Gabriel first started exhibiting small patches of eczema at 10 months old. He was prescribed a “light” steroid cream by the doctor, but the eczema only became worse. The doctor then prescribed Mometasone and Elidel creams. His parents did exactly what they were instructed to do, and they watched Gabriel become more itchy and miserable before their eyes. He was then prescribed, Triamcinolone Acetonide Ointment, Fluocinolone, oral antibiotics, and oral steroids. They were instructed to apply the topical steroids 3 times a day. This therapy worked temporarily, but when it stopped working, Gabriel’s mother described his skin looking as if it were “attacking itself.”
Diaper dermatitis results from prolonged contact with irritants such as moisture, chemical substances, and friction. Urine ammonia, formed from the breakdown of urea by fecal bacteria, is irritating to sensitive infant skin. Ammonia by itself does not cause skin breakdown. Only skin damaged by infrequent diaper changes and constant urine and feces contact is prone to damage from ammonia in urine. Inadequate fluid intake, heat, and detergents in diapers aggravate the condition. Bouts of diarrhea can quickly cause rashes in most children. Diaper rash begins with erythema in the perianal region. Left untreated, the area can quickly excoriate and progress to macules and papules, which form erosions and crust. Under certain circumstances (in infants under the age of six months, toddlers who have been on antibiotics , and immune compromised children) diaper dermatitis may become secondarily infected with Candida ablicans. Sometimes severe diaper dermatitis becomes super-infected with bacteria (streptococci or staphylococci).
My second little girl battled with horrible diaper rash when she was a baby. We switched diaper brands, watched what she ate, and tried every ointment from the store you could imagine. At one point when she was on antibiotics for an infection and her diaper rash was so bad that her bottom bled. They prescribed me a very expensive steroid cream and told me to mix it with another popular brand of diaper cream that also contained a slew of harmful ingredients. Being naive I took their word for it. It took almost a week before there were any improvements.