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The Answer Doc with Dr. Christopher Munger, M.D.
Be proactive in battling allergies
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    Q:  My infant child has had a diaper rash for one week. I have been using a diaper cream each time I change his diaper.  His little bottom is still very red and each time I clean him it seems to hurt.  Are there any tricks that I can use at home or do I need to see a doctor in order to get rid of this stubborn rash?
    A:  Diaper rashes are often caused by a fungal infection of the skin around an infant’s genitals and anus.  There are actually several things that you can do at home with over-the-counter medicines prior to seeing your doctor.
    I like to promote a several step process that helps not only control the infection, but also limit the irritation the skin is exposed to.
    1. Buy over-the-counter Monistat cream. This is an anti-fungal to treat the fungal infection.  You can apply this as a base layer to the affected area in the morning
    2. Buy a diaper rash cream, such as Desitin.  Apply this in a very, very thick layer twice a day.
    3. When the child has a bowel movement or a wet diaper wipe off only a very small amount of the diaper cream, leaving a barrier of diaper cream in place.  You can apply additional diaper cream if the layer is getting thin.
    4. In the evening during a diaper change, remove all the cream. Reapply the Monistat and the diaper rash ointment and continue the previous steps.
    5. Continue this process until the rash has healed, which is usually seven to ten days.  
    I like this way of treating a diaper rash for several reasons. Primarily it keeps the antifungal medicine against the skin and allows it to work over time without being removed.
    As well, the thick layer of diaper cream that is only partially removed with diaper changes provides a protective barrier for the skin preventing exposure to urine, feces, and wiping which can be irritating to already irritated skin.  
    If the rash has not healed in ten days, or if is getting progressively worse, you need to have your child seen by his doctor as more aggressive medical treatment may be necessary.
    Dr. Christopher Munger’s column appears every other Sunday. Dr. Munger is board certified in family practice. He is a member of the Family Health Care Center in Statesboro and admits patients to East Georgia Regional Medical Center. He is originally from California. He recieved his bachelors degree from UCLA, his medical degree from Columbia University in New York City, and completed his training in family practice at the University Of Virginia. He lives in Statesboro with his wife and two dogs.
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