How to treat diaper rash

How to treat diaper rash

Diaper rash is very common – especially in the first year of a baby's life. Changing wet and dirty diapers promptly can help your little one avoid diaper rash, but babies can get a rash even if you're diligent about diaper changes. There are several types of diaper rash, from simple irritation to an angry bacterial diaper rash. To treat a diaper rash, keep your baby's bottom clean and dry, let them have some diaper-free time, and apply diaper rash cream to protect your baby's delicate skin.

What is diaper rash?

A diaper rash is a rash that appears on the skin under your baby's diaper. Your baby can get diaper rash as early as one week after birth, but it's most common between 9 and 12 months.

You may see it on your baby's buttocks, lower abdomen, genitalia, and/or upper thighs. It's also called diaper dermatitis. Diaper rash can be mild to severe, with different causes and treatments.

Diaper rash is very common (affecting about one in four children) and isn't usually serious, but it can be painful and distressing.

Types of diaper rash

There are different kinds of diaper rash, depending on the causes. Each looks a bit different, which can help you know what you're dealing with.

Irritant diaper rash

This is the most common type of diaper rash. It often happens when pee or poop irritates your baby's skin. It can also occur if your baby is allergic or sensitive to an ingredient in their diaper or lotion, laundry detergent (if you're using cloth diapers), or another product.

Babies may be allergic to fragrances or preservatives in wipes, for example, or even the elastic in their diapers. Your baby might have pink or red patches on their skin wherever it touches the irritant. (The folds of their skin, which aren't exposed to the irritant, usually look normal.)

Diarrhea or teething can make matters worse. When your baby's teething, their saliva can make it into their poop and be irritating. Wetness is a common cause of diaper rash, but if the skin becomes very dry (from drying soaps, for example), it can also cause a mild irritant rash.

Yeast diaper rash

A yeast diaper rash happens when there's an overgrowth of Candida fungus (the same kind of fungus normally found in the digestive tract). Candida thrives in warm, moist locations, like the diaper area.

A diaper rash can start out as a yeast infection, or it can be a secondary infection – meaning that if your baby has a milder, irritant diaper rash that doesn't get treated for several days, it can become infected with Candida (or other organisms, such as strep or herpes).

If your baby has a yeast diaper rash, you may see little pimples or pink bumps. The skin may be shiny, bright red, and/or have sharp-edged pink patches. If it gets bad, your baby may have sores or cracking, bleeding, or oozing skin. The rash will probably be worse in the folds of the groin, where the fungus will thrive.

If your baby has a yeast diaper rash, they may also have oral thrush (also caused by Candida), with white spots inside their cheeks and on their gums, lips, tongue, and the roof of their mouth.

Bacterial diaper rash

A bacterial diaper rash is uncommon, and it needs to be seen by your baby's doctor (they can identify the bacteria and advise you how to treat it). If your baby's bacterial rash is due to strep, they may have bright red skin around the anus. If they have a staph infection, they may have yellow crusting, weeping skin, pimples, or widespread blisters. Your baby may also develop a painful red boil (lump).

If a bacterial infection spreads into the skin, it can cause a more serious infection called cellulitis. If your baby has cellulitis, their skin will be very red and painful to the touch.

What causes diaper rash?

If your baby is in a wet or dirty diaper for too long, they're more likely to develop diaper rash. But any child with sensitive skin can get a diaper rash, even if you're diligent about diaper changes. The culprit can be anything from your child's own urine to a new food.

The most common causes of diaper rash are:

Wetness. Even the most absorbent diaper leaves some moisture on your child's skin. Change your baby's diaper as soon as possible after it becomes wet. And make sure your baby's diaper isn't too tight, as this can trap moisture (as well as cause rubbing and irritation). Use a bigger diaper if the current size is leaving red marks on your baby's skin.

Poop. Poop contains bacteria and enzymes that digest food, both of which can be very irritating if left on the skin. When poop and pee are left in the diaper, they can combine and form ammonia, which can burn your baby's skin. (You can smell the ammonia when you change the diaper.) That's why a baby can get severe diaper rash from diarrhea. Change your baby every three to four hours or whenever they have a dirty diaper.

Chafing and chemical sensitivity. Your child's diaper rash may be the result of their diaper rubbing against their skin, especially if they're sensitive to chemicals, like fragrances in a disposable diaper or the laundry detergent used to wash a cloth diaper. It could also be that a product you're using during diaper changes (like a type of wipe or lotion) irritates your child's skin.

New foods. Diaper rash is also common when your baby first starts eating solid foods. Any new food changes the composition of poop, and the acids in certain foods (such as strawberries and fruit juices) can be especially troublesome for some kids. A new food also might increase the frequency of your baby's bowel movements. If you're breastfeeding, your baby could even be having a reaction to something you ate (although breastfed children are usually less likely to get a diaper rash). Once your baby is eating solid foods, it's a good idea to introduce one food at a time, waiting a few days between each new food. This makes it easier to determine whether a sensitivity to a new food is causing diaper rash. If it is, don't give your baby that food for now.

Antibiotics. Children taking antibiotics (or children whose breastfeeding mothers are on antibiotics) sometimes get yeast infections because these drugs can lead to an overgrowth of Candida fungus. Antibiotics can also cause diarrhea, which can contribute to diaper rash. If your child needs to take an antibiotic, ask the doctor about giving them a probiotic as well. Probiotics encourage the growth of healthy bacteria in the gut, which may reduce your child's chances of getting a diaper rash.

Rarely, a baby might get a diaper rash – or something that looks like diaper rash – from a condition such as seborrheic dermatitis, psoriasis, or an inherited form of zinc deficiency called acrodermatitis enteropathica.

What does diaper rash look like?

If your baby's diaper area looks irritated and red, chances are it's diaper rash. The skin may also be puffy. It will probably feel warm when you touch it

Diaper rash can be mild, with just a few diaper rash bumps – pink or red raised spots over a small area. The skin may be dry and peeling and may have scaling. Or, the bumps may be scattered over a larger area, with overall pinkness and perhaps some redness in concentrated spots.

If the diaper rash is extensive, your baby may have severe redness, peeling, and/or swelling. The diaper rash bumps may be large and connected, and some may contain fluid. The rash may spread to your child's tummy and thighs. Severe diaper rash may have a glossy appearance and will be very painful.

How to treat diaper rash

At-home remedies

If diaper rash develops, take these steps to heal your child's skin:

Keep your child clean and dry by changing their diaper frequently. That may mean getting them up at night for a diaper change

Rinse their diaper area well at each diaper change. Don't use wipes that contain alcohol or fragrance. Some parents keep cotton balls and a squirt bottle or an insulated container of warm water at the changing table for easy, gentle cleanups.

Pat your child's skin dry. Don't rub! You can also use a hair dryer set on low to dry the diaper area after each diaper change.

Keep the irritated area clean with a daily bath to remove irritants and possible bacteria.

Experiment to see if your baby might be allergic to a diaper or topical product you're using. Read labels and switch out potential offenders for a couple of weeks to see if it makes a difference.

Use a diaper rash cream or ointment that forms a barrier on the skin. This will protect your child's irritated skin from poop and urine. You don't have to use ointment at each diaper change: Apply a layer that's thick enough to last through a couple diaper changes. This helps prevent further skin irritation from too much rubbing.

Put your child's diaper on loosely, or use a diaper that's a little big on them to allow for better air circulation. Try disposable diapers for sensitive skin, or extra-absorbent diapers that pull more moisture away from your baby's skin.

Give your child diaper-free time at home when possible – exposure to the air will speed healing.

Consider letting your child sleep with a bare bottom. (You can use a mattress protector under the fitted sheet.)

Medications

For a stubborn rash, your child's doctor will recommend a topical corticosteroid.

If your baby has a yeast diaper rash, their doctor will prescribe or recommend an over-the-counter topical antifungal cream.

For a bacterial rash, the doctor will prescribe an oral and/or topical antibiotic.

If your child goes to daycare or preschool, talk to their caregivers about how you're treating their diaper rash and ask them to follow the same routine (as much as possible).

How long does diaper rash last?

In most cases, you'll be able to clear your child's diaper rash in three or four days without a visit to the doctor. Call the doctor if the rash isn't getting better after a few days of treatment, or if it looks as though it may be infected. Signs of infection include:

• Blisters
• Pus-filled pimples
• Oozing yellowish patches
• Open sores
• Fever
• Extremely painful rash

Also call the doctor if your newborn develops a diaper rash during the first few weeks after birth.