How Is Yeast Diaper Rash Treated?

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The primary treatment for candidal diaper rash involves antiyeast topical treatment and decreasing moisture in the diaper area. Nystatin (Mycostatin), econazole (Spectazole), clotrimazole (Lotrimin), and miconazole (Micatin, Monistat-Derm) are topical treatments of equal strength for treating candidal diaper dermatitis. Occasionally, other antifungal creams may be prescribed, such as ketoconazole (Nizoral cream). How long treatment should last has not been completely defined, although, typically, the cream or ointment is applied at each diaper change until the rash is resolved.

Because of the intestinal reservoir of Candida species in most patients with yeast diaper rash, some doctors recommend oral antifungal medications in addition to topical creams. No study has definitively answered the question whether oral antifungal medications are helpful.

Prevent diaper rash by applying barrier creams like zinc oxide (A&D Ointment, Desitin, Diaparene) or petroleum jelly (Vaseline, Aquaphor) to the diaper area after bathing. These products may help to decrease the ambient moisture in the diaper area. Gentle cleaning to minimize skin breakdown may also be helpful.

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Are Yeast Diaper Rashes Common?

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One fourth to one half of babies experience diaper rash. Of these, one sixth to one half are due to yeast. Yeast diaper rashes tend to decrease as children get older and end when the infant stops using diapers.

If few C albicans are present, they may not be significant. However, symptoms are aggravated with more extensive infection. One study noted C albicans was present in 37 of 40 patients with diaper rash, suggesting that C albicans infection from the gastrointestinal tract plays a major role in diaper rash. Another study noted that 30% of healthy infants and 92% of infants with diaper rash had C albicans in the stool. This reveals a definite relationship between candidal colonization of the stool and diaper dermatitis.

Antibiotic use can lead to increased growth of Candida species. Thus, the fact that the use of amoxicillin increases the risk for developing diaper rash is not surprising. Amoxicillin use in infants decreases the number of bacteria and increases the number of C albicans.

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