Diaper rash

Overview

Diaper rash is a common form of irritated skin (dermatitis) that looks like patches of inflamed skin on your baby's bottom. It's often related to wet or infrequently changed diapers, skin sensitivity, and chafing. It usually affects babies, though anyone who wears a diaper regularly can develop the condition.

Diaper rash usually clears up with simple at-home treatments, such as air drying, more-frequent diaper changes and ointment.

Symptoms

Signs and symptoms of diaper rash include:

• Inflamed skin in the diaper area — buttocks, thighs and genitals
• Itchy, tender skin in the diaper area
• Sores in the diaper area
• Discomfort, fussiness or crying, especially during diaper changes

When to see a doctor

If your baby's skin doesn't improve after a few days of home treatment, talk with your health care provider. You may need a prescription medication to treat diaper rash, or the rash may have another cause, such as zinc nutritional deficiency.

Take your child to your health care provider for:

• A rash with a fever
• A rash that's severe or unusual
• A rash that persists or gets worse despite home treatment
• A rash that bleeds, itches or oozes
• A rash that causes burning or pain when your baby urinates or has a bowel movement

Causes

Diaper rash may be caused by:

• Leaving on wet or soiled diapers too long. The tender skin of babies can develop a rash if wet or soiled diapers are left on too long. Babies may be more prone to diaper rash if they're experiencing frequent bowel movements or diarrhea.
• Chafing or rubbing. Tightfitting diapers or clothing that rubs against the skin can lead to a rash.
• Using a new product. Your baby's skin may react to a new brand of baby wipes, diapers or a detergent, bleach or fabric softener used to launder cloth diapers. Ingredients in lotions, powders and oils might add to the problem.
• Developing a bacterial or yeast (fungal) infection. What begins as a simple infection may spread to the surrounding skin. The area covered by a diaper is at risk because it's warm and moist, making a perfect breeding ground for bacteria and yeast. These rashes can be found within the creases of the skin. And you might notice red dots scattered around the creases.
• Introducing new foods. As babies start to eat solid foods, the content of their stool changes. This increases the likelihood of diaper rash. Changes in your baby's diet can also increase the frequency of stools, which can lead to diaper rash. Breastfed babies might develop diaper rash in response to something the mother has eaten.
• Having sensitive skin. Babies with skin conditions, such as atopic dermatitis (eczema) or seborrheic dermatitis, may be more likely to develop diaper rash. The irritated skin of atopic dermatitis is usually in areas not covered by a diaper.
• Using antibiotics. Antibiotics can contribute to a rash by killing bacteria that keep yeast growth in check. Antibiotic use also increases the risk of diarrhea. Breastfed babies whose mothers take antibiotics are also at increased risk of diaper rash.

Complications

• Changes in skin color. In babies with brown and Black skin, diaper rash might cause the affected area to lighten (post-inflammatory hypopigmentation). Mild hypopigmentation usually clears up in a few weeks. Severe cases might take months or years to return to the usual skin color.
• Infection. Diaper rash can develop into a severe infection that doesn't respond to treatment.

Prevention

The best way to prevent diaper rash is to keep the diaper area clean and dry. A few simple strategies can help decrease the likelihood of diaper rash developing on your baby's skin.

• Change diapers often. Remove wet or dirty diapers promptly. If your child is in child care, ask staff members to do the same. Disposable diapers that contain an absorbent gel are effective because 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 regularly. If your baby gets rashes often, apply a cream, paste or ointment during each diaper change. Petroleum jelly and zinc oxide are the time-proven ingredients in many diaper rash products. If the product you applied at the previous diaper change is clean, leave it in place and add another layer on top of it.
• After changing diapers, wash your hands well. Hand-washing can prevent the spread of bacteria or yeast to other parts of your baby's body, to you or to other children.
• Fasten diapers securely but not too tight. A diaper that allows some airflow helps prevent diaper rashes. Too-tight diapers can rub the skin. Take a break from plastic or tightfitting diaper covers.
• Give your baby's bottom more time without a diaper. When possible, let your baby go without a diaper. Exposing skin to air is a natural and gentle way to let it dry. To avoid messy accidents, try laying your bare-bottomed baby on a large towel and engage in some playtime.