University of California San Francisco

Diaper Area Skin Care After Perianal or Bowel Surgery

If your child has had a surgery on the bowel, it is likely that he/she will experience diaper rashes that may lead to skin breakdown. A little preventive skin care will minimize the amount of breakdown.

Following Surgery

Once stooling begins it is very important to protect the skin of the diaper area from the irritating effects of frequent, loose stools. A good product to use is 3M NO STRING BARRIER FILM®. This product is applied once daily to clean dry skin, usually following a bath. Barrier film should be placed directly on red areas including any rash or open sores. Begin at the anal opening, swiping out in a circle about 1 - 2 inches from the anus, where stool may come in contact with skin. The product goes on wet and dries in about one minute. While it is drying, hold the buttocks apart and do not allow skin to skin contact until completely dry. Once the barrier film is dry, ILEX® paste or Butt Balm can be applied as directed over the barrier film. Butt Balm should be applied thickly (1/8 inch) to the diaper area. After each stool remove the stool from the paste but do not completely remove paste from the skin. Reapply the Butt Balm. Once a day, before your baby's bath, gently remove the paste with mineral oil being careful not to rub the skin. Continue using Butt Balm until the skin is healed and the frequency of stool decreases.

To make Butt Balm, mix one large tube of DESITIN® (4 ounce) and STOMAHESIVE® powder (1 ounce) and NYSTATIN® (antifungal) powder (15cc or 1/2 ounce) together.

ILEX® paste is also very helpful for open sores. ILEX® can be used instead of butt balm and should be applied to a clean diaper area where broken skin is present and covered with vaseline. After each stool remove the stool from the paste but do not completely remove the paste from the skin. Reapply ILEX® and vaseline. Continue until broken down skin areas are healed and the frequency of stool decreases.

Discharge At Home

It will take several months before your child's diaper area is conditioned to stooling. Use the paste as long as frequent stooling occurs. ILEX® is available from:

  • MEDCON Biolab - 1-800-443-6332
  • The local distributor of 3M No String Barrier Film® can be found by calling: 3M -1-800-228-3957

ILEX® is an over-the-counter paste and no prescription is required; however, it may require a special order from local pharmacy. STOMAHESIVE® powder, NYSTATIN® and 3M® powder require a prescription and may need to be ordered from your local pharmacy or home care supplier.

Additional Tips

  • Use mineral oil and a cotton ball to gently remove paste or stool from skin.
  • A tub bath may be given 2 days after surgery. Soak the paste off, give the bath, pat the skin dry and reapply paste.
  • Always apply the paste thickly.
  • Air drying with a hairdryer set at cool is very useful when the skin is intact and the child's diaper area can be left open.
  • Change diapers frequently.
  • If your child is taking solids, foods such as rice, cereal, applesauce, and bananas may help thicken stool.
  • Call for advice if skin breakdown persists and there is no improvement. 415/476-2538