A novel treatment of diaper dermatitis in children and adults

Abstract

Background: Diaper dermatitis (DD) is an acute inflammatory reaction, regardless of the cause, of the diaper-covered area. Topical skin barrier repair cosmetic products are the mainstay treatment to cure and/or prevent DD.

Aims: To assess the efficacy/tolerability of a zinc gluconate-taurine/zinc oxide and panthenol/ glycerin/ Butyrospermum parkii butter barrier cream using clinical evaluation.

Methods: In this prospective, open-label trial, 20 patients (10 infants/10 adults), with mild/moderate DD enrolled at the Dermatology University Clinic of Catania (Italy) were instructed to apply the cream twice daily for 30 days. Degree of erythema was performed clinically by a 5-point severity scale (from 0 = no erythema to 4 = severe erythema), at baseline, at 15 and 30 days. An Investigator Global Assessment (IGA) using a 6-point scale (from -1 = worsening to 4 = complete response/clear) along with product tolerability was also performed at 15 and 30 days. Statistical analysis was performed using SAS version 9.

Results: At 15 days, a reduction of clinical erythema assessment (CEA) from baseline was observed (mean from 3.2 ± 0.8 to 2.5 ± 0.3; p < 0.06), that although nonsignificant, showed a significant progressive improvement at 30 days (mean from 3.2 ± 0.8 to 1.1 ± 0.9; p < 0.0001) without any age differences.

Conclusions: Our preliminary results indicate that the tested barrier cream may represent a promising approach in DD rash. It may be used in mild-to-moderate forms in monotherapy without significant side effects or, where required, in association with pharmacological agents. Its long-term use is likely safe.

Keywords: barrier cream; diaper dermatitis; topical treatments.

Conflict of interest statement

None to declare.

© 2021 The Authors. Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.

Figures

FIGURE 1

An 8‐month baby girl with a 2‐month history of mild perianal DD extending to the vulvar area had been treated with zinc oxide paste, but her mother refused to continue this treatment due to poor improvement. At clinical examination, on the perianal area a moderate erythema was observed (A). After 15 days of treatment with the tested barrier cream used twice daily, an excellent response was obtained, with the persistence of very mild erythema (B)

FIGURE 2

An 11‐month baby boy with a 1‐month history of mild DD on the scrotal skin area treated with a topical steroid agent was admitted for parents’ concern regarding side effects from prolonged treatment. At clinical examination, on the scrotal area a moderate erythema was observed along with mild skin atrophy likely resulting from the steroid treatment. Few pustular lesions were also present (arrows) (A). A complete clearing after 30 days of treatment with the tested barrier cream used twice daily (B) was obtained

FIGURE 3

A 12‐month infant with a 2‐month history of moderate scrotal DD extending to inguinal fold areas underwent evaluation for a clinical worsening despite treatment with a topical steroid agent and negative skin swabs. At clinical examination, on the scrotum and the inguinal folds, a moderate erythema was observed (A). A complete clearing after 30 days of treatment with the tested barrier cream used twice daily (B) was obtained