Redness in a One-Year-Old's Genital Area: Causes and Solutions - Pediatrics

Dr. Pei Rensheng reply Pediatrics

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Topic: Diaper Rash
Hello! A reddening reaction has occurred in the area covered by the diaper, which is known as diaper rash (commonly referred to as "red bottom").
Diaper rash not only affects appearance but, if not managed properly, can lead to secondary bacterial and fungal infections, causing the baby to cry and become irritable, which in turn affects sleep and feeding.
Statistics show that 40% of infants experience diaper rash at least once a month.
What are the manifestations of diaper rash? Whenever you bathe or change the diaper of your baby, you may occasionally notice small papules, erythema, and blisters on the rounded areas of the buttocks, waist, inner thighs, groin, vulva, scrotum, and around the anus; this is diaper rash.
If diaper rash is not addressed promptly, it can even lead to erosion and inflammation.
Fortunately, most cases of diaper rash can return to healthy skin within about three days with proper skin care, but they are easily recurrent due to various triggering factors.
As new parents, to help your baby overcome the nightmare of diaper rash, it is essential to understand its causes.
There are two main factors that contribute to the development of diaper rash: increased moisture content in the stratum corneum and an elevated pH level (making the skin more alkaline).
Newborns have faster gastrointestinal motility and tend to have frequent bowel movements (six to seven times a day is quite normal), often expelling stool before the moisture is fully absorbed, resulting in higher moisture content in their feces.
Additionally, infants have a higher body temperature than adults, and parents often worry about their babies getting cold, leading to excessive wrapping.
This makes the skin under the diaper prone to sweating; combined with several instances of urination throughout the day, this can increase the moisture content in the skin's stratum corneum.
What are the negative effects of increased moisture content in the stratum corneum? Research indicates that increased moisture content can triple the skin's friction coefficient, making the skin rougher and more susceptible to abrasions from minor external forces.
Furthermore, increased moisture sensitivity can double the skin's reactivity to irritants, meaning that the time required for the skin to redden in response to chemical irritants is significantly reduced.
If diapers are not changed frequently at this point, diaper rash can develop quickly.
Our feces contain urease, which can break down urea in urine into alkaline ammonia.
Before the age of one, infants' frequent urination and defecation can easily trigger this chemical reaction, resulting in alkaline skin.
Alkaline skin has three adverse effects: 1) Increased permeability, allowing small molecular irritants to penetrate the skin more easily.
2) Enhanced activity of digestive enzymes from the intestines, which can more readily compromise the integrity of the skin.
3) Certain harmful microorganisms (such as E.
coli and Candida) thrive in alkaline environments, leading to further skin damage.
Therefore, the occurrence of diaper rash can primarily be attributed to three risk factors: infant diarrhea (which increases moisture in the stratum corneum), infrequent diaper changes (which allows time for urease in feces to break down urea in urine into alkaline ammonia), and friction from the diaper against the skin.
The more risk factors present, the more likely diaper rash will occur.

Best regards,
Jun-An Pei Ren-Sheng

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Reply Date: 2006/02/14