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Diaper rash can affect anyone wearing diapers or incontinence briefs, including adults, babies, and toddlers. Symptoms in adults are the same as symptoms seen in babies and toddlers, and may include a pink-to-red colored rash, or peeling or irritated looking skin.

Diaper rash is commonly caused by infrequent diaper changes, which can lead to irritation from chemicals found in urine and stool. It may also be caused by an allergic reaction, or a yeast or fungal infection.

Adult diaper rash is uncomfortable but can usually be treated with over-the-counter (OTC) topical or prescription medication. Read on to learn more about this condition.

Symptoms of adult diaper rash may include:

  • pink, dry skin in mild rashes
  • red, irritated, raw, inflamed, or burnt-looking skin in more serious cases
  • skin lesions
  • burning
  • itching

The rash may appear on the buttocks, thighs, or genitals. It may also extend up to the hip area.

In the case of a candida diaper rash, or a rash that’s caused by a yeast infection, symptoms include bright red skin that’s slightly raised, and small red bumps going beyond the main part of the rash. It may extend into the skin folds.

Common causes of adult diaper rash include:

  • Skin irritation. This can be a result of friction from wet skin rubbing against the diaper, or prolonged contact to the chemicals in urine or stool.
  • Allergic reaction. Elderly adults wearing incontinence briefs may be allergic to the perfumes in the diaper material.
  • Improper washing. Not washing the genital area carefully when bathing can lead to a rash around the area where the diaper is worn.
  • Candida. Yeast infections are another common type of adult diaper rash. That’s because yeast grows in warm, dark, moist areas. Frequent diaper changes can reduce the risk for this type of infection.
  • Fungal infection.

In most cases, you can treat a mild adult diaper rash at home. One of the most effective treatments is an OTC zinc oxide diaper cream.

Examples of adult diaper creams include:

Instructions for treatment

These instructions are recommendations from the American Academy of Dermatology (AAD). Always follow your doctor’s instructions for treating your or, if you’re a caregiver, your loved one’s specific rash.

  1. Apply diaper rash ointment or cream liberally to the affected area, two to four times a day.
  2. For a painful rash, there’s no need to wash it off immediately, but you can pat off excessive product. Fully remove any residue left behind while bathing.
  3. If necessary, cover the cream or ointment with petroleum jelly so it doesn’t stick, and put on a clean, dry diaper.

It’s also a good idea to allow the affected area to air out for a few minutes a day without a diaper. The airflow will help heal the rash. For additional airflow, you can use larger than needed diapers until the rash heals.

If the rash is a result of a yeast or fungal infection, your doctor may recommend topical antifungals, including nystatin or ciclopirox (CNL8, Penlac), be applied to the affected area. They should be applied two to four times a day, or, in severe cases, with every diaper change.

Fluconazole (Diflucan) oral tablets may also be prescribed. Follow your doctor’s specific instructions for treatment, and remember to always check with your doctor to confirm that recommended diaper rash treatments don’t conflict with other medications you or your loved one may be taking.

Most cases of diaper rash will clear up after a few days of home treatment. However, it’s important to remember that elderly adults are more likely to experience infections. This is due to a weakening immune system. Any serious symptoms should be reported to a doctor.

See your doctor if the following occurs:

  • rash worsens and doesn’t improve after three days, even after home treatment
  • oozing, bleeding, or puss comes from the affected area
  • rash is accompanied by fever
  • burning or pain while urinating or during a bowel movement

There are usually no long-term complications from adult diaper rash. In most cases, it’ll clear up with proper treatment and management. In some adults, diaper rash may occur with other skin conditions including psoriasis, eczema, or seborrhea. See your doctor if you or your loved one experiences symptoms of these conditions.

If you or your loved one gets frequent diaper rashes, be sure to notify your doctor. It may be a more serious infection. In the case of nursing home care, an adult diaper rash may be a sign of neglect, that the diaper isn’t being changed frequently enough, or that the diaper area isn’t being cleaned well. In most cases, diaper rash will clear up on its own with proper treatment and care.

The best way to prevent adult diaper rash is to clean and change dirty diapers as soon as possible. This prevents moisture from turning into a rash.

  1. Gently clean the area covered by the diaper with a washcloth, such as Prevail Washcloths, every time you change the diaper.
  2. Once a day, wash the entire diaper area more thoroughly.
  3. Allow the diaper area to air out and dry.
  4. Also apply a moisture barrier ointment to the buttocks and other sensitive areas before putting on a clean diaper.

Treating diaper rash at the first signs of irritation can also help prevent the rash from becoming more serious.

Q: Can I develop a diaper rash even if I don’t wear diapers?

A: Yes, you can develop a diaper rash even without wearing diapers. A warm, moist environment or skin friction can lead to irritation or an infection in the skin folds around the genital area. This can be caused by numerous factors such as obesity, chafing of the skin from tight-fitting garments, or medical conditions that can cause suppression of the immune system such as diabetes, human immunodeficiency virus (HIV) infection, or the chronic use of steroids.

— Elaine K. Luo, M.D.

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