Diaper rash (or Nappy rash in British English) is termed medically as “irritant diaper dermatitis”. This condition is not often treated in a homeopathic consultation as it responds well to some well known topical approaches, either allopathic or natural. However, this condition is often a useful guide when first seeing a newborn, as the symptoms or timeline information are often scarce.
Even if the rash has been treated topically, I would ask for more information about its presentation and also any possible cause, as this may help me to find the best indicated remedy for the child, or for future treatment. You will find in this article some more information and suggestions, and how to look at the main remedies for Diaper Rash in this perspective.
What caused Irritant Diaper Dermatitis
Irritant diaper dermatitis is a term applied to skin rashes in the diaper / nappy area. Irritant diaper dermatitis develops when skin is exposed to prolonged wetness and increased skin acidity (pH) caused by the combination of urine and faecal matter.
Although wetness alone has the effect of macerating the skin and making it more prone to friction injury, it is nowadays an unlikely source of rash as modern reusable cloth diapers or modern disposable diapers are super-absorbent and use special gelling material or microfibers to capture the fluid very quickly.
Ammonia and urea, the two key components of urine are only mild skin irritants. However, the combination of ammonia and urea with faecal matter can significantly increase skin acidity very quickly. Also, bile salts, found in the stools, are a more significant skin irritant.
Diaper dermatitis can also become more severe and develop into secondary bacterial or fungal infections. So in conclusion, most diaper rashes are linked to the combination of faecal and urine substance in close contact to the skin, more than by the diaper itself. Bacterial or fungal infections can come as a complication.
Another subgroup of diaper rash is more similar to allergic contact dermatitis, and is caused by the diaper itself. While this is often disregarded as an unlikely cause by conventional doctors, this specific issue was presented to me when a female patient contacted me a month or so after the birth of her first child. I had completely lost contact with her as her family had moved to another part of the country.
She was the super-healthy type mother, had an un-eventful pregnancy, home birth, breast-fed, and never used any conventional drugs with the child. The poor little girl had developed a very severe diaper rash, and this was depressing the mother so much, and obviously causing a lot of suffering for the child.
Even natural ointments like Calendula or cream were not helping. It was only after a few days, when the mother contacted me again, that they finally realised that the rash started after using nappies given as part of a baby shower – the nappies were just part of the presentation, and were supposedly not meant to be used.
I offered the mother to try a tautopathic approach (she posted me one of the incriminating diapers, which I potentised to 6X and mixed with a calendula cream), and also gave SILICA 30C twice a day, as it fitted the child’s physical traits, and scores high in the DERMATITIS Section of the repertory. Obviously, not using the same nappy and following the advice below were also recommended.
Other things to watch when Diaper rash occurs
Beside the issue with faecal matter mixing with urine in the diapers, there are a few other factors that are known to trigger diaper rash:
– Infrequent changes of diapers – very often, in this case, the skin folds/creases are not affected as wetness or poo cannot reach. The skin is usually flat, red and irritated and rarely starts to pill.
– Teething or Illness – this is a significant effort for the body and often is related with episodes of diaper rash. In my view, this is partly caused by teething and will disrupt sleep, which is the key moment when an infant’s body will repair or grow. The presentation of the rash can vary. If this is the obvious reason, Chamomilla 30C or 200C, at time of teething can help a lot, as well as the constitutional remedy.
– Introduction to new food or food sensitivity or allergy – this can happen especially when the child is weaned off from breast-milk, or when new solid food is introduced. Again, this can be addressed with a more homeopathic constitutional support, and also the use of probiotics and food elimination / re-introduction techniques if required.
– Guts or Urine Imbalance – change in Urine PH or gut flora imbalances can lead to diaper rash, eczema, psoriasis and other conditions. The main thing to watch in my experience is the use or over-use of antibiotics in children. Often, the use of infants’ probiotics and of a well indicated remedy to detoxify the antibiotics like Nit-Ac or Merc-S can really bring great relief.
– Use of specific fabrics, detergents or diaper’s brands – this in my view can cause complication when the diaper rash is well established, but will not be the initial cause. Keep in mind to suggest natural, organic or low-chemical alternatives just to cover that base.
Some parents mention that standard disposable diapers work better and some mention that organic brands or cloth re-usable diapers are better, and I would just recommend that the parents use the ones that they feel more comfortable with, but keep an open mind if they believe this worsens the rash as in the case above.
The key rule to prevent diaper rash is to change the diapers as soon as the infant has had stool. This will reduce complication or the severity of any rash as well
Then, as Aphorisms 4 and 5 point out, address any underlying cause and help the body’s life force to do its job.
For an infant, this means good sleep, and when there is teething, infection or severe dermatitis, this can cause problems in the infant’s ability to sleep and recover. Address this by ensuring a good room temperature (20 / 21 Celsius).
Another key element is to give the child body contact to one of the parents’ skins during sleep to speed recovery (ideally the one less sleep deprived).
Diaper free time, and time in the sun or outdoor can also greatly help, as this is the natural way a child was designed to be. It will help with dryness as well.
Using special creams to protect the skin and reduce faecal or urine contact in the diaper area will also help a lot. Calendula creams are often recommended.
The use of talcum powder or other moisture-absorbing powders like corn starch was recommended before, and I still see it used by grandparents sometimes, and Talcum is still sold in the Baby Section of most British supermarkets. While this reduces moisture, airborne powders can also penetrate and irritate lung tissue or cause local complications in case of secondary infection. This procedure is not recommended by the medical establishment anymore.
Complications of Diaper Rash
If the former advice does not help or the rash is not addressed quickly, a secondary infection can occur. This can cause more problems and more severe suffering. For bacterial infection, pus, boils or raw skin or oozing raised patches can come in addition to the rash.
Yeast infections are more common, and will settle more quickly, especially in children who have suffered from oral thrush or of some antibiotic treatment at birth. Such rash will look like pimples or small open blisters and may spread quickly.
Probiotics and the indicated homeopathic remedies will be required. Using known anti-fungi or anti-bacterial topical lotions can also help a lot. A Mix of tea tree oil, calendula tincture or coconut oil can help in case of bacterial infection, and the use of diluted apple cider vinegar can also reduce yeast locally.
Therapeutics of Diaper Rash and also leading information for an Infant Case
Here is a compilation of suggestions of homeopathic therapeutic remedies. As infants will not itch or scratch their skins, assume that there is pain or itch if they cry or look uncomfortable.
– Calendula Tincture diluted or in low potency, as a gel or spray locally, concurrently with other remedies.
– Apis: nappy rash that is hot, red and swollen. Worse from being touched and washing, better for uncovering.
– Cantharis: rash resembles severe burn, and passing urine makes the child cry out.
– Nit-ac: dry skin, eroding and cracking in every angle. Coppery spots. Skin itches if undressing, ulcers bleed easily, sensitive. Stubborn suppuration. Crusts form and fall. Causations – antibiotics, fungal infection.
– Rhus Tox: Sore and raised spots that are flaky. Better from warm bathing and being covered.
– Sulphur: can be used for red, raw diaper rash that may bleed, worse for heat and better for being uncovered. Sulphur is also indicated for diaper rash during teething. It is the one that seem to fit more symptoms overall when repertorising. Sulphur is an important by-product of protein metabolism.
– Sul-Ac: itching, nodular urticaria, boils and other staphylococcus and streptococcus infections.
As explained earlier, except for the allergic contact dermatitis case detailed above, and another person, I never had parents who came solely to treat the diaper rash, and when it is presenting in the case, the general advice explained above, which helps to remove the original causes of the rah have helped to resolve or alleviate such rash.
Having said that, this is a very common ailment. Most infants I see in my practice do or did suffer from such a rash. While Sulphur comes to mind easily, the children’s appearance may fit any constitutional remedy we can think of for young children. So Diaper Rash is very much a “lesion layer” or “acute therapeutic” condition than a more subtle inner disturbance.
When parents have brought me infants, for any reason, I would also ask if the child has or suffers from diaper rash, and more often than not include the only rubrics I could find covering this condition in my four repertorisation books:
Robin Murphy’s Homeopathic Clinical Repertory 3rd Edition includes the following rubric
DIAPER, rash, buttocks
Scoring 3 – SUL-AC
Scoring 2 – Bapt, Bor, Kali-chl, Merc, Merc-c, Mur-Ac, Nit-ac, Sulph
Scoring 1 – Bry, Com.
– Robin Murphy – Homeopathic Remedy Guide, v2
– Robin Murphy’s Homeopathic Clinical Repertory 3rd Edition
– Thierry Clerc’s cases