طفح جلدي من الحفاض

September 21, 2022
مرض

اعرفي المزيد حول الأسباب والأساليب الوقائية والعلاجات المنزلية لهذه الحالة المَرضية الشائعة التي تهيِّج الجلد أسفل الحفاض.

نظرة عامة

طفح الحفاظ من أنواع الالتهاب الجلدي، ويظهر على هيئة بقع جلدية ملتهبة على الأليتين والفخذين والعضو التناسلي. وقد يتكون بسبب الحفاظات الرطبة أو المتسخة عند عدم تغييرها بالسرعة الكافية. أو قد يكون ناتجًا عن تحسس الجلد وتشققه. وعادةً ما يصيب الأطفال، ولكن يمكن أن يصيب أي شخص يرتدي الحفاظات على نحو مُنتظَم.

يَزول طفح الحفاظات في كثير من الأحيان باستخدام العلاجات المنزلية البسيطة، مثل التجفيف الهوائي أو تغيير الحفاظات بوتيرة أسرع أو استخدام كْريم أو مرهم عازل للماء.

الأعراض

تشمل أعراض طفح الحفاظات ما يلي:

  • التهاب الجلد في منطقة ارتداء الحفاظ: الأليتان والفخذان والعضو التناسلي
  • الحكة والإيلام باللمس في منطقة ارتداء الحفاظ
  • التقرح في منطقة ارتداء الحفاظ
  • انزعاج الطفل أو بكاؤه أو صعوبة تهدئته، خاصة أثناء تغيير الحفاظات

متى تزور الطبيب

إذا لم يتحسن طفح الحفاظ خلال بضعة أيام من العلاج المنزلي، يُنصح باستشارة الطبيب. قد يتطلب علاج طفح الحفاظ استخدام دواء متاح بوصفة طبية. وقد يكون الطفح الجلدي ناتجًا عن حالة أخرى، مثل التهاب الجلد المَثِّي أو التهاب الجلد التَأَتُّبي أو نقص التغذية.

يجب أخذ الطفل للطبيب لفحصه في الحالات التالية:

  • الإصابة بطفح جلدي مصحوب بحمى.
  • الإصابة بطفح جلدي شديد أو غير معتاد.
  • الإصابة بطفح جلدي مستمر أو متفاقم رغم العلاج المنزلي.
  • الإصابة بطفح جلدي نازف أو مسبب للحكة أو مفرز للصديد.
  • الإصابة بطفح جلدي مسبب للحرقة أو الألم عند تبول الطفل أو تبرّزه.

الأسباب

قد يحدث طفح الحفاظات بسبب ما يلي:

  • عدم تغيير الحفاظات المبتلة أو المتسخة لمدة طويلة. قد يُصاب الجلد بالطفح إذا تُركت الحفاظات المبتلة أو المتسخة دون تغيير لفترة طويلة. وقد يكون الأطفال أكثر عرضة لطفح الحفاظ في حال إصابتهم بالإسهال أو كثرة التبرّز.
  • الفرك أو الاحتكاك. يمكن أن يسبب الاحتكاك الناتج عن الحفاظات أو الملابس الضيقة حدوث طفح جلدي.
  • استخدام منتج جديد. قد يتحسس جلد الرضيع تجاه نوع جديد من المناديل المبللة أو الحفاظات أو مسحوق الغسيل أو المُبيّض أو المُنعّم المستخدَم لغسل الحفاظات القماشية. وربما تؤدي مكونات الدَهون والبودرة والزيوت إلى تفاقم المشكلة.
  • الإصابة بالتهاب بكتيري أو خميري. قد يبدأ الأمر بعدوى بسيطة، ولكنها قد تنتشر وتصيب أجزاء الجلد المحيطة. فالمنطقة التي يغطيها الحفاظ مُعرضة للخطر بسبب دفئها ورطوبتها، ولذلك فهي بيئة مثالية لنمو البكتيريا والخمائر. ويظهر هذا النوع من الطفح في ثنايا الجلد.
  • إضافة أنواع طعام جديدة. عندما يبدأ الرضّع في تناول الأطعمة الصلبة، تتغير مكونات البراز لديهم. وبالتالي سيزيد احتمال ظهور طفح الحفاظات. كما أن تغيير النظام الغذائي للرضيع يزيد أيضًا من معدل تغوّطه، الأمر الذي قد يؤدي إلى طفح الحفاظ. وقد يُصاب الأطفال الذين يرضعون رضاعة طبيعية بطفح الحفاظات بسبب عناصر غذائية تناولتها الأم المُرضعة.
  • طبيعة البشرة الحساسة. قد يكون الرضّع المصابون بالتهاب الجلد التأتُّبي أو التهاب الجلد المَثِّي أكثر عُرضة للإصابة بطفح الحفاظات. وعادةً ما يظهر التهيج الجلدي الناتج عن التهاب الجلد التأتُّبي في مناطق لا يغطيها الحفاظ.
  • استخدام المضادات الحيوية. يمكن أن تسهم المضادات الحيوية في ظهور الطفح الجلدي بسبب قتلها للبكتيريا التي تحدّ من نمو الخمائر. كما أن استخدام المضادات الحيوية يزيد من خطر الإصابة بالإسهال. ويزداد خطر حدوث طفح الحفاظات أيضًا لدى الرضّع الذين يعتمدون على الرضاعة الطبيعية أثناء تناول أمهاتهم للمضادات الحيوية.

عوامل الخطورة

التباطؤ في تغيير الحفاظات، أو طبيعة البشرة الحساسة لدى الطفل، هي من عوامل الخطورة المرتبطة بظهور طفح الحفاظ.

المضاعفات

  • تغيرات في لون الجلد. يمكن أن يسبب التهاب الجلد لدى الأطفال ذوي البشرة السمراء والسوداء إلى تفتيح لون المنطقة المصابة. يسمى ذلك نقص التصبّغ التالي للالتهاب. وإذا كان نقص التصبغ خفيفًا فإنه يشفى خلال بضعة أسابيع. أما أذا كانت الإصابة الجلدية شديدة فإنه قد تستغرق عدة شهور أو سنوات لتستعيد لونها الطبيعي.
  • الالتهاب. يمكن أن يتطور طفح الحفاظ إلى عدوى حادة لا تستجيب للعلاج.

الوقاية

الطريقة المثلى للوقاية من طفح الحفاظ هي إبقاء المنطقة التي يغطيها الحفاظ نظيفة وجافة. بعض نصائح العناية بالبشرة قد تفيد، ومنها:

  • تغيير الحفاظ بسرعة. يجب استبدال الحفاظات المتسخة والمبتلة بأسرع وقت ممكن. وعند وجود الطفل في الحضانة، يجب على الموظفين فعل الشيء نفسه. ومن الحلول التي قد تنفع استخدامُ الحفاظات أحادية الاستخدام المحتوية على هلام ماصّ، لأنها تمتص البلل وتبقي الجلد جافًا.
  • شطف مؤخرة الطفل بالماء الدافئ عند تغيير كل حفاظ. يمكن استخدام حوض الحنفية أو حوض استحمام أو زجاجة مياه لهذا الغرض. ويمكن استعمال المناشف المبللة والكرات القطنية والمناديل المبللة المخصصة للأطفال في تنظيف بشرة الطفل. ويجب التنظيف بلطف. بعض مناديل الأطفال قد تسبب تهيج الجلد. لذا يجب استخدام مناديل خالية من الكحول والمعطرات. أو يُكتفى باستخدام الماء الصافي، أو ماء مع صابون لطيف على البشرة.
  • تجفيف البشرة بالتربيت بلطف بمنشفة نظيفة، أو ترك البشرة لتجف في الهواء. يجب الحذر من فرك مؤخرة الطفل. كما يجب عدم وضع بودرة الطَلق.
  • وضع كْريم أو معجون أو مرهم. في حال تكرار إصابة الطفل بالطفح الجلدي، يُستعمل كْريم أو معجون أو مرهم عازل للرطوبة عند تغيير كل حفاظ. وهُلام النفط (الفازلين) وأكسيد الزنك من المكونات التي أثبتت فعاليتها منذ زمن طويل في العديد من مستحضرات معالجة طفح الحفاظات. وإذا كان المستحضر المستخدم عند تغيير الحفاظ السابق نظيفًا، يُترك وتُضاف إليه طبقة أخرى.
  • غسل اليدين جيدًا بعد تغيير الحفاظ. يمكن أن يَحول غسل اليدين دون انتقال البكتيريا أو الخمائر لأجزاء أخرى من جسم الطفل أو للأهل أو لأطفال آخرين.
  • وضع الحفاظ بطريقة تسمح بالتهوية. يُثبَّت الحفاظ، لكن دون المبالغة في شدّه. فتدفق الهواء داخل الحفاظ مفيد للجلد. أما إذا كان الحفاظ ضيقًا جداً، فإنه يحتك بالبشرة. ويُنصح بتجنب استخدام أغطية الحفاظات البلاستيكية أو الضيقة لبعض الوقت.
  • زيادة الوقت الذي يقضيه الطفل دون حفاظات. يُنصح بنزع الحفاظ عن الطفل عندما يكون ذلك ممكنًا. فمن الطرق الطبيعية واليسيرة لتجفيف البشرة تعريضها للهواء. وخلال هذه الفترة، يمكن وضع مقعدة الطفل العارية على منشفة كبيرة وملاعبته تجنبًا للتوسيخ.

التشخيص

يمكن غالبًا تشخيص طفح الحفاظ بمجرد معاينة الجلد المصاب. قد يلزم إجراء اختبار لاستبعاد الحالات الأخرى، مثل التهاب الجلد التماسي التحسُّسي.

العلاج

أفضل علاج لطفح الحفاظ هو الحفاظ على بشرة الطفل نظيفة وجافة قدر الإمكان. وإذا لم يُشفَ الطفح الجلدي بالعلاج المنزلي، فقد يصف الطبيب ما يلي:

  • كريم (ستيرويدي) خفيف من الهيدروكورتيزون (0.5% إلى 1%) مرتين يوميًا لمدة 3 إلى 5 أيام.
  • كريم مضاد للفطريات إذا كان الطفل مصابًا بعدوى فطرية.
  • مضاد حيوي يُؤخذ عبر الفم إذا كان الطفل مصابًا بعدوى بكتيرية.

قد يستغرق طفح الحفاظ عدة أيام حتى يتحسّن، حسب مستوى شدّته. وربما يعاود الطفح الجلدي الظهور مرارًا وتكرارًا. وإذا استمر الطفح الجلدي حتى بعد استخدام المنتجات المصروفة بوصفة طبية، فقد يوصي الطبيب بأن يُعرَض الطفل على متخصص في الأمراض الجلدية.

الرعاية الذاتية

عمومًا، يمكن علاج طفح الحفاظ بنجاح في المنزل باتباع الممارسات الآتية:

  • إبقاء منطقة الحفاظ نظيفة وجافة. إن أفضل طريقة لإبقاء منطقة الحفاظ نظيفة وجافة هي تغيير الحفاظات بأسرع وقت ممكن عند اتساخها بالبول أو البراز. وإلى أن يتحسن الطفح الجلدي، قد يلزم الاستيقاظ أثناء الليل لتغيير الحفاظ. كما يُنصح أيضًا باستخدام الحفاظات أحادية الاستخدام المحتوية على جِل ماص، فهي تتميز بامتصاص البلل من الجلد.
  • شطف مؤخرة الطفل بالماء الدافئ عند تغيير كل حفاظ. يمكن استخدام حوض الحنفية أو حوض استحمام أو زجاجة مياه لهذا الغرض. ويمكن استعمال المناشف المبللة والكرات القطنية والمناديل المبللة المخصصة للأطفال في تنظيف بشرة الطفل. ويجب التنظيف بلطف. بعض أنواع المناديل المبللة قد تسبب تهيج الجلد، لذا يجب استخدام مناديل خالية من الكحول والمعطرات. أو يُكتفى باستخدام الماء الدافئ الصافي، أو ماء مع صابون أو منظّف لطيف على البشرة.
  • تجفيف البشرة بالتربيت بلطف بمنشفة نظيفة، أو ترك البشرة لتجف في الهواء. يجب الحذر من فرك مؤخرة الطفل. كما يجب عدم وضع بودرة الطَلق.

  • وضع كْريم أو معجون أو مرهم. بعد تنظيف البشرة وتجفيفها برفق، يوضع عليها كْريم أو معجون أو مرهم. وإذا كان المستحضر المستخدم عند تغيير الحفاظ السابق نظيفًا، يُترك وتُضاف إليه طبقة أخرى. في حال الرغبة بإزالة المستحضر الموجود، يمكن استخدام كرة قطنية مبللة بزيت معدني.

    تتميز المستحضرات المحتوية على نسبة عالية من أكسيد الزنك أو الفازلين بكفاءة عالية في حماية البشرة من الرطوبة. وتتوفر عدة أدوية تُصرف من دون وصفة طبية لعلاج طفح الحفاظ. تشمل بعض المستحضرات الشائعة: A + D و Balmex و Desitin و Triple Paste. اطلب من الطبيب أو الصيدلي اقتراح مستحضر ما.

    بعد وضع المستحضر المخصص لطفح الحفاظ، يمكن أيضًا وضع هلام النفط (الفازلين) فوقه. يساعد ذلك على منع التصاق الحفاظ بالمعجون أو المرهم أو الكْريم. في حال استخدام المستحضر دون فائدة مع كل تغيير للحفاظ، فربما يكون من المفيد تجربة كْريم أو مرهم مضاد للفطريات. ومن أمثلة ذلك، Lotrimin. يجب استخدام المنتجات المضادة للفطريات مرتين في اليوم. وإذا لم يتحسن الطفح الجلدي خلال 5 إلى 7 أيام، يجب فحص الطفل لدى الطبيب.

    كقاعدة عامة، يجب الالتزام بالمستحضرات المصنعة خصيصًا للأطفال. ويجب تجنّب المستحضرات المحتوية على صودا الخَبز أو حمض البوريك أو الكافور أو الفينول أو البنزوكايين أو الديفينهيدرامين أو الساليسيلات. حيث يمكن أن تكون هذه المكونات سامة للأطفال.

  • زيادة تهوية المنطقة. للمساعدة في تعافي طفح الحفاظ، يجب الحرص على زيادة تعرض منطقة الحفاظ للهواء. فيما يلي بعض النصائح المفيدة:
    • يُترك الطفل بلا حفاظ أو كْريم أو مرهم لفترات زمنية قصيرة، أثناء أخذه غفوة مثلاً.
    • ويُنصح لبعض الوقت بتجنب استخدام أغطية الحفاظات البلاستيكية أو الضيقة.
    • وتُستخدَم بدلًا منها حفاظات أكبر من مقاسه المعتاد لحين زوال الطفح الجلدي.
  • تحميم الطفل يوميًا. يجب تحميم الطفل يوميًا حتى يزول الطفح الجلدي. يُستخدم ماء دافئ مع صابون لطيف خالٍ من العطور، أو يُستخدَم منظف لطيف خالٍ من الصابون.
  • التوقف عن استخدام المنتجات التي قد تحفز الإصابة بالطفح الجلدي لدى الرضيع. يمكن تجريب نوع بديل من مناديل الأطفال المبللة أو الحفاظات أحادية الاستخدام أو صابون غسل الملابس، أو بديل لأي منتج آخر يُشتبَه بأنه السبب.

الطب البديل

نجَحَت بعض العلاجات البديلة التالية مع بعض المرضى:

  • حليب الأم. تباينت نتائج الدراسات حول إذا ما كان حليب الأم الموضوع على طفح الحفاظات أفضل من العلاجات الأخرى. وأظهرت دراسة واحدة أن وضع حليب الأم على طفح الحفاظات هو علاج فعّال وآمن. وخلال الدراسة، عُولج الأطفال المصابون بهذا الطفح الجلدي إما باستخدام مَرْهم هيدروكورتيزون بنسبة 1% أو بحليب الأم. وكانت فعالية العلاج بحليب الأم تعادل فعالية المَرْهم وحده. وشملت الدراسة 141 طفلاً.

    قارنت دراسة أخرى بين حليب الأم والمرهم المحتوي على أكسيد الزنك وزيت كبد سمك القد. وفي هذه الدراسة عُولج الأطفال حديثو الولادة المصابون بطفح الحفاظ إما باستخدام المرهم أو حليب الأم. وأظهرت نتائجها أن العلاج بالمرهم كان أكثر فعالية.

  • المواد الأخرى. جُرّبت علاجات طبيعية أخرى، بما في ذلك الألوفيرا والآذريون وحبوب لقاح النحل وشمع العسل وزيت كبد سمك القد. ولكن يلزم إجراء المزيد من الدراسات لإثبات فعاليتها في علاج طفح الحفاظ. وقد تحفز بعض هذه المواد نمو البكتيريا.

الاستعداد لموعدك

عمومًا يمكن علاج طفح الحفاظ منزليًا بنجاح. تنبغي زيارة طبيب الأطفال إذا تفاقم الطفح الجلدي رغم استمرار علاجه في المنزل عدة أيام، أو إذا كان شديدًا، أو إذا كان مصحوبًا بحُمى.

فيما يلي بعض المعلومات المفيدة في الاستعداد للموعد الطبي.

ما يمكنك فعله</h3> <ul dir="rtl"> <li dir="rtl">تدوين الأعراض التي يشعر بها الطفل ووقت ظهورها.</li> <li dir="rtl">إعداد قائمة بالمعلومات الأساسية حول حالات الطفل الطبية والطعام الذي يتناوله. على سبيل المثال، هل تلقى الطفل مؤخرًا علاجًا لأي مرض أو تناوَل أي أدوية؟ هل تغير نظام الطفل الغذائي؟ إذا كان طفلكِ يرضع رضاعة طبيعية، فيجب أيضًا تدوين أي أدوية قد تصل إليه عبر حليب الثدي. كما يجب تدوين التغيرات في نظام الأم الغذائي، مثل زيادة الأطعمة المحتوية على الأحماض.</li> <li dir="rtl">إعداد قائمة بكل المنتجات التي تلامس جلد الطفل. سيرغب طبيب الطفل بمعرفة أنواع المناديل المبللة والحفاظات ومسحوق الغسيل والصابون والدَّهون والبودرة والزيوت التي تُستخدم للعناية بالطفل. فإذا شك الأهل في أن واحدًا أو أكثر من المنتجات هو المسبب لطفح الحفاظ، فينبغي إحضار المنتجات إلى الموعد الطبي لكي يقرأ الطبيب ملصقاتها.</li> <li dir="rtl">إعداد قائمةً بالأسئلة التي يرغب الأهل بطرحها على الطبيب. إعداد قائمة بالأسئلة يمكن أن يساعد على الاستفادة القصوى من الموعد الطبي.</li> </ul> <p dir="rtl">فيما يلي بعض الأسئلة الأساسية لطرحها على الطبيب بشأن طفح الحفاظ:</p> <ul dir="rtl"> <li>ما السبب الأرجح لطفح الحفاظ لدى الطفل؟</li> <li dir="rtl">ما هي الأسباب الأخرى المحتملة؟</li> <li dir="rtl">ما الذي يمكن للأهل فعله لمساعدة بشرة الطفل على التعافي؟</li> <li dir="rtl">ما هي المَراهم والكْريمات والمستحضرات التي تقترح استخدامها؟</li> <li dir="rtl">متى يجب أن أستخدم مرهمًا أو معجونًا بدلاً من الكْريم أو الدَهون؟</li> <li dir="rtl">هل تقترح أي علاجات أخرى؟</li> <li dir="rtl">ما المنتجات أو المكونات التي يجب أن أتجنب استخدامها؟</li> <li dir="rtl">هل ينبغي تجنيب الطفل أي نوع من الأطعمة؟</li> <li dir="rtl">في حال الإرضاع الطبيعي، هل يجب أن أتجنب أي أطعمة قد تؤثر على الطفل؟</li> <li dir="rtl">متى يُتوقع أن تتحسّن أعراض الطفل؟</li> <li dir="rtl">ما الذي يمكن فعله لتجنب تكرار هذه الحالة؟</li> <li>هل الطفح الجلدي علامة على مشكلة داخلية أخرى؟</li> </ul> <title dir="rtl">ما الذي يمكن توقُعُه من الطبيب</h3> <p dir="rtl">يُرجَّح أن يطرح عليك الطبيب بعض الأسئلة. وقد يوفر تحضيرك للإجابة عنها مزيدًا من الوقت لمناقشة أي نقاط تستدعي الخوض في التفاصيل. قد يطرح عليك طبيبك الأسئلة التالية:</p> <ul dir="rtl"> <li dir="rtl">متى لاحظت أعراض الطفل لأول مرة؟</li> <li dir="rtl">ما نوع الحفاظ الذي يرتديه الطفل؟</li> <li dir="rtl">كم مرة يتم تغيير حفاظ الرضيع، سواء من قِبل الأهل أو مقدمي الرعاية للطفل؟</li> <li dir="rtl">ما أنواع الصابون أو المناديل المبللة المستخدَمة لتنظيف الرضيع؟</li> <li dir="rtl">هل تُستخدَم أي منتجات للعناية ببشرة الطفل؟</li> <li dir="rtl">هل يعتمد الطفل على الرضاعة الطبيعية؟ إذا كانت الإجابة نعم، فهل تتناول الأم مضادات حيوية؟ هل حصلَت أي تغييرات في نظام الأم الغذائي؟</li> <li dir="rtl">هل بدأ الأهل بإدخال الأطعمة الصلبة في طعام الطفل؟</li> <li dir="rtl">ما هي العلاجات التي جربها الأهل حتى الآن لعلاج الطفح الجلدي لدى الطفل؟ هل كانت أي منها مفيدة؟</li> <li dir="rtl">هل أُصيب الطفل مؤخرًا بأي أمراض أخرى، بما في ذلك أي مرض سبب له الإسهال؟</li> <li>هل تلقّى الطفل أي أدوية مؤخرًا؟</li> </ul> </div> </section> </div> <div class="posted-on"></div> <hr/> <div class="copyright-library"> <small>© 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