Diaper rash

Diaper rash is a form of dermatitis that looks like patches of inflamed skin on the buttocks, thighs and genitals. It can be caused by wet or soiled diapers that aren't changed often enough. Or it may be due to skin sensitivity and chafing. The condition is common in babies, though anyone who wears a diaper regularly can develop it.

Diaper rash usually clears up with simple at-home care, such as air drying, more-frequent diaper changes, and using a barrier cream or ointment.

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.

If the diaper rash hasn't improved after a few days of home treatment, talk with your doctor or other health care professional. You may need prescription medicine to treat diaper rash. Or the rash may have another cause, such as seborrheic dermatitis, atopic dermatitis, psoriasis or nutritional deficiency.

Take your child to a doctor or other health care professional for:

• A rash with a fever.
• A rash that's severe or unusual.
• A rash that persists or gets worse despite home care.
• A rash that bleeds, itches or oozes.
• A rash that causes burning or pain when your baby passes urine or stool.

Diaper rash may be caused by:

• Leaving on wet or soiled diapers too long. Skin 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 having many stools 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 wash cloth diapers. Ingredients in lotions, powders and oils might add to the problem.
• Developing a bacterial or yeast 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.
• 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 atopic dermatitis, seborrheic dermatitis or other skin conditions may be more likely to develop diaper rash. The irritated skin of atopic dermatitis also tends to be 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 also are at increased risk of diaper rash.

Risk factors for diaper rash include wearing diapers that aren't changed often enough and having sensitive skin.

• Changes in skin color. In babies with brown or Black skin, diaper rash might cause the affected area to lighten. This is called post-inflammatory hypopigmentation. Mild skin lightening often clears up in a few weeks. Skin affected more severely could take months or years to return to its usual color.
• Infection. Diaper rash can develop into a severe infection that doesn't respond to treatment.

The best way to prevent diaper rash is to keep the diaper area clean and dry. A few simple skin care tips can help:

• Change diapers often. Remove wet or dirty diapers as soon as you can. If your child is in child care, ask staff members to do the same. Disposable diapers that contain an absorbent gel may help 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 or baby wipes can aid in cleaning the skin. Be gentle. Some baby wipes can be irritating, so use wipes that don't contain alcohol or fragrance. Or use plain water or water with a mild soap or 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. If your baby gets rashes often, apply a barrier cream, paste or ointment with 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 and to other children.
• Allow airflow under the diaper. Secure the diaper, but not too tightly. Airflow within the diaper helps the skin. Diapers that are too tight can rub against 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.