How inflammation develops in the fold
Inside the fold, the skin is in contact with itself, almost no air gets in there, and the temperature and humidity are higher than outside. Sweat, sebum, urine or detergent residues soften the stratum corneum and the protective barrier stops working. Friction during movement completes the job: microcracks appear. In such an environment, yeast-like fungi of the genus Candida and streptococci actively multiply, so simple irritation easily turns into infectious inflammation with weeping and plaque. This is why cream without eliminating moisture usually does not help.
- First degree - redness without compromising the integrity of the skin
- Second degree - erosion, cracks, weeping
- Third degree - ulcers, purulent plaque, unpleasant odor
- Frequent places: groin, under the breasts, armpits, abdomen, interdigital spaces
- In infants - diaper area and neck folds
Who encounters more often
Diaper rash is not associated with untidiness: it also occurs with careful care, if the fold is deep and the weather is hot. Those most at risk are infants due to their delicate skin and diapers, people who are overweight and have large folds, and patients with diabetes whose sugar in their sweat and reduced immunity contribute to the growth of fungi. A separate group includes bedridden patients and people with incontinence, as well as those who sweat a lot at work or wear tight synthetic clothing.
- Children of the first year of life
- Obesity and deep skin folds
- Diabetes mellitus and other endocrine diseases
- Urinary and fecal incontinence, bed rest
- Excessive sweating and hot climate
- Tight synthetic clothing and shoes
Symptoms and differences from other diseases
Diaper rash begins with a bright pink or red shiny spot that follows the contours of the fold. There is a burning sensation, itching, and pain when moving. When candida attaches along the edge of the lesion, small bubbles and screenings are visible in the form of individual points beyond the border of the main spot, and the surface is covered with a whitish coating. Fungus of the inguinal folds usually gives a clear ridge along the edge, psoriasis - dense red plaques with a shine, and allergic dermatitis extends beyond the fold and is associated with a new care product or fabric.
- Redness and shine of the skin strictly in the fold
- Burning, itching, pain when moving
- Wetting, cracks in the depths of the fold
- White plaque and screenings along the edges are a sign of candida
- Unpleasant odor when the process is running
- The child has anxiety when changing a diaper
How to care for your skin
The main principle is to make the fold dry and remove friction. The skin is washed with a mild product without aggressive fragrances, gently blotted with a towel without rubbing, and allowed to air dry completely. Short air baths work well: for a baby - a few minutes without a diaper after each change, for an adult - loose cotton clothes. You can place a clean cotton cloth between the surfaces of the fold. Do not apply powders to a wet surface: they roll into lumps and increase irritation.
- Gentle cleansing and thorough drying
- Air baths several times a day
- Barrier creams with zinc oxide or dexpanthenol
- Loose clothing made from natural fabrics
- Frequent diaper changes, avoiding wet wipes with alcohol
- Weight loss and sugar control for chronic diaper rash
When do you need treatment from a doctor?
If after a few days of proper care there is no improvement, oozing, plaque or purulent crusts appear, an examination is needed. The doctor takes a scraping or culture to understand whether there is a fungus and what bacteria are present, and selects medications: antifungal creams for candidiasis, local antibacterial drugs for pyoderma, short courses of anti-inflammatory external agents for severe swelling. Adults with persistent diaper rash have their blood glucose checked—sometimes this is how diabetes is first diagnosed. Treatment is always prescribed by a doctor.
- Scraping and culture from the lesion
- Antifungal agents for candidiasis
- Antibacterial drugs for purulent inflammation
- Drying lotions when getting wet
- Blood test for glucose and glycated hemoglobin
- Treatment of associated sweating and incontinence