Another diaper rash question

My 10mo has had a rash on his diaper area that just. won't. go. away. I'm going to call the pedi tomorrow (who said the next step would be a dermatologist), but I'm hoping maybe someone has an idea of what is causing this that we're missing.

Bennett wears cloth dipes during the day and sposies at night or if we're away from home. I make my own wipes with a mild solution of baby shampoo, baby oil, and water. I use one of the best rated detergents in terms of irritants for his dipes and Tide Free for all of our clothes. I use the rubber dryer balls - no chemicals - in the dryer. I've put him in strictly sposies and then cloth only to see if it was the dipes...no change.

The Dr. originally thought it was eczema, not diaper rash. Our full course of trial solutions have included: Bag Balm (our 1st choice for diaper rash), Triple Paste, hydrocortizone, then prescription Nastatin and finally, Mupirocin. I let his butt air dry for a bit at each diaper change and have even bathed him in baking soda water (said to neutralize the skin's pH and make it inhospitable for fungus/bacteria). This rash seems to get better - then worse - but with no real consistency that I can find. It is on his lower belly (but he's gotten a few small spots higher on his abdomen), in his genital area, and in the crease of his thigh/butt. It hasn't progressed to open sores at all, just red patches.

Like I said, I'm guessing I'll have to call the Pedi, but the last time I spoke to him he said we were running out of options aside from a dermatologist referral. So this is a last ditch effort before I go that route. Perhaps I'm missing something?

Thanks for your help!!

 

Maybe after you wipe him or when he gets out of the bath, the creases aren't getting completely dry? I know if i don't get the fold on my daughters neck completely dry, it rashes up. Good luck.

 

What about the wipe solution? Maybe the baby oil is a skin irritant. I am allergic to baby oil. It makes me break out in a red rash. Just a thought?

What happens during treatment with the Nystatin or the Murpirocin? What about a Staph infection? The Murpirocin should help with that, but maybe it needs longer treatment? ardon:

 

With both the Nystatin and Mupirocin, it looks promising at first - clearing up to a barely visible spot(s). Then, it gets bright red again. It goes back and forth, seeming to get better then it flairs up. He did almost 2 wks on the Nystatin (with these back and forth results) and he's been on the Mupirocin for over a week. Today was the worst I've seen it.

I think I will try eliminating the wipe solution entirely tomorrow and see how it goes. You might be right. I'm pretty sure it's not the baby wash, as I do use it to bathe him, too, and have had no other issues. But the baby oil... :unknw:

Thanks! I'll keep my fingers crossed that's all it is (and then kick myself for not trying that sooner :blush: ).

 

This sounds exactly like what Abby has been going through. Well, we seem to have gotten a handle on it at this point. But, we thought it was a strep infection at first and used a cream for that (mupricon I think?), then antibiotics. It seemed to get better for a few days, but then flared right back up. We did hydrocortisone, lotrimin (yeast), triple paste, some other prescription cream, calmoseptine, aquaphor, desitin, EVERYTHING and she was on 3 antibiotics. We were finally given a very high potency steroid cream that did the trick, but as soon as we stopped using it it flared right back up. We ended up having to go to a pediatric dermatologist and they said they felt it was b/c she needed to be weaned off of a steroid cream. They gave me a step down cream to use for 2 weeks, then every other day for a week, then every 2 x's a week, then full wean. When all was said and done, it was 5 months before it was clear. For some reason her eczema seems really sensitive in that area and we have to use Aquaphor or a thick moisturizer on her butt, inner thighs multiple times a day and this seems to be helping to keep it at bay. I know how frustrating it can be. We went through so many meds and Dr.'s and trials of OTC stuff. I hope you can get something figured out. I kept wanting to use our Pedi, but we really only saw her once and saw nurse practitioners and other Pedi's and everyone wanted to treat it differently. It took us a month to get into the dermatologist, so that was rough knowing there wasn't much else we could do until she got seen there. I hope you get it figured out and the area gets cleared up. Sorry to be so long winded here, but I was in your shoes not so long ago and remember no being able to get this figured out.

 

:blink: Wow. Ok, really, that WASN'T what I wanted to hear, but it's very helpful all the same. Thank you! *sigh*

It really does sound exactly like what Bennett's going thru. The area is red, sometimes looks a little raised, and the last part to clear up is the perimeter. And it just won't leave. Our pedi did say it appeared to be eczema when he saw them at 9mos. Fortunately, he didn't go the steroid route! But the steroid/step-down cream did eventually clear it up for Abby?

Boy, I'm praying even HARDER it's just a sensitivity to the oil (although I kind of expect not). Frequent cream usage does NOT jive well w/ cloth diapers! Argh!

Thanks for the insight, Melissa! I appreciate you taking the time to help!

 

What about food he is eating? I know my last dd loved the baby food creamed corn but wow did she get a diaper rash after eating that! Also skin gets irritated by baby oil so here's to hoping that works for him too. The only thing that clears up my dd's rashes (even prescription creams did not) is Burts Bees Diaper Ointment. Good luck!!!

 

Poor thing!!!
My son had a similar issue, but not as bad as yours. We did see the pediatric dermatologist…..and this is what he said:
Stop using a cocktail of products (ie different soaps, bathing lotions, butt paste, hydro-cortisone etc). If you keep trying all these different things you will never know what is causing the problem and could be making things worse. He told us to use brown (bleach free diapers), the sensitive skin wipes (pick one brand and stay with it), cetaphil bar soap, and cetaphil cream (not the lotion). He said to bath him each evening in luke-warm water (not hot) and then apply the cream twice a day all over his body.
Now that was to prevent and, for the mildly irritated spots. To heal the bad areas he gave us a prescription cream and an oral med. It took about two weeks for everything to clear up. It has been two years and we still use the same routine and product, with only minor flare-ups…..which we use the prescription cream at the first sign and thing clear up in a day or two.
I think the key was to stop trying so many different things and stick with his recommendation. He did warn me to give it a week, and if I did not see improvement that we then would look at switching a product.
For us the doctor said that our son would out grow this over time usually by three or four.
Since your little one is so sore in the diaper area, you may want to try putting him in the pac-n-play with-out a diaper for several hours a day…..allowing air to get to the area.
I hope this helps??

 

I considered this, but wouldn't the rash be more centralized to his butt area? The problem started w/ a spot just below his belly button...it didn't migrate to his butt for a few weeks. I dunno...certainly not out of the realm of possibilities, tho.

You know, I've been wondering about this. That's why we don't introduce too many new foods at once, no? Makes sense. I guess the trick is going to be figuring out a starting point...so I guess the dermatologist visit is probably inevitable. I don't want to monkey around with this forever...poor lil' guy doesn't need that.

Since you do cd, how do you deal with the creams and such, since they're bad for cloth? Do you use liners? Or just strip the diapers frequently? I have liners but they are so thin I wonder if they really protect the diaper, besides it just seems like something else to irritate his skin.

Thanks, everyone, for your very helpful input!! :hug:

 

I don't have much to offer with regards to the rash other than :hug: but wonder if it could be something in the diapers? We are just switching to cloth diapers and I feel like I have done more research on CD's than on any subject that I did during my entire three years at law school. On some of the other boards that I visit, there have been lots of moms who have commented on creams that are suitable for CD and different tips/tricks for using them and not getting a build-up of product. Some of those mamas have talked about recurrent yeast infections (that look like diaper rash) and cloth diapers. I know you said that you were using CD friendly detergent. Are you also using something like Bac-Out? Just a thought--but, maybe the diapers have some sort of "something" lurking in them that could be reinfecting your poor baby.

 

I hear you!! I had NO idea what a "science" there is to cd'ing. Sheesh!

Re the Bac-out, no, I've never tried this...in fact, I forgot it existed. But I did take him out of cloth for 3 straight days and the rash was no better...at times it was worse. Again, I think I might be muddying the water with all of the experimentation. Patience is NOT a virtue I possess. :blush:

 

Thank you so much for posing this question because I am in the exact same boat with one of my girls. She also has eczema and I'm bfeeding. It is such a headache. It has been a month already and I just want the redness to clear up. Nystatin just isn't getting the job done. I have an appt. with the ped next week. I'm praying that he has a solution to this problem.