Emollients for diapers? Yes! Type? It doesn’t matter! | Image credit: Contemporary Pediatrics

Disposable diapers containing an emollient protect a baby’s diapered area better than diapers without such a product. But compared with the familiar petrolatum-based emollient (PBE), the relatively recently developed shea butter-based emollient (SBE) is just as effective in mitigating erythema, is well-tolerated, and provides similar protection. These were the findings of a 6-week study that compared diapered skin erythema from PBE- and SBE-containing diapers and with diapers not containing an emollient. In a separate study, investigators confirmed that emollient transfers well from diaper to baby, covering the entire diapered area, including genitals, buttocks, and intertriginous and perianal regions. 

After wearing the PBE diaper for 3 weeks, the babies were divided into 3 groups: One group wore an SBE diaper (123 babies), another a diaper with no emollient (121), and the third remained on the PBE diaper (127) for another 3 weeks. Babies in the no emollient group had a significant increase in skin erythema, unlike those who transitioned from the PBE to the SBE diaper. Indeed, babies who wore the SBE diaper were 2.6 times more likely to be free of erythema in the perianal area (the site of highest erythema) than those wearing the nonemollient diaper. Investigators observed similar trends at the buttocks, genitals, and intertriginous sites. However, the proportion of erythema-free babies was similar between the groups wearing PBE and SBE diapers.

Thoughts From Dr Farber

After this study, I expect an SBE diaper, probably more expensive than an untreated one, to hit the market soon. Parents may ask your expert advice on whether to use an SBE or PBE diaper, or a regular one with manual application of ointment, for the treatment/prevention of minor diaper rashes. I personally don’t have an opinion, and suggest parents decide based on cost vs convenience.

Reference:

O'Connor RJ, Visscher MO, Narendran V, Wang Y, Wiesemann F, Carr AN. Clinical evaluation of a diaper containing a shea butter-based emollient and impact on diapered skin erythema. Pediatr Dermatol. 2025;42(3):532-538. doi:10.1111/pde.15944