Diaper dermatitis: a survey of risk factors in Thai children aged under 24 months

Chonnakarn Sukhneewat, Jitjira Chaiyarit, Leelawadee Techasatian, Chonnakarn Sukhneewat, Jitjira Chaiyarit, Leelawadee Techasatian

Abstract

Background: To identify the prevalence and risk factors associated with diaper dermatitis in Thai children aged 1-24 months.

Methods: This was a cross-sectional study of 1153 participants using structural questionnaires, which was conducted at Khon Kaen University Faculty of Medicine Pediatric department in Thailand. Univariate and multivariate logistic regression analyses were used to test the association between diaper dermatitis and its possible risk factors.

Results: The prevalence of diaper dermatitis among the study population was 36.1%, a rate which significantly decreased with age. The highest prevalence was found in subjects who were one to six months old. Risk factors that had a statistically significant association with diaper dermatitis in both univariate and multivariate analysis were i) diaper changing fewer than three times/night, ii) previous episodes of diaper rash, iii) using cloth diapers, and iv) topical application of baby talcum powder to the diaper area.

Conclusions: Frequent diaper changings during the daytime do not compensate for fewer changings during the night. Moreover, the use of baby talcum powder on the diaper area significantly increased the risk of diaper dermatitis among the study population. These findings should be applied in future preventive strategies for diaper dermatitis in this age group.

Keywords: Baby talcum powder; Dermatitis; Diaper dermatitis; Risk factor.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Variation in the prevalence of diaper dermatitis among different age groups

References

    1. Atherton DJ. A review of the pathophysiology, prevention and treatment of irritant diaper dermatitis. Curr Med Res Opin. 2004;20(5):645–649. doi: 10.1185/030079904125003575.
    1. Shin HT. Diagnosis and management of diaper dermatitis. Pediatr Clin N Am. 2014;61(2):367–382. doi: 10.1016/j.pcl.2013.11.009.
    1. Berg RW. Etiology and pathophysiology of diaper dermatitis. Adv Dermatol. 1988;3:75–98.
    1. Ravanfar P, Wallace JS, Pace NC. Diaper dermatitis: a review and update. Curr Opin Pediatr. 2012;24(4):472–479.
    1. Li CH, Zhu ZH, Dai YH. Diaper Dermatitis: a survey of risk factors for children aged 1 – 24 months in China. J Int Med Res. 2012;40(5):1752–1760. doi: 10.1177/030006051204000514.
    1. Ward DB, Fleischer AB, Feldman SR, Krowchuk DP. Characterization of diaper dermatitis in the United States. Arch Pediatr Adolesc Med. 2000;154(9):943–946. doi: 10.1001/archpedi.154.9.943.
    1. Singalavanija S, Frieden IJ. Diaper Dermatitis. Pediatr Rev. 1995;16(4):142–147. doi: 10.1542/pir.16-4-142.
    1. Adalat S, Wall D, Goodyear H. Diaper dermatitis-frequency and contributory factors in hospital attending children. Pediatr Dermatol. 2007;24(5):483–488. doi: 10.1111/j.1525-1470.2007.00499.x.
    1. Scheinfeld N. Diaper dermatitis: a review and brief survey of eruptions of the diaper area. Am J Clin Dermatol. 2005;6(5):273–281. doi: 10.2165/00128071-200506050-00001.
    1. Prasad HRY, Srivastava P, Verma KK. Diaper dermatitis--an overview. Indian J Pediatr. 2003;70(8):635–637. doi: 10.1007/BF02724253.
    1. Thaman LA, Eichenfield LF. Diapering habits: a global perspective. Pediatr Dermatol. 2014;31:15–18. doi: 10.1111/pde.12468.
    1. Klunk C, Domingues E, Wiss K. An update on diaper dermatitis. Clin Dermatol. 2014;32(4):477–487. doi: 10.1016/j.clindermatol.2014.02.003.
    1. Coughlin CC, Frieden IJ, Eichenfield LF. Clinical approaches to skin cleansing of the diaper area: practice and challenges. Pediatr Dermatol. 2014;31:1:1–1:4.
    1. Odio M, Friedlander SF. Diaper dermatitis and advances in diaper technology. Curr Opin Pediatr. 2000;12(4):342–346. doi: 10.1097/00008480-200008000-00011.
    1. Humphrey S, Bergman JN, Au S. Practical management strategies for diaper dermatitis. Skin Ther Lett. 2006;11(7):1–6.
    1. Baer EL, Davies MW, Easterbrook K. Disposable nappies for preventing napkin dermatitis in infants [Internet]. In: Cochrane Database of Systematic Reviews. John Wiley & Sons, Ltd; 2006 [cited 2017 Jul 14]. Available from:
    1. Odio M, Thaman L. Diapering, diaper technology, and diaper area skin health. Pediatr Dermatol. 2014;31(Suppl 1):9–14. doi: 10.1111/pde.12501.
    1. Burdall O, Willgress L, Goad N. Neonatal skin care: developments in care to maintain neonatal barrier function and prevention of diaper dermatitis. Pediatr Dermatol. 2019;36(1):31–35. doi: 10.1111/pde.13714.
    1. Blume-Peytavi U, Hauser M, Lünnemann L, Stamatas GN, Kottner J, Garcia Bartels N. Prevention of diaper dermatitis in infants--a literature review. Pediatr Dermatol. 2014;31(4):413–429. doi: 10.1111/pde.12348.
    1. Wananukul S, Limpongsanuruk W, Singalavanija S, Wisuthsarewong W. Comparison of dexpanthenol and zinc oxide ointment with ointment base in the treatment of irritant diaper dermatitis from diarrhea: a multicenter study. J Med Assoc Thail Chotmaihet Thangphaet. 2006;89(10):1654–1658.
    1. Proksch E, Nissen HP. Dexpanthenol enhances skin barrier repair and reduces inflammation after sodium lauryl sulphate-induced irritation. J Dermatol Treat. 2002;13(4):173–178. doi: 10.1080/09546630212345674.
    1. Ebner F, Heller A, Rippke F, Tausch I. Topical use of dexpanthenol in skin disorders. Am J Clin Dermatol. 2002;3(6):427–433. doi: 10.2165/00128071-200203060-00005.
    1. Goldman M, Lodhi I. A real-world evidence study evaluating a treatment for nappy rash. Br J Nurs Mark Allen Publ. 2016;25(8):432–439. doi: 10.12968/bjon.2016.25.8.432.
    1. Scheinfeld DN. Diaper Dermatitis. Am J Clin Dermatol. 2012;6(5):273–281. doi: 10.2165/00128071-200506050-00001.
    1. Fiume MM, Boyer I, Bergfeld WF, Belsito DV, Hill RA, Klaassen CD, et al. Safety assessment of talc as used in cosmetics. Int J Toxicol. 2015;34:66S–129S. doi: 10.1177/1091581815586797.
    1. Garcia Bartels N, Lünnemann L, Stroux A, Kottner J, Serrano J, Blume-Peytavi U. Effect of diaper cream and wet wipes on skin barrier properties in infants: a prospective randomized controlled trial. Pediatr Dermatol. 2014;31(6):683–691. doi: 10.1111/pde.12370.
    1. Brouillette F, Weber ML. Massive aspiration of talcum powder by an infant. Can Med Assoc J. 1978;119(4):354–355.
    1. Matina F, Collura M, Maggio MC, Vitulo P, Lo Piparo C, Corsello G. Inhaled surfactant in the treatment of accidental talc powder inhalation: a new case report. Ital J Pediatr. 2011;37:47. doi: 10.1186/1824-7288-37-47.

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