Nappy rash

L22

• Description
• General measures
• Medicine treatment
• Referral

DESCRIPTION

A diffuse reddish eruption in the nappy area, usually caused by irritation from:

• persistent moisture and irregular cleaning and drying of the nappy area,
• diarrhoeal stools,
• underlying skin conditions in some cases, or
• improper rinsing of nappies to remove urine and stool breakdown products.

Rash is predominantly on areas in contact with the nappy, and spares the flexures.

GENERAL MEASURES

• Prompt changing of soiled nappies.
• Avoid waterproof pants. Expose nappy area to air if possible especially with severe nappy dermatitis.
• Educate caregiver on:
  • washing, rinsing and drying of the nappy when soiled.

MEDICINE TREATMENT

• Zinc and castor oil ointment, topical, apply ointment after each nappy change.

If rash involves the flexures, suspect candida:

• Imidazole, e.g.:
  • Clotrimazole 1%, topical, apply cream beneath zinc and castor oil ointment after each nappy change until symptoms are resolved.

REFERRAL

No improvement after 3 days of treatment.