The Pediatricians’ Knowledge, Attitudes, and Therapeutic Approaches Regarding Diaper Dermatitis: A Common Condition with Many Different Practices [Letter]

Dear editor

We have read a paper by Yildiz et al on Pediatricians’ Knowledge, Attitudes, and Therapeutic Approaches Regarding Diaper Dermatitis.¹ Congratulations to the author for reviewing the pediatrician’s therapeutic approach to the incidence of diaper dermatitis which worries many mothers. Diaper dermatitis is a chronic inflammatory skin condition in infants which is characterized by a red rash in the diaper area that is not flat, this is affected by moisture retention, urine, sweat and feces in the baby.² Diaper dermatitis is a common problem faced by babies who use diapers which are affected by the absorption of liquid in the diapers used, transfer of emollient from diapers, with acidic pH buffers and whether these diapers can reduce the negative impact of urine and feces on baby’s skin.³

The study conducted by Yildiz et al aims to evaluate pediatrician management strategies for cases of diaper dermatitis, including follow-up and prevention strategies. Yildiz et al found that the most preferred therapy of choice for pediatric patients with diaper dermatitis was zinc oxide, panthenol and hamamelis virginiana extract.¹ However, we would like to introduce a new therapy as an option for diaper dermatitis, namely a new combination of topical treatments containing zinc gluconate, zinc oxide, dexpanthenol, and taurine that are clinically proven to reduce skin erythema and irritation in the diaper area; however, patients still have to pay attention to choosing the right diapers, namely diapers that have high absorption power and are safe for baby’s skin.⁴ We also recommend using a barrier cream that contains mild to moderate antifungals or corticosteroids as monotherapy because it has been proven safe and well tolerated for the prevention of diaper dermatitis.⁵

Yildiz et al, in their study, used a questionnaire-based cross-sectional study method where the first questionnaire contained questions related to demographic characteristics of pediatricians, treatment attitudes and opinions about medical advice from their pediatricians. The second questionnaire contains strategies for preventing diaper dermatitis by pediatricians.¹ However, we would like to recommend adding questions related to diaper products used by pediatric patients because the ingredients of the diaper products used can have a significant impact on physiological pH, irritation and damage to baby’s skin.³

In conclusion, we agree that zinc oxide, panthenol/dexpanthenol, and hamamelis virginiana extract are the most frequently prescribed topical treatment options and most pediatricians apply topical antimicrobial and anti-inflammatory treatment to their patients when there is no response to first-line treatment,¹ however we recommend to conduct a more prospective and controlled study that synergizes with objective diagnostic tools that can evaluate the signs and symptoms of diaper dermatitis and add insight in the management of diaper dermatitis.⁴