Allergic contact diaper dermatitis: what is causing this rash?

Diaper rashes (diaper dermatitis) can be frustrating for parents of babies. Figuring out what is causing the child’s rash is sometimes a challenge. Diaper dermatitis is a term used to describe many different types of skin conditions affecting the diaper area common during the early years of life. At any given time anywhere from 7-35% of babies have a diaper rash. The most common age is 9-12 months. Causes of diaper rashes include:

  • Anatomy: some babies have more skin folds than others which make it harder to keep clean. This also creates an area for moisture to accumulate.
  • Diarrhea: produces moisture and is acidic which can cause the skin to become irritated.
  • Moisture: creates an environment for bacteria growth and can also cause the skin to break down.
  • Heat: leads to sweating (moisture) and creates a more favorable environment for bacteria to grow.
  • Antibiotics sometimes cause yeast infections in the diaper area.  Remember to tell your health care provider if your child has taken one recently. Yeast infections typically do not get better without a prescription cream.
  • Diapers
    • Cloth diapers don’t contain fragrance or dyes but they do tend to hold more moisture. More moisture leads to more rashes.
    • Disposable diapers contain preservatives, dyes, fragrances, and additives that are not harmful unless your child is allergic to one of the ingredients. An allergy to any of the ingredients can cause a rash. See the list below for diapers that tend to be less irritating and where to buy them.
  • Wipes: these also contain preservatives and fragrances which your child could be allergic to. If you think this is the case, you can try cleaning your child with soap and water on a washcloth instead of a wipe. Some washcloths are more harsh than wipes, so be gentle. See the list below for wipes that tend to be less irritating.

What else can I do if my child tends to get diaper rashes?

  • Topical protectant creams: these form a barrier so that moisture or chemicals don’t come in direct contact with skin. Look for products with zinc oxide, beeswax, mineral oil, dimethicone, petrolatum or vitamins A and D.
  • Skin restoration creams: these help to heal irritated skin. Look for products with contain lanolin, ceramides or cod liver oil.
  • In some cases your child may need a prescription strength ointment or cream. If you have tried the above recommendations with little to no success, contact your healthcare provider. Some children need to be evaluated in the office to determine the correct treatment option.
  • Diapers with less irritating ingredients:
    • Bamboo Nature Diapers (Babies R Us, Amazon)
    • Earth’s Best Chlorine Free Diapers (Amazon, Target, Babies R Us)
    • The Honest Co. Honest Diapers (Amazon, honest.com)        
    • Huggies Pure & Natural Diapers (Babies R Us)
    • Naty by Nature Babycare Diapers (CVS, Amazon, diapers.com)
    • Pampers (WalMart)
    • Seventh Generation Free & Clear Diapers (WalMart, Amazon, diapers.com)
  • Wipes with less irritating ingredients:
    • Baby Ganics Thick n’ Kleen Flushable Wipes (Walgreens, Amazon)
    • Johnson’s Hand & Face Wipes (Target, WalMart)
    • Pampers Sensitive Wipes (WalMart)
    • Luvs Ultra Clean Wipes (WalMart)
    • Seventh Generation Free & Clear Wipes (Amazon, Target)