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Diaper dermatitis candidiasis in Child
See also in: Anogenital
Other Resources UpToDate PubMed

Diaper dermatitis candidiasis in Child

See also in: Anogenital
Contributors: Romi Bloom MD, Susan Burgin MD
Other Resources UpToDate PubMed


Candidal diaper dermatitis develops when sufficient moisture in the diaper area allows Candida albicans, normal flora in the mouth and gastrointestinal tract, to proliferate and invade the stratum corneum. The dermatitis usually begins around 6 weeks of age and is often associated with recent antibiotic use or diarrhea, although it can be seen without any inciting factor. It can occur in conjunction with oral thrush. Candida may also secondarily infect and exacerbate irritant diaper dermatitis, seborrheic dermatitis, and flexural psoriasis.

An alkaline pH in the diaper area predisposes a patient to candidal diaper dermatitis. In both children and adults, fecal bacteria further alkalize urinary pH, which increases the risk of candidal infections. Breast-fed infants have a lower incidence of diaper dermatitis than formula-fed infants, which is theorized to be secondary to a lower stool pH in the breast-fed infants. Furthermore, patients with a defective Th17 response are predisposed to recurrent cutaneous candidal infections.

In adults, risk factors for candidal diaper dermatitis include urinary and fecal incontinence, diabetes mellitus, obesity, human immunodeficiency virus (HIV) infection, antibiotic use, systemic immunosuppressive medications including corticosteroids, prolonged hospitalizations, nursing home stays, and bedbound patients.

Related topics: Male genital candidiasis, Vulvovaginal candidiasis


L22 – Diaper dermatitis

240711004 – Diaper candidiasis

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The diaper area and distant skin should be examined for signs of other dermatoses. Candida may superinfect any diaper dermatitis that persists longer than 72 hours (especially irritant diaper dermatitis). Therefore, isolated candidal diaper dermatitis should be considered only when other possibly coexistent dermatoses have been ruled out.

Other diaper-area dermatoses include the following:

Diaper-induced or exacerbated dermatoses Dermatoses unrelated to the presence of a diaper

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Last Reviewed:12/26/2018
Last Updated:01/23/2019
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Patient Information for Diaper dermatitis candidiasis in Child
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Contributors: Medical staff writer


Candida albicans is a type of fungus normally found in the digestive (gastrointestinal) tract. If your baby is wearing a moist or blocked up (occluded) diaper, particularly one that is dirty (has fecal contamination), an inflammatory skin rash (dermatitis) may develop on the baby's skin. Diarrhea increases the risk for developing candidal diaper dermatitis, and candida infection in the mouth (oral thrush) may also occur.

Who’s At Risk

Diaper dermatitis is one of the most common skin conditions in infants and children. Candidal diaper dermatitis is the second most common type of diaper dermatitis, with noninfected areas of redness and tenderness (irritant diaper dermatitis) being the most common type.

Signs & Symptoms

  • Candidal diaper dermatitis most commonly appears in the genitals and diaper area, particularly the deep folds, and it consists of red elevated areas (papules) and flat, solid areas of skin (plaques) with sharp edges and skin flakes (scale) as well as surrounding "satellite" skin elevations containing pus (pustules).
  • Redness (erythema) may appear to be joined into one area (confluent).
  • Breakdown (erosions) or loss of the upper layer of skin may be present.
  • Alternatively, the lesions may be merging together (coalescing) small pink bumps with overlying scale, without any redness.

Self-Care Guidelines

  • Keep the diaper open as much as possible while the infant sleeps to allow drying of the skin.
  • Use barrier ointments such as zinc oxide paste or petrolatum (Vaseline) with diaper changes.
  • Gently cleanse the diaper area with plain water or mild soap.
  • Be sure to change your baby's diapers, using disposable diapers.

When to Seek Medical Care

See your baby's doctor or a dermatologist for evaluation if your baby's diaper dermatitis does not improve with self-care measures.


Topical therapies, applied twice a day:
  • Nystatin cream
  • Econazole cream
  • Miconazole cream
  • Clotrimazole cream
The doctor may also reassure you that once your baby is toilet trained, the diaper dermatitis will no longer develop.


Bolognia, Jean L., ed. Dermatology, pp.1186. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick's Dermatology in General Medicine. 6th ed. pp.1373-1374, 2010-2011. New York: McGraw-Hill, 2003.
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Diaper dermatitis candidiasis in Child
See also in: Anogenital
A medical illustration showing key findings of Diaper dermatitis candidiasis (Adult) : Confluent configuration, Erythema, Nursing home resident, Scaly plaque
Clinical image of Diaper dermatitis candidiasis - imageId=2026908. Click to open in gallery.
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