What’s happening under the diaper?
The many causes of diaper rash
The primary cause of diaper rash is prolonged and increased exposure to wetness/moisture to the skin. Other contributing factors to diaper rash are:
- The closed environment created by the diaper
- Chafing from friction or rubbing
- Prolonged contact of the skin with urine, feces or both
Closed environment created by the diaper
Diapers are usually snug fitting. This results in little air reaching baby’s diaper area, which causes baby’s skin to become warmer and moister and therefore have a higher pH (which is a measure of acidity vs. alkalinity) than elsewhere in the body. Excessive moisture in the skin makes it more easily penetrated by irritants and more vulnerable to swelling.
Friction can weaken the protective barrier of the skin. Moist skin is more vulnerable to friction than dry skin, making the diaper area particularly prone to this problem. Friction between the diaper and the skin, two areas of skin (such as in skin creases and folds), and constant wiping and cleaning in the diaper area can facilitate the penetration of irritating substances into the skin.
Contact with urine and feces
The enzymes in feces (protease and lipase) may irritate baby’s tender skin. In addition, feces contain organisms that can cause skin infection. Urine further irritates the diaper area. As urine breaks down, it releases ammonia. This causes the pH of the skin to rise (in other words, to become increasingly basic, or alkaline) and the enzymes from baby’s stool to become more active. This may result in tissue/skin damage and lead to diaper rash.