What factors contribute to diaper dermatitis?

Updated: Oct 16, 2020
  • Author: Ruchir Agrawal, MD; Chief Editor: Dirk M Elston, MD  more...
  • Print
Answer

Diaper rash affects the areas within the confines of the diaper. Increased wetness in the diaper area makes the skin more susceptible to damage by physical, chemical, and enzymatic mechanisms. Wet skin increases the penetration of irritant substances. Superhydration urease enzyme found in the stratum corneum liberates ammonia from cutaneous bacteria. Urease has a mild irritant effect on nonintact skin. Lipases and proteases in feces mix with urine on nonintact skin and cause an alkaline surface pH, adding to the irritation. (Feces in breastfed infants have a lower pH, and breastfed infants are less susceptible to diaper dermatitis.) [5]  The bile salts in the stools enhance the activity of fecal enzymes, adding to the effect. pH-balanced wipes and simple washing or rinsing can help restore balance. [6]

Candida albicans has been identified as another contributing factor to diaper dermatitis; infection often occurs after 48-72 hours of active eruption. It is isolated from the perineal area in as many as 92% of children with diaper dermatitis. Other microbial agents have been isolated less frequently, perhaps more as a result of secondary infections.


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!