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Rashes on the bottom and genital area are a problem for some children who wet the bed. The kidney makes urine by mixing unwanted chemicals with water. When the urine is concentrated and exposed to the skin for a long time, these chemicals can be irritating.
Skin rashes develop more often in children who wear absorbent underpants that contain the urine. The rash is usually most pronounced around the waste or leg bands where the concentrated nighttime urine pools. Early signs of irritation are redness. If the problem continues for weeks, the skin thickens and dries with a flaky appearance. When the problem continues for months and years, the skin might eventually become a paler color or wrinkled.
The best approach is to prevent the rash by treating the bedwetting. Until this is successful there are several ways to minimize the possibility of a rash. Thoroughly rinse the bottom and genital area every morning after waking. Use the correct size absorbent underpant that absorbs the most urine and minimizes the pressure around the waist and leg band areas. Each night before bed, spread a petroleum ointment over the skin area exposed to urine. If this is not enough, ask your doctor for a special mediated cream.
Sometimes the rash feels uncomfortable against clothes, and in the presence of sweat, the rash can itch. Some children scratch at the rash and this can lead to a bacterial infection on top of the chemical irritation. When this happens, the rash looks wet and pussy and an anti-bacterial cream might be necessary.
Yeast is a common skin organism that will easily grow on irritated wet skin. When yeast becomes a problem the rash is often a brighter red and little spots spread out from the main area of the rash. Yeast rashes can be treated with a special anti-yeast cream.
A rash does not mean that an absorbent underpant cannot be used. Most rashes can be prevented if promptly treated even though a child continues to wear absorbent underpants. For many children absorbent underpants are a good idea; the child is usually more comfortable compared to sleeping and waking up in a cold urine-soaked bed, odor problems are much less, and the sheets, pillows and mattress are protected. However, absorbent underpants are not for everyone. Absorbent underpants should only be used with the approval of the child and should never be forced on a child or otherwise used in a fashion that the child might interpret as a punishment.