Diaper dermatitis is a common problem in outpatient pediatric office settings. Although most diaper rashes represent a form of contact dermatitis in response to irritants in the diaper environment, other rashes may be the result of an allergen in the diaper. On the basis of clinical examination results for 5 patients and patch testing results for 2 patients, we suspect that the patients demonstrated allergic contact dermatitis in response to the various blue, pink, and green dyes in diapers. Although topically administered corticosteroids are useful in the treatment regimen, the preferred treatment for allergic contact dermatitis in the diaper area is the use of dye-free diapers for allergen avoidance. Patch testing may also be valuable in identifying the allergen, because allergen avoidance is the key to prevention of recurrent disease.
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September 2005
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Diaper Dye Clarification
As one of the leading manufacturers of disposable diapers, we have read with interest the article “Diaper Dye Dermatitis” published in the September issue of Pediatrics. The authors make an assumption about colorants used in diapers that we would like to clarify. In their discussion the authors indicated that they were unable to get detailed information about dyes used in diapers, and concluded that “it is likely that the dyes used in the diapers are disperse dyes.” Pampers® and Luvs® do not contain disperse dyes.
In their article, the authors point out that disperse dyes “…adhere loosely to manufactured fibers. They have been found to release easily from fabrics, primarily from areas of increased friction and sweating.” In contrast, the colorants used in our diapers are pigments that are a part of the chemistry of the fibers themselves, and as such do not release from the non-woven materials that they color. Additionally, all of the raw materials in our diapers are intensively reviewed for their safety profile. This includes review of the chemicals used (like pigments) and their allergenicity potential. Our diaper products are extensively tested for safety per standard dermatology testing protocols (e.g. Human Repeat Insult Patch Test). Moreover, for any type of coloring agent (pigments) we conduct leachability tests under rigorous extraction conditions. Finally, before marketing, our diapers undergo intensive in-use tests to verify product performance and to ensure that there is no in-use leaching to the skin. Therefore, we agree with the corresponding author, Dr. Karen Wiss, when she was quoted as saying “that the ‘vast majority’ of babies and toddlers can probably wear colorful diapers without a problem.”1
References: 1. Norton, Amy. 2005. Dyes in diapers can cause skin rash. Integra Rx Health News website, Reuters Health, NY. http://www.integrarx.com/news/article-diapers-cause-9183.html
Conflict of Interest:
Authors are employed by Procter & Gamble, a consumer products company and maker of disposable diapers under the Pampers® and Luvs® brand names.