non-pharmacological options
Place in Therapy
Place in Therapy: Non-Pharmacological Interventions
Minimizing hydration in the diaper region is a key non-pharmacological prevention measure of diaper dermatitis. Several techniques can be used to minimize hydration, including frequent diaper changes, use of superabsorbent diapers and “air-drying.” It is important to note that non-pharmacological approaches should never be used alone in cases where the child is actively experiencing signs and symptoms of diaper dermatitis. However, it is considered an important adjunct therapy to other treatment approaches.<1>
Frequent Diaper Changes
Frequent diaper changes are an important component of both the treatment and prevention of irritant diaper dermatitis. The frequency of diaper dermatitis has been shown to decreases in relation to an increased number of diaper changes. <2> In general, soiled diapers should be changed as soon as possible. If diaper dermatitis is present, the diaper should be changed at least every 2 hours during the day and once during the night. <2> If the child presents with diarrhea or is a newborn, even more frequent diaper changes are warranted. <3>
The Use of Superabsorbent Diapers
In comparison to cloth diapers and conventional diapers (100% cellulose core), disposable diapers are associated with less diaper dermatitis and Jacquet’s erosive dermatitis.<4> Newer disposable diapers, such as superabsorbent diapers, contain absorbent gelling material (AGM) that extracts moisture into the diaper and reduce moisture against skin.<4> AGM consists of cross-linked sodium polyacrylates that bind water and form a gel matrix.<2> Several clinical trials in North American and Western Europe documented that AGM disposable diapers were associated with significantly reduced skin wetness, closer to normal skin pH, and lower degrees of diaper dermatitis.<5>
“Air drying” and having “Diaper-free periods”
The continuous use of diapers is at the root of irritable diaper dermatitis. Therefore maximizing “diaper-free” time is a widely recommended strategy. <6> However, due to the fact that this practice is associated with potential messes, it is not always a practical technique. To minimize soiling, place a water-proof barrier under the child.<6>
References
1. Sibbald, D. Diaper Dermatitis. In: McLeod PJ, Allen M, Conly J, eds. Patient Self-Care - Helping Your Patients Make Therapeutic Choices. 2nd ed. Ottawa, ON: Canadian Pharmacists Association; 2010: 534-545.
2. Borkowski S. Diaper Rash Care and Management. Pediatr Nurs 2004;30(6):467-470.
3. Nield, L. S., & Kamat, D. Prevention, diagnosis, and management of diaper dermatitis. Clinical Pediatrics 2007;46(6): 480-486.
4. Bikowski J. Update on Prevention and Treatment of Diaper Dermatitis. Practical Dermatology for Pediatrics 2011; 16-19.
5. Odio M. Friedlander SF. Diaper dermatitis and advances in diaper technology. Curr Opin Pediatr 2000; 12: 342-6.
6. Scheinfeld, N. Diaper dermatitis: A review and brief survey of eruptions of the diaper area. American Journal of Clinical Dermatology 2005; 6(5):273-281.
Minimizing hydration in the diaper region is a key non-pharmacological prevention measure of diaper dermatitis. Several techniques can be used to minimize hydration, including frequent diaper changes, use of superabsorbent diapers and “air-drying.” It is important to note that non-pharmacological approaches should never be used alone in cases where the child is actively experiencing signs and symptoms of diaper dermatitis. However, it is considered an important adjunct therapy to other treatment approaches.<1>
Frequent Diaper Changes
Frequent diaper changes are an important component of both the treatment and prevention of irritant diaper dermatitis. The frequency of diaper dermatitis has been shown to decreases in relation to an increased number of diaper changes. <2> In general, soiled diapers should be changed as soon as possible. If diaper dermatitis is present, the diaper should be changed at least every 2 hours during the day and once during the night. <2> If the child presents with diarrhea or is a newborn, even more frequent diaper changes are warranted. <3>
The Use of Superabsorbent Diapers
In comparison to cloth diapers and conventional diapers (100% cellulose core), disposable diapers are associated with less diaper dermatitis and Jacquet’s erosive dermatitis.<4> Newer disposable diapers, such as superabsorbent diapers, contain absorbent gelling material (AGM) that extracts moisture into the diaper and reduce moisture against skin.<4> AGM consists of cross-linked sodium polyacrylates that bind water and form a gel matrix.<2> Several clinical trials in North American and Western Europe documented that AGM disposable diapers were associated with significantly reduced skin wetness, closer to normal skin pH, and lower degrees of diaper dermatitis.<5>
“Air drying” and having “Diaper-free periods”
The continuous use of diapers is at the root of irritable diaper dermatitis. Therefore maximizing “diaper-free” time is a widely recommended strategy. <6> However, due to the fact that this practice is associated with potential messes, it is not always a practical technique. To minimize soiling, place a water-proof barrier under the child.<6>
References
1. Sibbald, D. Diaper Dermatitis. In: McLeod PJ, Allen M, Conly J, eds. Patient Self-Care - Helping Your Patients Make Therapeutic Choices. 2nd ed. Ottawa, ON: Canadian Pharmacists Association; 2010: 534-545.
2. Borkowski S. Diaper Rash Care and Management. Pediatr Nurs 2004;30(6):467-470.
3. Nield, L. S., & Kamat, D. Prevention, diagnosis, and management of diaper dermatitis. Clinical Pediatrics 2007;46(6): 480-486.
4. Bikowski J. Update on Prevention and Treatment of Diaper Dermatitis. Practical Dermatology for Pediatrics 2011; 16-19.
5. Odio M. Friedlander SF. Diaper dermatitis and advances in diaper technology. Curr Opin Pediatr 2000; 12: 342-6.
6. Scheinfeld, N. Diaper dermatitis: A review and brief survey of eruptions of the diaper area. American Journal of Clinical Dermatology 2005; 6(5):273-281.