2017 HCHB_digital

Nappy Rash
Nappy rash is a red rash that occurs on the skin covered by a baby’s nappy. Any
part of the groin area, particularly around the genitals and buttocks may be
affected. Symptoms vary, depending on how severe the rash is.
With mild nappy rash, only a small part of the nappy area is covered in either
small pink spots or blotches. Babies may experience a stinging sensation and cry
when passing urine or a bowel motion.
In more severe nappy rash, the rash may spread down the legs or up onto the
tummy. The skin may crack or break and blisters may appear. The baby may seem
more irritable than usual and cry more often.
Nappy rash is a very common problem – most babies will have it at some
time – and it is important to reassure caregivers it does not mean the baby is not
being looked after properly.
antibiotics, and residual detergents left in cotton nappies after washing may also
aggravate it.
Nappy rash due to a yeast infection
The warm, damp skin under a baby’s nappy provides a good place for microorganisms
to grow. Candida albicans is a yeast (a type of fungus) that is
Causes
Simple nappy rash
Simple nappy rash is most often due to irritation from urine and faeces touching
the baby’s sensitive skin for extended periods of time. Some babies may also
develop nappy rash when they start eating solid foods, particularly foods such as
citrus, peas and raisins which aren’t as easily digested.
Other triggers of nappy rash include diarrhoea, teething, or taking oral
TREATMENT OPTIONS
Category Examples Comments
Barrier creams
Soap alternatives
Antifungal preparations
Antifungal + hydrocortisone
combinations
Healing/soothing preparations
Natural / herbal products /
supplements
[GENERAL SALE] eg, dimethicone (Silic 15), vitamin
A and calamine (Ungvita Cream), zinc and castor
oil, zinc and shea butter (Mustela Vitamin Barrier
Cream), zinc oxide (Made 4 Baby Botty Barrier
Cream, Curash Anti-rash Cream)
[GENERAL SALE]
eg, Pinetarsol*, Aqueous Cream, DermaLab,
Dermaveen, Emulsifying Ointment, Epaderm
ointment, QV Gentle Wash
[PHARMACY ONLY MEDICINE]
eg, bifonazole (Canesten Bifonazole), clotrimazole
(Canesten range), miconazole (Daktarin, Resolve),
miconazole and zinc oxide (Daktozin)
[PHARMACY ONLY MEDICINE]
eg, Resolve Plus 0.5%
[PHARMACIST ONLY MEDICINE]
eg, Canesten Plus, Resolve Plus 1%
[GENERAL SALE]
eg, Bepanthen Ointment, Kiwiherb Baby Balm, Lucas
Papaw ointment, Mustela Cold Cream, Mustela
Stelactiv, Sudocrem, Re Gen cream, Weleda Nappy
Rash Cream
Aloe vera, calendula, chamomile (eg, Kiwiherb Baby
Balm), vitamin A, B & E, zinc
Products with an asterisk have a detailed listing in the Nappy Rash section of OTC Products, on page 252.
Provide a barrier between the baby’s skin and urine and faeces.
Apply with each nappy change, after first washing the area with a pH-neutral non-soap
cleanser, rinsing and allowing to dry thoroughly.
Use instead of soap to wash away urine and faeces from the area, without stripping oils
off the skin.
Use antifungal creams to treat the fungal infection and continue for one week after the rash
has cleared.
Use in combination with a barrier cream to protect and soothe the skin.
Useful if the skin is particularly inflamed and red, or if there is concurrent dermatitis.
Avoid use for longer than one week without seeking further advice. Always use corticosteroids
in combination with an antifungal when used in the nappy area.
Apply sparingly and change to a formulation without hydrocortisone as soon as possible.
Reduce redness, soothe, heal and protect the skin. Most contain a barrier-like agent.
Natural products with soothing properties help heal nappy rash.
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Page 110 HEALTHCARE HANDBOOK 2017-2018 Common Disorders