All babies who wear diapers are susceptible to developing a diaper rash; however, the condition is most common among babies between 4 and 10 months old. Though worrisome for parents and uncomfortable for babies, diaper rash is generally a harmless condition that responds well to home remedies. Occasionally, depending on the cause for the rash, additional treatment may be required.
Diaper rash is a common skin condition that affects babies and is characterized by a bright red rash in the diaper region. The affected skin is raised and inflamed. Diaper rash will usually not clear up without proper treatment. Depending on the cause, treatment options may include simple home remedies or more intensive treatments with topical creams. To treat a fungal diaper rash, prescription medication may be required.
In general, most diaper rashes share the same characteristics. Occasionally, a severe diaper rash or a diaper rash that develops as a result of a fungal infection may present with more intense symptoms. Typical characteristics of basic diaper rash include:
- Bright red rash that is blotchy
- Skin in diaper region is puffy and tender
- Scaly skin on the penis and scrotum (males)
- Scaly skin on the vagina and labia (females)
- The presence of tiny pimples, blister or ulcers
- The presence of large, inflamed bumps or open sores filled with pus
- Tiny patches of rash that spread and connect to each other
Diaper rash can be very uncomfortable and painful for babies. Babies who are suffering from a diaper rash may fuss or cry during diaper changes, or during bath time. Because the area is tender, babies may squirm or cry when the genitals are touched. Babies over the age of 6 months may scratch their genitals immediately after their diaper is removed.
Diaper rash can develop for a variety of reasons. One of the most common factors in the development of diaper rash is a baby being left in a wet diaper for an extended period of time. If diapers are not changed frequently, a baby’s delicate skin is exposed to soiled matter leading to irritation. Other common causes of diaper rash include:
- Diarrhea or frequent bowel movements
- The use of plastic pants as a diaper cover
- Introducing solid foods to baby’s diet
- Any change in the baby’s diet
- Sensitivity to foods in the breastfeeding mother’s diet
- Antibiotics taken by a breastfeeding mother
- Prolonged exposure to fecal matter or urine in the diaper
- Sensitive skin
- Skin conditions such as eczema or atopic dermatitis
- Irritation from a new brand of baby wipes, diapers, laundry soap, bath soap or lotions
- Dressing baby in diapers that are too tight
- Dressing baby in clothing that chaffs the skin
Diaper rash that develops as a result of a fungal infection, such as Candida (yeast infection) will usually start out with a rash that develops in the folds of the skin. This type of rash presents with red dots that occur in the skin’s creases. Fungal diaper rash quickly spreads throughout the entire diaper region and will usually not clear up without proper treatment.
Diaper rash often begins to clear up after a few days of home care. If the rash is severe, does not improve or worsens after three days of home treatment, schedule an appointment with the baby’s pediatrician. The doctor will likely be able to determine the origin of the rash based on its appearance. If the rash presents as red dots in the skin creases, the doctor will likely prescribe anti-fungal medication. A KOH skin test can be performed to confirm the presence of a fungal yeast infection.
To help your doctor make an accurate diagnosis, it is a good idea to bring with you a list of any over-the-counter or prescription medications your baby has taken. If breastfeeding, include any medications the baby may have come in contact with through breast milk. Bring any suspect products, such as soaps or detergents, with you to the appointment so your doctor can read the label and determine if there are any irritating ingredients that may be to blame.
One of the best treatments for diaper rash is to keep baby’s bottom clean and dry. Change baby’s diaper immediately after it has become soiled. Let baby soak in the bath for as long as possible. Do not use scented soaps. Gently blot baby’s bottom with a towel or allow the skin to air dry. Allow your baby to go diaper-free for as long as possible. Additional steps you can take to help heal diaper rash at home include:
- Use a rag soaked in clean water to gently wash baby’s bottom after every diaper change
- If you must use baby wipes, use only those that are alcohol-free and fragrance-free
- Avoid soaps, lotions or creams that contain fragrance or any other skin irritants
- Change diapers frequently
- Apply an over-the-counter diaper rash medication
- Refrain from using plastic diaper covers
- Avoid tight-fitting clothing
- Use diapers that are one size larger than what baby usually wears
If basic home remedies aren’t working, additional treatment with topical diaper rash cream may be required. There are several over-the-counter medications to choose from. Zinc oxide is a main ingredient in many diaper rash medications. These creams and ointments work in two ways. When applied to the affected skin, the medication helps to both soothe irritated skin and protect it from further irritation.
Diaper rash that is caused by a fungal infection such as Candida will require the use of an antifungal cream. Your pediatrician will be able to prescribe the cream after examining your baby and confirming the diagnosis.
If the diaper rash is not due to a fungal infection but your baby’s skin is severely irritated or inflamed, your doctor may prescribe a mild hydrocortisone cream to help bring down any swelling.
Diaper rash can occasionally lead to the development of a secondary infection that would require the use of prescription medication. Contact your pediatrician if any of the following symptoms occur along with the diaper rash:
- The rash spreads beyond the diaper region
- Pus oozing out of the rash
- Weeping discharge
Diaper rash that occurs as a result of medications taken by either baby or a breastfeeding mother cannot be prevented. For all other diaper rashes, there are some simple steps parents can take to help keep baby’s bottom soft and diaper rash-free. Simple strategies to prevent diaper rash include:
- Frequent diaper changes
- Briefly dip baby’s bottom in clean water after each diaper change.
- Avoid wipes and use a spray bottle and cotton balls to clean baby’s bottom during diaper changes.
- Avoid anything abrasive on baby’s bottom; blot dry instead of rubbing after baths.
- Keep diapers loosely fastened to increase air flow.
- Expose baby’s bottom to air frequently; allow baby to go diaper-free as much as possible.
- Be diligent about washing cloth diapers properly; always pre-soak and use hot water to clean them.
- Use only mild laundry soaps that do not contain fragrances, alcohol or other irritants.
- Use diaper rash creams or ointments after each diaper change to form a barrier on the skin that can prevent diaper rash from developing.
- Always wash your hands thoroughly after each diaper change to prevent the spread of bacteria or yeast.
Many parents have a difficult time deciding which type of diaper is best for baby, cloth or disposable. There is no evidence that one is better than the other for basic diapering needs. When diaper rash is present, some experts suggest that disposable diapers may help keep baby’s skin slightly drier than cloth diapers. Regardless of the type of diaper you choose for your baby, the most important factor in preventing and treating diaper rash is changing diapers frequently to ensure baby’s skin remains as clean and dry as possible.