Etiologic factors in diaper dermatitis: a model for development of improved diapers.

Common diaper dermatitis is an episodic disease that results from attack of the skin by physical, chemical, enzymatic, and microbial factors in the diaper environment. A model for the cyclic nature of this disease has been developed which incorporates various roles these factors play as they interact to produce skin with compromised physical properties, and further damage it to produce diaper dermatitis. Resolution occurs naturally or through caretaker intervention, resulting in mean episodic durations of 2-3 days. The model predicts that preventing excessive skin hydration, maintaining skin near its normal physiologic pH, and minimizing interaction of urine and feces (which increases pH and fecal enzyme activity) will result in decreased incidence and severity of diaper dermatitis.