Children™s skin problems span nearly two decades from birth through adolescence. Several common pediatric skin conditions will be discussed including diaper dermatitis, atopic dermatitis, warts, and acne.
What is diaper dermatitis?
Diaper dermatitis, or diaper rash as it is more commonly known, is not a diagnosis but rather a category of skin conditions affecting the diaper area. There are four types of diaper dermatitis, including:
- Irritant contact dermatitis
- Overgrowth of yeast (Candida albicans)
- Allergic contact dermatitis
- Inflammatory skin conditions such as seborrheic dermatitis
The most common type of diaper dermatitis is irritant contact dermatitis, associated with skin exposure to either urine or feces (or both) for a long period of time. Irritant contact dermatitis usually appears as bright red, sometimes slightly swollen, or even blister-like patches in the diaper area. Prolonged irritant contact dermatitis can increase the risk of infection in the affected area.
The primary treatment and prevention of irritant contact dermatitis include barrier creams and ointments, most commonly containing zinc oxide. A mild topical steroid ointment or cream can also be very helpful in more quickly reducing the inflammation.
The next most common type of diaper dermatitis is the overgrowth of yeast, most commonly Candida albicans. The warm, moist, and often irritated environment of the diaper makes the skin more prone to an overgrowth of yeast. This condition generally develops on top of irritant contact dermatitis.
Usually, it appears as bright red bumps, patches, and sometimes pus-bumps that are found on the skin and in its folds. The condition can be treated with an over-the-counter topical antifungal cream such as clotrimazole (Mycelex), Mycostatin (Nystatin), or prescription medication. A barrier cream, often containing zinc oxide, is also recommended to treat and prevent this skin condition. If irritant contact dermatitis is also present, sometimes an additional mild topical steroid is prescribed. If this condition is only treated with topical steroids, the yeast will spread.
Rarely, allergic contact dermatitis will occur. This condition is usually associated with a component of the diaper itself. Symptoms include redness and swelling with the itchiness that continues to recur in the same area such as near the diaper™s adhesive tape, or around the leg where there is elastic in the diaper.
Treatment of allergic contact dermatitis is very similar to the treatment of irritant contact dermatitis: barrier creams and ointments, most commonly containing zinc oxide, or mild topical steroid ointment if necessary.
To prevent allergic contact dermatitis, you need to identify the material that is causing the problem and avoid it.
Seborrheic dermatitis, commonly known as cradle cap in infants and dandruff in older children and adults, can also be the cause of diaper dermatitis. This condition also affects other areas of the body such as the scalp, eyebrows, around the nose, and sometimes the chest area. Treatment includes the careful use of mild topical steroid and antifungal creams.
Topical steroids require very careful use, especially in the diaper area to prevent potential side effects such as thinning of the skin and stretch marks. These effects can be prevented by using low potency topical steroids, such as hydrocortisone 1 to 2 percent, and applying topical steroids sparingly to the affected areas only twice daily as needed for no longer than two weeks at a time.
What is atopic dermatitis?
Atopic dermatitis, or eczema, is a skin condition that can occur at any time in life. It often starts early in childhood and may not diminish until early adulthood. Over half of the infants with atopic dermatitis grow out of the condition by age 2, though flare-ups can occur throughout life.
Atopic dermatitis is a chronic condition, which means that it cannot be cured but it can be treated and controlled with proper guidance from a physician.
The condition is most common among families who have a history of allergies. Although food allergies may cause flare-ups, removing suspected foods (such as eggs, milk, fish, wheat, and peanuts) from your child™s diet is not likely to cure the problem. If you suspect that a food is worsening the rash, discuss this with your health care provider.
Atopic dermatitis can also get worse when the skin comes into contact with irritating substances such as harsh soaps and scratchy, tight-fitting clothing. Scratching can also promote infections that require treatment.