Clinical Effectiveness of Barrier Preparations in the Management of Diaper Dermatitis: A Systematic Review and Meta-Analysis

The inflammatory skin condition known as diaper dermatitis (DD) often affects infants and preschoolers. Barrier preparations are commonly used in their management, but their effectiveness remains unclear. This systematic review aimed to evaluate the extent to which barrier preparations reduce DD compared to a placebo or other therapies. To gather relevant information, we conducted electronic searches on databases such as Medical Literature Analysis and Retrieval System Online (MEDLINE) via PubMed, Scopus, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar for data extraction. We included studies based on randomized controlled trials (RCTs), quasi-randomized controlled studies, and cohort studies. The collected data were analyzed using RevMan version 5.3 (The Cochrane Collaboration, London, United Kingdom) for Windows. This study included a total of six studies, comprising four randomized controlled trials and two cohort studies. The analysis focused on the incidence rates of dermatitis among both experimental and placebo groups across approximately four studies. A significant difference in dermatitis prevalence was observed between the intervention and placebo groups (odds ratio {ORs} = 0.77; confidence interval {CI} = 0.37-1.61; p = 0.0002), with notable heterogeneity noted (degrees of freedom {df} = 3; I2 = 79%). Among the six included studies, clotrimazole emerged as an effective management strategy, demonstrating minimal incidence rates of dermatitis compared to placebo. Additionally, zinc oxide (ZnO) paste showed effectiveness in managing diaper dermatitis among neonates. The use of diaper cream or moisturizers, along with soap, was found to be effective in preventing nappy rash. However, only one study reported no efficacy of petroleum jelly or Vaseline in reducing the severity and incidence of dermatitis symptoms. The effectiveness of barrier preparations in treating DD varies depending on the preparation and study design. Clotrimazole shows potential, especially for suspected fungal infections. To gain a deeper understanding of barrier preparations, identify the factors influencing their efficacy, and explore their role in high-risk patients, additional research is necessary.