Diaper rash

Treatment

The best treatment for diaper rash is to keep your baby's skin as clean and dry as possible. If the rash doesn't go away with home treatment, your health care provider might suggest:

• A mild (0.5% to 1%) hydrocortisone (steroid) cream twice a day for 3 to 5 days
• An antifungal cream, if your baby has a fungal infection
• Antibiotic medicine taken by mouth, if your baby has a bacterial infection

A diaper rash might take several days to improve, depending on how severe it is. A rash may come back again and again. If a rash persists even with prescription products, your health care provider may recommend that your baby see a specialist in skin conditions (dermatologist).

Lifestyle and home remedies

Generally, a diaper rash can be treated successfully at home with these practices:

• Keep the diaper area clean and dry. The best way to keep your baby's diaper area clean and dry is by changing diapers promptly after they are wet or soiled. Until the rash is better, this may mean getting up during the night to change the diaper. Try using disposable diapers that contain an absorbent gel. They draw wetness away from the skin.
• Rinse your baby's bottom with warm water as part of each diaper change. You can use a sink, tub or water bottle for this purpose. Moist washcloths, cotton balls and baby wipes can aid in cleaning the skin. Be gentle. Use wipes that don't contain alcohol or fragrance. Or use a mild soap or a gentle nonsoap cleanser.
• Gently pat the skin dry with a clean towel or let it air dry. Don't scrub your baby's bottom. Don't use talcum powder.

• Apply cream, paste or ointment. After you've gently cleaned and dried the skin, apply a cream, paste or ointment. If the product you applied at the previous diaper change is clean, leave it in place and add another layer on top of it. If you do want to remove it, try using mineral oil on a cotton ball.

  Products with a high percentage of zinc oxide or petroleum jelly work well to protect the skin from moisture. Various diaper rash medications are available without a prescription. Talk to your health care provider or pharmacist for specific recommendations. Some popular products include A + D, Balmex, Desitin, Triple Paste and Lotrimin (for yeast infections).

  Zinc oxide is the active ingredient in many diaper rash products. Such products are usually applied to the rash throughout the day to soothe and protect babies' skin. It doesn't take much – a thin covering will do. The product can be applied over medicated creams, such as an antifungal or a steroid, when needed. You could also apply petroleum jelly on top, which helps keep the diaper from sticking to the paste, ointment or cream.

  Ointments, pastes or creams may be less irritating than lotions. But ointments and pastes create a barrier over the skin and don't allow it to receive air. Creams dry on the skin and allow air through.

  As a general rule, stick with products designed for babies. Avoid items containing baking soda, boric acid, camphor, phenol, benzocaine, diphenhydramine or salicylates. These ingredients can be toxic for babies.

• Increase airflow. To aid the healing of diaper rash, do what you can to increase air exposure to the diaper region. These tips may help:
  • Let your baby go without a diaper and ointment for short periods of time, such as during naps.
  • Take a break from plastic or tightfitting diaper covers.
  • Use diapers that are larger than usual until the rash goes away.
• Bathe your baby daily. Until the rash clears up, give your baby a bath each day. Use warm water with mild, fragrance-free soap or a gentle nonsoap cleanser.
• Stop using products that seem to trigger your baby's rash. Try a different brand of baby wipe, disposable diaper, laundry soap or whatever other product you suspect.

Alternative medicine

The following alternative treatments have worked for some people:

• Witch hazel (winter bloom), a flowering plant. A study showed that applying an ointment made with witch hazel to diaper rash helped. The study included 309 children.

• Human breast milk. Results are mixed on whether human breast milk applied to diaper rash is better than other treatments. One study showed that applying breast milk to diaper rash is an effective and safe treatment. Infants with diaper rash were treated with either 1% hydrocortisone ointment or breast milk. The study included 141 infants. Treatment with breast milk was as effective as the ointment alone.

  Another study compared human breast milk with a cream made from zinc oxide and cod liver oil. Newborns with diaper rash were treated with the cream or the breast milk. The study included 63 babies. Treatment with the cream was more effective.

• Shampoo clay (bentonite). A study showed that shampoo clay was effective in healing diaper rash and that it worked faster than calendula. The study included 60 infants.
• Other substances. Other natural remedies have been tried, including aloe vera, calendula, bee pollen, beeswax and cod liver oil. Further study is needed to prove their effectiveness for treating diaper rash. Some of these substances may promote bacterial growth.

Preparing for your appointment

Generally, diaper rash can be treated successfully at home. Make an appointment with your baby's health care provider if the rash gets worse despite several days of home treatment, is severe or occurs along with a fever.

Here's some information to help you get ready for your appointment.

What you can do

• List your baby's signs and symptoms, and for how long your baby has had them.
• List key information about your baby's medical conditions and food intake. For example, has your baby been treated for any illness or given any medications recently? Has the baby's diet changed? If your baby is breastfed also note any medications that might reach the baby through breast milk. Also note changes in the mother's diet, such as an increase in tomato-based foods.
• List all products that come into contact with your baby's skin. Your baby's health care provider will want to know what brand of wipes, diapers, laundry detergent, soaps, lotions, powders and oils you use for your baby. If you suspect that one or more products may be causing your baby's diaper rash, you may wish to bring them to the appointment so your health care provider can read the label.
• List questions to ask your health care provider. Creating your list of questions in advance can help you make the most of your time with your health care provider.

Below are some basic questions to ask your health care provider about diaper rash.

• What is the most likely cause of my baby's rash?
• What are other possible causes?
• What can I do to help my baby's skin heal?
• What diaper ointments, pastes, creams or lotions would you recommend for my baby?
• When should I use an ointment or paste instead of a cream or lotion?
• Do you suggest any other treatments?
• What products or ingredients should I avoid using with my baby?
• Should I avoid exposing my baby to certain foods, either through breast milk or through my baby's diet?
• How soon do you expect my baby's symptoms to improve?
• What can I do to prevent this condition from recurring?
• Is the rash a sign of some other internal problem?

What to expect from your doctor

Your health care provider is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to talk about in-depth. Your health care provider may ask:

• When did you first notice your baby's signs and symptoms?
• What type of diaper does your baby typically wear?
• How often do you or your baby's child care provider change your baby's diaper?
• What types of soap and wipes do you use to clean your baby?
• Do you apply any skin care products to your baby, such as lotions, powders, creams and oils?
• Is the baby breastfed? If so, is the mother taking antibiotics? Are there any changes to the mother's own diet?
• Have you introduced your baby to solid foods?
• What treatments have you tried so far for your baby's rash? Has anything helped?
• Has your baby recently had any other medical conditions, including any illness that caused diarrhea?
• Has your baby recently taken any new medications?