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DIAPER RASH
You
can't do without diapers but at the same time you have to
deal with problems associated with diapers. No doubt it is
a wonderful invention but still it causes great discomfort
if care is not taken. A rash in the diaper area might be caused
by friction, irritants, allergies, infections, seborrhea,
psoriasis, diarrhea, or a long list of systemic diseases.
Skin wetness is the common denominator underlying the various
causes of diaper rash. Urinary wetness increases skin friction,
raises the skin pH, makes the skin less cohesive, and makes
it more permeable. These effects combine to intensify the
action of stool enzymes or other irritants that then inflame
the skin. In all of the diaper rashes mentioned above, the
outermost layer of skin--stratum corneum--has been damaged.
With this protective layer breached, it is easy for microorganisms
such as yeast or bacteria to invade the inflamed skin. This
makes the rash worse and less responsive to the usual treatments.
Types of rashes:
Irritant rash:
This is most conspicuous on the exposed areas, such as the
round part of the buttocks. It tends to spare skin folds and
creases. It's generally the result of contact with stool enzymes
or irritants such as harsh soaps, baby wipes, detergents,
or topical medicines.
Allergic rash:
This may occur in combination with an irritant rash or by
itself. It is also more common in exposed areas. The rash
looks like poison oak.
Intertrigo:
Moist heat causes this common type of diaper rash that occurs
deep in the skin folds. The involved skin looks thin, as if
it has lost several layers.
Seborrhea rash:
A salmon-colored, greasy rash with yellowish scales characterizes
this diaper rash that is also worse in the skin folds.
Psoriasis:
This stubborn rash doesn't necessarily look distinctive. Other
signs of psoriasis usually accompany the diaper rash, such
as pitting of the nails or dark red areas with sharp borders
and fine silvery scales on the trunk, face, or scalp.
Causes:
Yeast is by far the most common type of organism found in
a diaper rash. The organism is quite prevalent and thrives
in warm, moist skin. Yeast involvement should be suspected
in any diaper rash that has not improved dramatically with
72 hours of appropriate therapy. Current or recent antibiotic
use makes a yeast infection even more likely, since this reduces
the amount of the skin's "good" bacteria that fight infection.
Classically, a yeast rash is beefy red with sharp raised borders
and white scales. Small satellite lesions surround the main
rash. Even without the classic pattern, yeast is often present.
How to prevent diaper rash:
Change dirty diapers as soon as possible, gently cleaning
the diaper area to reduce exposure to urine and stool. Airing
out the diaper area can help prevent rashes.
Breastfeeding, avoiding unnecessary antibiotics, and taking
yogurt or beneficial bacteria when antibiotics are needed
can prevent diaper rashes.
Treatment:
Normally common diaper rashes are treated with frequent diaper
changes, airing out, and protective lotions or creams while
the baby is in the diaper. Yeast diaper rashes require the
addition of an anti-yeast cream. The treatment of other specific
diaper rashes varies depending on the specific type.
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