Comparison of Rice Starch Powder and Zinc Oxide Cream for the Prevention of Irritant Diaper Dermatitis
Nadda Samakayanusorn MD*, Suthida Chaithirayanon MD**, Thep Chalermchai MD*, Suwirakorn Ophaswongs MD*, Nampen Siriwat MD*, Montree Udompataikul MD*
Affiliation : * Skin Center, Faculty of Medicine, Srinakharinwirot University, Bangkok, Thailand ** Department of Pediatrics, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand
Background : Diaper dermatitis is a common skin disorder during infancy. A recent study indicated that efficacy in preventing
diaper dermatitis using talcum powder was five times less than zinc oxide cream, and research demonstrated that talcum
powder usage was associated with lung diseases and ovarian cancer in adults. Due to these limitations, rice starch powder,
an organic substance with water repellent, may be benefit in preventing diaper dermatitis. As there has been no study of the
effectiveness of rice starch powder, it was investigated in the present study.
Objective : To compare the effectiveness of rice starch powder with zinc oxide cream for the prevention of diaper dermatitis
Material and Method: A total of 104 healthy infants, aged between 6 and 24 months with normal skin in the diaper area were
divided equally into two groups. One group was applied with rice starch powder over the diaper area and the other with zinc
oxide cream. Both groups used the same disposable diapers with four supplied per day. Clinical outcomes were evaluated at
the 4th and 8th week for the occurrence and duration of the disease, with clinical severity assessed using the diaper dermatitis
severity scoring scale. Parental satisfaction was also evaluated and side effects were recorded.
Results : One hundred infants, 56 males and 44 females completed the study with average age 12.6 months. The diaper
dermatitis occurrence in the rice starch powder group was 26 percent (n = 13) whereas it was 22 percent (n = 11) in the zinc
oxide cream group. This showed no statistically significant difference between two groups (p = 0.584). Median time to event
for infants applied with rice starch powder was 22 days (IQR: 21 to 23) and 26 days for the zinc oxide cream group (IQR: 20
to 31) with no statistically significant difference (p = 0.105, log rank test). Multivariate analysis using the Cox proportional
hazard regression model found that the risk of diaper dermatitis occurrence in the rice starch powder group was 3.5 times
higher than in the zinc oxide cream group (95% CI: 0.7 to 16.1), with no statistically significant difference (p = 0.105). No
adverse effects resulted from the use of the test substances in either group.
Conclusion : Rice starch powder can be considered as an alternative choice for preventing diaper dermatitis.
Keywords : Diaper dermatitis, Rice starch powder, Talcum powder, Zinc oxide cream
