What are the differences between diaper rash and a fungal infection?

Fungal infection is a contagious skin disease caused by fungi. This can be yeast of the type Candida or dermatophytes, microorganisms that feed on the keratin found on the skin, scalp, and nails. The proliferation of these fungi is particularly encouraged by moisture, perspiration, and also corticosteroids. Fungal infections can affect any part of the body, but they are frequently found on the feet and buttocks, areas prone to friction and maceration.

The diaper rash is a common skin inflammation in infants and young children that manifests as redness and irritation in the diaper area. It primarily results from prolonged skin contact with moisture, particularly urine and feces, which disrupt the skin barrier and promote the onset of irritations. The friction of diapers, inappropriate hygiene, or the use of irritating products can also exacerbate the situation. In some cases, a bacterial or fungal infection, such as an overgrowth of Candida albicans, can occur and complicate the diaper rash. It is particularly in this circumstance that it can become difficult to distinguish a diaper rash from a fungal infection.

The symptoms of a diaper rash and a fungal infection are quite similar, making it difficult to distinguish between them.

However, certain elements can provide clues and help differentiate a fungal infection from diaper rash. Firstly, in the presence of diaper rash, the skin is generally smooth and red, without the formation of raised lesions. When this condition is exacerbated by a bacterial or fungal infection, symptoms can evolve and vesicles, sometimes filled with pus, can develop. A fungal infection is immediately characterized by marked lesions, resembling red patches surrounded by a clear border, often lighter in the center and darker at the edge. Moreover, areas affected by a fungal infection are often more painful and itchier than those due to diaper rash. Additionally, in some cases, the fungal infection is accompanied by cracks and crusts.

Another factor to monitor in determining whether one is dealing with a fungal infection or diaper rash is the circumstances of onset. Indeed, a fungal infection is solely caused by a fungal invasion, whereas the development of diaper rash is linked to friction and prolonged skin contact with moisture. Thus, redness appearing without the use of diapers or ill-fitting underwear should suggest a fungal infection, not diaper rash. Lastly, diaper rash only develops in the buttocks, groin, and thigh areas, which is not the case for fungal infections that can appear on the hands or feet.

Unlike the diaper rash, which typically disappears quickly with some hygiene rules and, in some cases, medication, a fungal infection requires the use of antifungal agents to eradicate the infection.

Please note : This article only provides a few key points to distinguish between diaper rash and a fungal infection. If you have any doubts, the first step should be to consult a healthcare professional.

• TIERNEY N. & al. Diaper Dermatitis: Etiology, Manifestations, Prevention, and Management. Pediatric Dermatology (2013).

• ROSA MARIA P. O. & al. Superficial Mycoses Associated with Diaper Dermatitis. Mycopathologia (2016).

• SAURAT J. H., LACHAPELLE J. M., LIPSKER D., THOMAS L. et BORRADORI L. Dermatologie et infections sexuellement transmissibles. Elsevier Masson (2017).