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Wednesday, June 19, 2013
Dealing with diaper dermatitis
As a father of six boys and a practicing dermatologist for twenty years, I have dealt with a lot of diaper dermatitits problems both in my personal and professional capacities. Among other things, through the years i have recommended and used the usual assortment of petrolatum and zinc-based ointments and concoctions for maintenance and treatment of this problem. But it is only in the past several months, since the birth of my youngest son, that I have discovered whathas so far proven to be a terrific way for dealing with diaper dermatitis due to hanical irritation and maceration: Lida Mantle cream, a relatively new prescription item from Doak Dermatologics, Fairfield, N.J. The preparation is essentially 3% lidocaine in the old, familiar Acid Mantle cream base. One day, a few months back when my son was shrieking from a rather irritated diaper rash that had appeared suddenly (as they often do) betwen routine changes, I decided to try the Lida Mantle, which I had received as a sample. Almost immediately, the shrieking stopped and I was able to get on with the diaper change uneventfully. A couple more applications of the Lida Mantle at the next diaper changes and the problem was well on its way to clearing. I have since prescribed this treatment for parents in my practice for dealing with inflamed diaper rashes, and the feedback has thus far been quite gratifying. It has literally turned diaper changes of infants with diaper rashes from what would otherwise have been described as a nightmare to a liveable experience for both parent and child. Considering the relatively small surface area involved, the minimal quantity needed, and the limited number of applications required. I doubt whether there is even much concern regarding any significant absorption of the lidocaine. Subsequently, I experimented with plain Acid Mantle cream, which is produced by the same company, for preventive maintenance use at each diaper change and have also found this to be well tolerated, not messy and effective for this purpose. I am interested in having your feedback as a pediatric specialist on this method of dealing with diaper rashes.
Your question is quite informative. I have nothing to add to your expertise, other than to agree that the potential for absorption of lidocaine should limit its use to more extreme cases of discomfort. If the other product is equally effective in clearing the dermatitis, then it seems prudent that it would be preferentially used. Working for a large pediatric tertiary care facility, I have seen many creams used. I have never found one that seemed far different from the rest. Thank you for this reference.
Caroline Mueller, MD
College of Medicine
University of Cincinnati