Diaper Rash (Dermatitis)

Approximately two-thirds of infants experience diaper rash. Customized diaper rash preparations -ointments, powders, or creams- tailored to treat each baby’s specific symptoms, can be compounded using ingredients which will protect the skin from additional irritation, soothe and encourage healing, and prevent secondary infections. Skin protectants (zinc oxide, petrolatum) provide a physical barrier against external irritants such as urine or gastrointestinal enzymes in stool. Antifungal creams can be used when a yeast(Candida) infection is suspected. Topical steroids (such as hydrocortisone 1%) should be reserved for severe diaper rash, because a baby’s skin can absorb enough medication to lead to systemic effects.

Decreased gastrointestinal transit time can mean less time for bile acid resorption in the distal ileum, and high concentrations of bile acids in the stool can irritate the anus and buttocks in a manner similar to the skin irritation associated with ostomies. When applied topically, cholestyramine, a bile acid sequestrant, can irreversibly bind the bile and bring relief to the patient. Annals of Pharmacotherapy 30(9):954-956 reported the case study of a two-month old boy with reflux and regurgitation who was treated with a promotility agent. He developed a rash on his buttocks and anal irritation that progressed in severity despite the use of numerous topical products and extended diaper-free periods. A compounded topical cholestyramine ointment was administered and resulted in complete resolution within three days.

Ask our pharmacist about economical therapies for diaper rash.