Answered by Anthony J. Mancini MD
"Every day offers a new surprise, and my job is never dull or boring," says pediatric dermatologist Anthony Mancini. "How could it be with all those kids?"
Anthony J. Mancini, MD, is Assistant Professor of Pediatrics andDermatology at Northwestern University Medical School in Chicago, Illinois, and an attending physician at the city's Children's Memorial Hospital. In addition to his active clinical practice, Dr Mancini continues to be involved in clinical research and has written for a number of prestigious medical journals and textbooks. Dr. Mancini has special interests in the treatment of skin disorders in infants and children, fetal skin development and skin problems of premature babies, and infectious skin diseases in children.
Dr Mancini trained in pediatrics, pediatric dermatology, and dermatology at Stanford University Medical Center in Palo Alto, California, where he was the chief resident in dermatology. He is a fellow of the American Academy of Pediatrics and the American Academy of Dermatology, and an active member of the Society for Pediatric Dermatology and the Chicago Dermatological Society.
Dr Mancini and his wife, a neonatal intensive care nurse, have two children.
Question
My 11-month-old son keeps getting nappy rash even though we give him a bath every night. We use Desitin nappy rash cream and Pampers nappies. What could be the problem?
Answer
Nappy rash has many causes, but most cases are related to skin irritation from moisture in the nappy area. Changes in the skin pH, damage from proteins found in the stool, and secondary infection with bacteria or yeast can further aggravate skin irritation. You are already doing many of the right things: daily bathing, using a super-absorbent disposable nappy, and applying a skin protectant. Be sure to change his nappy regularly throughout the day and apply the skin protectant at every change: the less time the skin is exposed to moisture, the better. After bathing, dry the nappy area completely and then apply the skin protectant. Plain petroleum jelly or a thick cream that comes in a tub would be a better choice for forming an effective artificial barrier on the skin to protect it from further damage. If you see any small red bumps, especially if you also see white pus bumps, your son may have a yeast infection. If this is the case, or if the measures above do not lead to improvement within one week, have him examined by his GP. Don't worry - even stubborn cases clear with toilet training!
