Nappy rash: current evidence for the prevention and management

02 May 2020
8 min read
 Midwives need to be aware of the causes of nappy rash in order to better advise on treatment methods
Volume 28 · Issue 5

Abstract

Nappy rash affects up to 25% of nappy wearing infants and can be distressing for the infant, their family and carers. This paper focuses on the cause, prevention, diagnosis and management of nappy rash based on current evidence and guidance to provide optimum care and advice antenatally and postnatally. The aim is to shed light on assessment, diagnosis, self-management and therapeutic options to prevent, manage and treat nappy rash. Although common, nappy rash can provide diagnostic challenges. Thus, the paper will highlight further potential causes of nappy rash and when to seek further advice and guidance.

Nappy rash, also known as diaper rash, nappy dermatitis, diaper dermatitis or irritant diaper dermatitis, is one of the most common skin conditions found in infants and is an acute inflammatory reaction of the skin in the nappy area most commonly caused by an irritant contact dermatitis. There are no differences between boys, girls or ethnic groups (Merrill, 2015) and prevalence varies geographically, depending on cultural differences in the use of nappies, toilet training and skincare practices (National Institute for Health and Care Excellence [NICE] CKS, 2018). It affects up to 25% of nappy wearing infants within the first four weeks of life to as much as 100% at some point in infancy (Ravanfar et al 2012, Burdall et al 2019) with the highest prevalence between 9–12 months of age (Cohen, 2017).

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