milk
“Daycare-itis”
Can eczema be found on the buttocks?
No, but psoriasis and impetigo are possible on the buttocks
How to prevent diaper rash?
Change diapers as quickly as possible
Keep area clean
Vaseline can be applied during each diaper change. Reduces contact with skin and feces/urine
Are cornstarch baby powders effective at preventing infections of the genital areas in babies?
No, cornstarch can serve as a food source for bacteria.
Talcum powder-based products were used previously, but those products are less popular due to lawsuits
How to treat a general diaper rash?
Keep the area clean
Use a barrier product (Vaseline) after every change
Expose the affected areas to the air (naked baby)
If the rash resolves in under 3 days, it is not infected. If the rash persists for more than 3 days, C. albicans (yeast infection) is likely to be present (changes our approach to therapy)
How to visually differentiate between non-infected and infected diaper rash?
Uninfected diaper rash does not affect the skin folds and the rash is more diffuse.
Infected(yeast infection) diaper rash on the other hand has vesicles and the skin folds are affected
What agents are available for resolving uninfected diaper rashes?
Keep area clean
+/- steroid (can be used for a few days to calm down inflammation)
Barrier cream (keeps out feces/urine from the skin)
What agents are available for resolving infected (yeast) diaper rashes?
Antifungals (only agent different compared to uninfected diaper rashes)
Keep area clean
+/- steroid (use for a few days to calm down inflammation, and then discontinue use.
Barrier cream (keeps out feces/urine from the skin)
Should pharmacists assume an infant with oral thrush also has diaper rash?
Yes, they are both caused C. albicans, so we assume that the infection is most likely in the groin as well.
What antifungal products can be used in treating infected (yeast) diaper rashes?
OTC azoles are perfectly fine, but no baby version exists. Just use something like clomitrazole 1% or external vaginal cream for diaper rashes (works fine on boys and girls)
If symptoms do not improve, they might have a bacterial infection instead
How to use steroids for diaper rash?
Stick to 0.5-1% of hydrocortisone, only 1-2 applications for a max of 2 days
What is the advantage of antifungal/steroid combo products?
They are covered by insurance and are more convenient vs. separate products
A disadvantage is that steroids are used for the entire duration of therapy (only need it for 2 days)
How to apply multiple products for diaper rash?
If rash is uninfected: First apply steroid (HC 0.5-1% BID x 1-2 days), then barrier cream 4-5x per day everyday
If rash is infected (yeast): First apply antifungal cream BID x 14 days, then HC 0.5-1% BID x 1-2 days, and finally barrier cream 4-5x per day everyday
