Sometimes the best advice is not from the pediatrician, but from a specialist. Last month I was at the dermatologist and casually mentioned how frustrating diaper rashes could be. What the doctor suggested made common sense! When asked why my pediatrician didn't recommend it blew me away!

History
I have two small children who sporadically get diaper rashes. The cause is either due to diarrhea or the consumption of sand.

I'll start by explaining the sand phenomenon: Babies and toddlers manage to eat sand no matter how careful we are to prevent this. Sand finds it way into those little crevices of their hands, in their ears, nose and inside of the diaper. Sometimes, I think it gets into their bodies by osmosis!

Sand very quickly gets flushed through the body and changes the bowel composition to a thinner material. For my children, this guarantees a very nasty diaper rash, regardless of the number of times I change them. These rashes occur in the summer months when it is already hot and steamy, making for the perfect breeding ground for bacteria. Typically these rashes only occur for us when we are at the beach.

Sickness Diaper Rashes:

Any time either of my children get diarrhea, they immediately get a diaper rash. At the first sign of liquid, I start changing those diapers as soon as I hear the smallest sound of gas passing. I don't recommend this method until you really know your child. My second has continued to go while on the changing table, making a far bigger mess than had I waited, so with him, I wait a minute or two until the sound stops.

The Pediatrician Odyssey

Our first pediatrician recommended using Balmex or Desitin for the diaper rash. I chose not to use Desitin because the fragrance is horrible to my nose. I did stock up on Balmex and used it until the first really bad diaper rash. On our way back from a vacation on the Delaware/Maryland shore, my first born developed one of those horrible rashes, complete with blood. Upon arriving at my mom's house in New York, my mother exclaimed in horror and told me that it was unacceptable to have a child in pain and blood over a diaper rash. She promptly call a friend whose daughter was some sort of doctor. This friend recommended using Lamisil, an anti-fungal cream marketed for jock itch.

My son's diaper rash improved dramatically after the first application and was gone at the end of the second day. I stopped using Balmex because the thick barrier it provides also hurts to take off during diaper changes because my sons' melt the product no matter how thickly I apply and there is this great glob of fecal matter and Balmex that needs to be changed!

Through coincidence, we changed pediatricians.

During the next bout of diaper rash I called the office to see if I could get something stronger because the rash was due to diarrhea. As long as the diarrhea is present, the rash will not subside. Think of it this way, you fall and scrape your hand. Just think of constantly applying a gauze of rubbing alcohol on the scrape and not allowing it any air to heal. It just hurts!

The nurse and pediatrician both told me to continue using the Lamisil, Lotrin (basically any jock itch medicine on the market) and to call if it persisted for more time.

Butt Cocktail? Get to the Point!

I use Balmex when we get an ordinary diaper rash. A slightly red to medium red area without any sickness or sand.

So, as I mentioned, I was at the dermatologist for myself and casually mentioned that the Lamisil really didn't do much when the diarrhea was in full swing. He then recommended the following cocktail for those times:

Cocktail is made up of three equal parts of:
Zinc Oxide (Balmex, Desitin or generic Zinc Oxide)
Lamisil (or another antifungal cream)
Hydrocortrisone (1/2% with aloe if possible).

The Zinc provides a barrier to keep the moisture off the skin, the Lamisil kills the bacteria and the hydrocortisone soothes the area.

Recently we had a sickness I've nicknamed the Linda Blair (if you've ever seen the Exorcist - you can relate to vomiting and diarrhea continuously) and I mixed up this cocktail. Miracle of miracles. The area was red until the diarrhea subsided, but I didn't have blood curdling screams or blood and that is so much better for everyone!

I asked the dermatologist why my pediatrician did not recommend this and he said that pediatricians might want to see the patient because sometimes the rash can get very bad and turn into other, ickier things. I did call my pediatrician and asked her advice. She felt fine about the cocktail and again told me to call if either the rash or the diarrhea persisted for more than a few days. Sound adivce!

Ingredients of Balmex: Zinc Oxide (skin protectant, not even uv rays can get through), Aloe Vera Gel, Balsan (preservative), Beeswax (thickener), Benzoic Acid (emulsifier), Dimethicone, Methylparaben, Mineral Oil (humectant), Propylparaben, Purified Water, Sodium Borate, Tocopheryl (Vitamin E) Acetate.

Recommended: Yes