Managing nappy rash

Abstract

Approximately a quarter of infants develop nappy rash, which arises from the interaction between several mutually reinforcing factors. Three possible causes of nappy rash are: poor hygiene and skin care; sensitivity to detergents, fabric softeners and other external products; and infection. Once nappy rash develops, management aims to repair damage and prevent recurrence. The cornerstones of prevention and treatment are good routine skincare, frequent nappy changes, gentle cleansing and applying a barrier formulation at every nappy change. Candida albicans may cause moderate-to-severe nappy rash, for which topical antifungals may be appropriate. Brief courses of low-potency topical corticosteroids are suitable only when very inflamed dermatitis does not respond to other treatments. There is a need for further investigations of the pathogenesis (e.g. clarifying the role of C. albicans) and management of nappy rash, such as the relative efficacy of over-the-counter treatments.