Nappy Rash

Question 1

What are 3 symptoms of nappy rash?

Answer 1

1. Erythematous rash on the buttock and groin area.
2. Caused by contact of urine and faeces with skin
3. Wetness and maceration of skin due to infrequent nappy changes and inadequate skin care

Question 2

Does nappy rash require a counselling room?

Answer 2

No

Question 3

What are 3 red flags for referral with nappy rash?

Answer 3

1. OTC treatment failure after 1 week.
2. Severe/unusual rash
3. Signs of secondary infection for example, fever.

Question 4

Does nappy rash have a PSA self-care card?

Answer 4

Yes (Nappy Rash)

Question 5

What is the preferred treatment option for nappy rash?

Answer 5

Zinc Barrier Cream 15.25% (Sudocrem)

Question 6

What are the directions for Zinc Barrier Cream 15.25% (Sudocrem) in nappy rash?

Answer 6

Apply to the nappy region after each nappy change

Question 7

What are 3 non-preferred options for nappy rash and why?

Answer 7

1. Topical hydrocortisone (can be used for inflammation + pain, however not suitable on broken skin, children under 2, and only for short-term use)
2. Topical clotrimazole (only appropriate if fungal component in children over 2)
3. Topical nystatin (only appropriate if fungal component)

Question 8

Is Zinc Barrier Cream 15.25% (Sudocrem) safe in pregnancy?

Answer 8

Yes

Question 9

Is Zinc Barrier Cream 15.25% (Sudocrem) safe in breastfeeding?

Answer 9

Yes

Question 10

What is the age range for Zinc Barrier Cream 15.25% (Sudocrem)?

Answer 10

Safe in all ages

Question 11

What are 9 pieces of non-pharmacological advice for nappy rash?

Answer 11

1. Apply emollient or barrier preparation at each nappy change (thick layer): pastes/ointments are preferred over creams/lotions
2. Change nappies frequently (for example, every 2-3 hours) and immediately after they are soiled
3. Allow nappy-free periods (increase airflow to nappy area)
4. Use disposable nappies if possible
5. If using cloth nappies, use nappy liners
6. Clean area with warm water and a soft cloth and use soap-free wash if necessary
7. Pat the area gently with a soft towel and allow to air dry
8. Avoid baby-wipes as they may be irritating (even if ‘gentle on skin’: still made with chemicals), warm water is best
9. AVOID cornstarch and talcum powder to ‘dry’ the nappy area

Question 12

What can be done when treating nappy rash If inflammation is severe, causing discomfort, or is unresponsive to barrier cream alone?

Answer 12

Hydrocortisone 1% can be used until it settles (usually 3 to 5 days)

Question 13

If applying both a topical antifungal a topical corticosteroid, which should you apply first?

Answer 13

Apply antifungal first and then steroid