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Can Baby Wipes cause Diaper Rashes?

Can baby wipes cause a diaper rash?

Baby Wipes can cause Diaper Rash

The medical terminology for diaper rash is  “diaper dermatitis”.  It is the most common skin disorder in babies.

The most common causes of diaper rashes:

  1. Irritation from prolonged contact with urine and stool.  Be especially vigilant in changing and cleaning your child’s diaper area if the child has diarrheaThis is because the yellow-greenish “poo” (consisting of bile acids from the gallbladder and other digestive enzymes) has not fully had the chance to break down, neutralize and convert into “less acidic” solid brown fecal matter.  Immediate cleaning and diaper changing is important when the child suffers diarrhea because it will cause severe irritation to the baby’s sensitive skin.
  2. The chemicals used in disposable diapers and physical irritation from the surface of the diapers themselves: ie. from the flourescent whitening agents that are known to cause contact dermatitis, chemical absorbents used in the pads,  etc.
  3. Infection - ie. Yeast infection and other bacterial infections like staphylococcal or streptococcal; fungal infections are typically more bright red and “mean” looking while bacterial infections commonly exhibit blisters, pus filled elevations and yellowish crust.
  4. Residues from detergents/fabric softeners (including fragrances, flourescent whitening agents, dyes and enzymes) that may irritate the skin from their use in cloth diapers.
  5. Food allergies and transitions between new foods.  Even allergies from soap or lotions should be considered.
  6. BABY WIPES CAN CAUSE DIAPER RASHES!

Certain Preservatives in Baby Wipes – Causes Sensitization and Allergic Reaction

Even the unscented ones with all the goodies such as sensitive baby wipes with aloe vera can cause a diaper rash.  Has anyone ever wondered why baby wipes don’t get mold in them as often as they should? The answer is  PRESERVATIVES (ie. methylchloroisothiazolinone and methylisothiazoline).  Even facial baby wipes and moist tissues contain preservatives.  This is not necessarily a harmful thing because preservatives protect the baby wipes from going bad.  Actually most baby wipes will contain some kind of preservative to help prevent bacteria or fungus from growing.

However to some babies, these preservatives act as severe irritants and cause “baby-wipe” dermatitis [1].  Even some adults using baby wipes for their babies experience contact dermatits (eczema) on their hands [2,3].  The preservatives in facial lotion and cosmetics are the same ones used in some baby wipes that are known to cause dermatitis in some adults [3].  There are even calls questioning the use of certain preservatives in cosmetics [4].  Another question which should be in the minds of parents is this: By using such products with these preservatives, can my baby be sensitized and develop an immune reaction to those preservatives after some time?  The answer is “yes”.  It is possible [4].

Baby wipes are indeed a convenient way to clean parts of the baby’s body especially when cleaning the buttocks.   Parents just need to be aware that even though baby-wipe brands advertise their appropriateness for sensitive skin along with “purified” and “chlorine-free” water, some kind of preservatives are added nonetheless.  These preservatives can be the cause of skin problems such as diaper rashes.  There are a few baby wipes in the market that seem to recognize the problem and claim not to use artificial preservatives but instead use natural preservatives such as grapefruit extract.  Some parents seem to have good success when switching to those kinds of wipes.

It may seem laborious but washing your babies buttocks after each “poo” (especially diarrhea) with warm water and a mild baby soap instead of just using wipes may be the best solution both environmentally and health-wise for your baby.  Just remember to use baby lotion afterwards to prevent dryness – make sure the lotion doesn’t contain methylchloroisothiazolinone or methylisothiazoline.

This article is not written against the use of baby wipes but to bring awareness and raise caution especially for allergy-prone parents who have babies suffering from an eczema or skin problems.  As a preventive measure, Happy Baby USA does not advocate use of baby wipes that contain methylchloroisothiazolinone/ methylisothiazolinone.  Since these chemicals have been known to cause sensitization, it is better to be safe than sorry.  To be fair, the question about whether sensitization is more easily achieved in certain artificial preservatives - methylchloroisothiazolinone/ methylisothiazolinone versus other preservatives — still needs further research and verification.  Maybe a more practical question should be, “What preservatives used in baby wipes is safe and truly hypoallergenic?”  One thing is certain.  Parents whose babies still have skin problems despite going through the more common causes of diaper rash should consider preservatives in baby wipes as a culprit.  Preservatives in baby wipes can cause diaper rashes.

<[Added 5/12/2014]  Apparently there are some manufacuterers who indeed recognize the problem of combination methylchloroisothiazolinone (MCI)/ methylisothiazolinone (MI) causing allergic contact dermatitis (ACD).  Thus measures have been used to change preservatives by excluding MCI but still include MI in order to minimize ACD .  Despite the change, research by Chang et. al. show that MI still cause allergic reactions and discontinuation of the baby wipes that contain MI resolves the rash. [5]>

Based on continuing research, more evidence supports discontinued use of all products (from diaper wipes to lotions) which use a combination of MCI/MI or even stand-alone MI as preservatives.

What about baby wipe warmers – bacteria and fungal growth?

Going slightly off topic, Happy Baby USA do not advocate the use of baby wipe warmers.  Although it may seem like a good idea, when you wipe your little one’s bums with a warm wipe, the “warm” temperature is ideal for fungal and bacterial growth.  That is why some warmer producers emphasize that their products are made from antibacterial material.  Yet this material can also be a toxic chemical source that will seep into the baby wipes.  Other warmers have even antibacterial “inserts” to prevent mold from growing or bacterial growth from going out of control.  There have been complaints that the baby warmers aren’t even warm.  Furthermore once the warm wipes are taken out of the warmer, it often cools down so quickly that there really isn’t much of a difference.

References:

    1. Fields KS, Nelson T, Powell D. J Am Acad Dermatol. 2006 May;54(5 Suppl):S230-2. Contact dermatitis caused by baby wipes.
    2. Guin JD, Kincannon J, Church FL.  Am J Contact Dermat. 2001 Dec;12(4):189-92.  Baby-wipe dermatitis: preservative-induced hand eczema in parents and persons using moist towelettes.
    3. Timmermans A, De Hertog S, Gladys K, Vanacker H, Goossens A. Contact Dermatitis. 2007 Aug;57(2):97-9. ‘Dermatologically tested’ baby toilet tissues: a cause of allergic contact dermatitis in adults.
    4. Macias VC, Fernandes S, Amaro C, Santos R, Cardoso J.  Cutan Ocul Toxicol. 2013 Jun;32(2):99-101. doi: 10.3109/15569527.2012.707266. Epub  2012 Aug 10.  Sensitization to Methylisothiazolinone in a group of Methylchloroisothiazolinone/ Methylisothiazolinone allergic Patients.
    5. Chang MW, Nakrani R. Pediatrics 2014;133(2):e434-8. doi: 10.1542/peds.2013-1453. Epub 2014 Jan 13. Six children with allergic contact dermatitis to methylisothiazolinone in wet wipes (baby wipes).
  1. January 17, 2014 at 12:06 am

    Finally the news media outlet has gotten the word out that a chemical in baby wipes is responsible for allergic reactions in some children. While it was not emphasized in this article, the same preservatives found to cause dermatitis in children are also found in some lotions. Many parents know that a treatment for eczema is keeping the skin moist with lotion. Watch out for lotions that also contain MI. This may be a culprit and the reason why there is no improvement of the allergic skin reaction.

  2. May 11, 2014 at 2:51 am

    Here is a recent study published in March 2014 – Med J Aust titled: “Methylisothiazolinone in baby wipes: a rising star among causes of contact dermatitis.

    and another published Feb. 2014 – Pediatrics titled: “Six children with allergic contact dermatitis to methylisothiazolinone in wet wipes (baby wipes)” with abstract included.

    Methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) is a combination preservative used in personal care and household products and is a common cause of allergic contact dermatitis (ACD). Recently, MI alone, without MCI, has been increasingly used in consumer products in attempts to minimize allergic reactions. Wet wipes are extensively tested and traditionally believed to be innocuous. MI in wet wipes (“baby wipes”) has not been previously reported to cause ACD in children in the United States. Only 1 previous report of ACD in a child in Belgium has been recently reported. We report 6 children with chronic, perianal/buttock, and facial eczematous dermatitis, refractory to multiple topical and oral antibiotics and corticosteroids. All tested positive to MCI/MI on patch testing. None wore diapers. All patients had been using wet wipes containing MI (without MCI) to affected areas. Discontinuation of wipes resulted in rapid and complete resolution. This is the first report of pediatric ACD to MI in wet wipes in the United States, and the largest series to date. ACD to MI in wet wipes is frequently misdiagnosed as eczema, impetigo, or psoriasis. Wet wipes are increasingly marketed in personal care products for all ages, and MI exposure and sensitization will likely increase. Dermatitis of the perianal, buttock, facial, and hand areas with a history of wet wipe use should raise suspicion of ACD to MI and prompt appropriate patch testing. Rapid resolution occurs after the allergen exposure is eliminated. All isothiozolinones should be avoided in personal care and household products for these patients.

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