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What to Do About Diaper Rash (Nappy Rash)

With a background in life sciences and education, Amanda often writes informative, actionable articles about health and well-being.

Most times diaper rash is uncomfortable for your baby but doesn't represent a risk to her health. However, it can be a sign of more serious conditions which parents should know about

Most times diaper rash is uncomfortable for your baby but doesn't represent a risk to her health. However, it can be a sign of more serious conditions which parents should know about

Diaper Rash Is Uncomfortable But Common

Diaper rash is a common condition among infants. You can treat it with powders or lotions available over-the-counter at the drugstore. Diaper rash is almost unavoidable.

Most babies soil themselves again within an hour after a diaper change. As hourly changes, particularly through the night, are not practical, dampness and chafing will lead to the irritation and reddening of the skin known as diaper rash.

Chafing Dermatitis or Allergic Rash?

The two most common types of diaper rash are:

  • Chafing dermatitis, also called "friction rash"
  • and allergic rash

Your baby's skin rubbing against a wet, soiled diaper causes the first condition. The second can be a reaction to the lotions and powders you're using to protect your baby1.

Simple Treatments for Diaper Rash

It may be best to avoid scented baby wipes and use traditional warm water and a soft, washable cloth.

Even if your infant responds well to treatments from the drugstore, it's a good idea to allow the child a period of diaper-free time every day. A few hours in which air can circulate proves the simplest cure for most rashes2.

Choosing diapers one size too big and making sure you don't over-tighten the tabs can also help.

Choosing diapers in the store can seem overwhelming but it doesn't really matter much which you select if they're a comfortable fit and you change them often

Choosing diapers in the store can seem overwhelming but it doesn't really matter much which you select if they're a comfortable fit and you change them often

The Dangers of Diaper Rash Infections

Even though diaper rash is a normal condition and treatable, parents should always keep an eye on how it develops. If it doesn't respond to treatment or becomes very red and sore, and if there is any sign of blood, then your baby may be at risk of infection. Severe rashes can stop your baby sleeping and cause other symptoms such as general malaise and a high temperature3.

Antibiotics and Fungal Diaper Rash (Candidal dermatitis)

Fungal infection sometimes causes persistent rashes such as Candidal dermatitis. Applying an anti-fungal cream cures most instances. This is something to look out for if your child is being treated with antibiotics. Antibiotic medication can make children more susceptible4.

To help avoid diaper rash, diapers should be slightly loose fitting and changed before they're "full" with urine, even if the manufacturer describes them as super- or extra-absorbent

To help avoid diaper rash, diapers should be slightly loose fitting and changed before they're "full" with urine, even if the manufacturer describes them as super- or extra-absorbent

Weaning Your Baby and Perianal Dermatitis

Perianal dermatitis can lead to reddening and soreness around the baby's anus. A sudden change in diet is the most common cause. If you're moving too quickly from formula or breast-feeding onto solids, that may be the cause5. If your child experiences this condition after weaning, seek advice from a pediatrician. A simple change in diet may be all that your baby needs to resolve the issue.

Perianal dermatitis causes soreness around your baby's bottom and is often caused by too sudden a change from mother's milk or formula milk to solids.

Perianal dermatitis causes soreness around your baby's bottom and is often caused by too sudden a change from mother's milk or formula milk to solids.

Diaper Rash or Eczema?

A persistent rash which also leads to flaky skin may be a sign of eczema. The causes of eczema are still unknown, but may include genetic factors and allergic reactions. A visit to the doctor is a good idea. Treatment will be a hydrocortisone cream6.

Microbial infection eczema presents as a persistent flakiness of the skin and a sore rash. In infants it may be mistaken for diaper rash and so go untreated. If in doubt, see a doctor without delay

Microbial infection eczema presents as a persistent flakiness of the skin and a sore rash. In infants it may be mistaken for diaper rash and so go untreated. If in doubt, see a doctor without delay

Diaper Rash and Cradle Cap

A common ailment related to diaper rash is a condition known as Seborrheic dermatitis or "cradle cap"7. Presenting as a red rash with yellow, scaly skin, the condition looks worse than it is. It's mostly harmless and is treated with steroid cream. Many babies experience little discomfort with this condition. Even left untreated it will often vanish on its own.

Cradle cap is common and often occurs alongside diaper rash. The condition is harmless and if left alone usually clears up without intervention. However, it can also be treated with steroid creams

Cradle cap is common and often occurs alongside diaper rash. The condition is harmless and if left alone usually clears up without intervention. However, it can also be treated with steroid creams

Diaper Rash and the Risk of Bacterial Infection

Bacterial infections may cause more severe forms of diaper rash. Invasions of Streptococci or Staphylococci are the most common causes of this condition. Antibiotic treatment is the most effective solution8.

Signs of Diaper Rash and Infection with Common Treatments

Signs of Diaper RashSymptoms of InfectionTreatment

Discomfort

Pustules

Gentle cleaning with warm water

Soreness, bleeding

Pimples

"Air time"

Bumps

Blisters

Petroleum jelly / zinc oxide cream

When to See a Doctor

If you suspect your baby is suffering from a more severe form of diaper rash, you should seek medical advice. Once your doctor has examined your infant, she may prescribe a course of medication. Even the more severe forms of skin irritation need not be a cause for concern if you recognize and treat them early.

References

1. "Patient education: Diaper rash in infants and children". Retrieved from: https://www.uptodate.com/contents/diaper-rash-in-infants-and-children-beyond-the-basics

2. "Your Baby's Diaper Rash". WebMD. Retrieved from: https://www.webmd.com/parenting/diaper-rash-treatment#1

3. "Diaper Rash". Retrieved from: http://www.pediatricweb.com/webpost/iframe/WGA_500.asp?tCategoryId=1&tArticleId=626

4. "Nappy Rash". Baby Centre UK. Retrieved from: https://www.babycentre.co.uk/a81/nappy-rash

5. Morris H, "The bottom line on nappy rash", British Journal of Midwifery, September 2012, Vol 20, No 9, pages 540-543

6. "Eczema: What’s the Best Treatment for You?" WebMD. Retrieved from: https://www.webmd.com/skin-problems-and-treatments/eczema/treatment-16/treatments-for-you

7. "Nappy rash and cradle cap". Ipswich and East Suffolk Clinical Commissioning Group. Retrieved from: http://www.ipswichandeastsuffolkccg.nhs.uk/Prevention/Childhealth05/Firstmonths/Nappyrashcradlecap.aspx

8. "Diaper Rash" Mayo Clinic. Retrieved from: https://www.mayoclinic.org/diseases-conditions/diaper-rash/diagnosis-treatment/drc-20371641

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2018 Amanda Littlejohn

Comments

Amanda Littlejohn (author) on October 29, 2018:

Hi Shelley,

Me, too! Although I've re-lived it with my grandkids. I hope this article helps reassure and inform new parents about the problem of diaper rash.

FlourishAnyway from USA on October 29, 2018:

It’s been a long time since I’ve had to worry about this, but you give new parents great advice. That one photo of the eczema looks especially unpleasant.