Hi Sandra, my young baby is suffering from nappy rash. I want to use something gentle and preferably natural to support healing. There is so much on the market that the choice is confusing - what should I be looking for in a nappy-rash product? Thanks, Janine.

Hi Janine, thanks for your question. A baby's skin is five times thinner than that of an adult and is exceptionally sensitive. As such, it's important to be selecting products for our babies that are as gentle and natural as possible. When the skin is irritated like with nappy rash, it's even more important to be using products that can calm and repair the skin's natural barrier.

The most important consideration is that our baby products are free from unnecessary ingredients. Historically it was thought that cosmetic ingredients applied to the skin rarely get into the body, and when they do, the amounts are too low to matter. However, we now know that the skin is a sponge, absorbing everything we apply to it. Studies are finding health problems in people exposed to common fragrance and sunscreen ingredients, including increased risk of sperm damage in men and low birth weight in girls where there mothers were exposed to synthetic substances found in skin care. Ingredients in personal care products are less regulated then medicines so consumers need to educate themselves rather than rely on industry regulation to ensure safety.

Choose products that clearly state that they are free from artificial colours or fragrances, detergents, GE-modified plant materials or extracts, mineral oils, parabens, propylene glycol, sulphates or synthetic fillers. If there are confusing scientific names on the label, use the Environmental Working Group's Skin Deep database to look them up. Each ingredient is given a hazard rating with the associated evidence to help you make an informed decision. Staff in health stores are often willing to do this for you or have knowledge of the ingredients themselves.

The best baby products use plant oils and plant extracts that are naturally protective, allowing the skin to breathe and regenerate unlike mineral oil derivatives such as petroleum or paraffin in conventional barrier creams. These tend to form an occlusive film over the sensitive baby skin and interfere with its normal functioning.

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In terms of active ingredients, there are a several key plants that traditionally are used to protect and restore damaged skin. Their use is supported by modern scientific evidence. Plants to look out for include:

Calendula (Calendula officinalis) and Chamomile (Matricaria chamomilla): Both have proven wound healing, anti-inflammatory, antiseptic and skin restoring properties.

Soothing and cooling, both are great choices for a nappy rash cream.

St. John's Wort Oil (Hypericum perforatum) has proven skin protecting and skin regenerating properties and helps to repair epithelial damage of skin. It leaves the skin silky and smooth. Recent studies have shown that its antibacterial properties are effective against gram-positive bacteria such as Staphylococcus aureus, often encountered in skin conditions.

Propolis is a substance collected by honeybees that can be used as a substitute for zinc oxide to protect and heal the delicate skin of baby's bottom. Zinc Oxide is often used in creams of this type but can be harmful with long-term use. Propolis has proven antibacterial and antifungal properties that can help to resolve resistant baby skin problems like fungal infections and thrush.

I hope this information will help in the selection of a safe and effective nappy rash cream for your baby. If your condition persists or does not improve, see your leading healthcare professional.


References
de Groot, A. (2013). Propolis: A Review of Properties, Applications, Chemical Composition, Contact Allergy, and Other Adverse Effects. Dermatitis, 24(6), 263-82. doi: 10.1097/DER.0000000000000011.
Duty, S., Singh, N., Silva, M., Barr, D., Brock, J., Ryan, L. (2003). The Relationship between Environmental Exposures to Phthalates and DNA Damage in Human Sperm Using the Neutral Comet Assay. Environmental Health Perspectives, 111(9), 1164-9.

Referen Lavagna, S. M., Secci, D., Chimenti, P., Bonsignore, L., Ottaviani, A., & Bizzarri, B. (2001). Efficacy of Hypericum and Calendula oils in the epithelial reconstruction of surgical wounds in childbirth with caesarean section. Farmaco, 56(5-7), 451-453.

Reichling J, Weseler A, Saller R. (2001). A Current review of the Antimicrobial Activity of Hypericum perforatum L. Pharmacopsychiatry, 34, 116-118.

Wolff, M., Engel, S., Berkowitz, G., Ye X., Silva, M., Zhu, C., Wetmur, J., Calafat, A. (2008). Prenatal phenol and phthalate exposures and birth outcomes. Environmental Health Perspectives, 116(8), 1092-7.