Diaper rash

What is diaper rash?

Diaper rash is a skin irritation that affects babies or toddlers in the diaper area. Most often, it is due to contact between urine and stool with your baby's sensitive skin. Most babies will have at least one diaper rash before being toilet trained.

Signs and symptoms of diaper rash

A baby with diaper rash may show these signs or symptoms:

• pink or red patches on the skin
  
• irritated or painful skin
• spots or blisters in the diaper area
• bright red patches and sometimes open sores (these are often very painful)

Causes

The most common cause of diaper rash is contact with urine and stool. This is called "irritant diaper dermatitis." It often occurs when the baby has diarrhea. It most commonly affects the buttocks and thighs. Snug-fitting, plastic pants or diapers that prevent wetness from drying can make the rash worse.

Diaper rash can also be caused by yeast infection (Candida). This fungal infection thrives in warm, moist area such as skin creases. Yeast diaper dermatitis looks red, and often has small red spots around the edges. It is usually not painful. It can be caused or becomes worse when the baby is on antibiotics.

Other rashes can occur in the diaper area. These include eczema, bacterial, viral and allergic rashes. They may also be seen on other parts of the body as well.

Treatment

Leave the diaper off. Expose your baby's skin to warm, dry air as much as you can.

When changing the diaper, wash your baby's bottom with mild soap and warm water, rinse and pat dry. It may be less painful for your baby if you wash the area in a warm bath. Avoid wipes with alcohol; this may cause more pain.

Use an unscented barrier ointment, such as zinc oxide, to protect the area after each diaper change. If the diaper rash is more severe, use an ointment with a higher percentage of zinc oxide (up to 40%). Put a thick layer of the ointment on the affected area after each diaper change. Try not to scrub it off with diaper changes. Do not share creams with other children. Do not contaminate the cream. Wash your hands before putting them into the jar.

Candida (yeast) diaper dermatitis should be treated with a topical antifungal cream such as mycostatin or clotrimazole.

Prevention

The best way to prevent diaper rash is to change your baby's diaper often. If your baby has diarrhea, change the diaper even more often. Applying a thin layer of unscented barrier cream can also protect the skin. It is not known whether cloth or disposable diapers are better in preventing diaper rashes.

When to see a doctor

Make an appointment with your child's doctor if the rash does not get better within a few days or if the baby seems unwell or has a fever.