Diaper Rash

What Is Diaper Rash?

Diaper rash is a common condition that can make a baby's skin sore, red, scaly, and tender. Most cases will clear up with simple changes in diapering.

What Causes Diaper Rash?

Usually, diaper rash is the result of an irritation, infection, or allergy.

• Irritation. A baby's skin can get irritated when a diaper is left on for too long and poop (or the diaper itself) rubs against the skin repeatedly.
• Infection. Urine (pee) changes the skin's pH levels, and that lets bacteria and fungi grow more easily. The substances that stop diapers from leaking also prevent air circulation, creating a warm, moist environment where bacteria and fungi can thrive, causing a rash.
• Allergies. Babies with sensitive skin also can develop rashes. Some types of detergent, soaps, diapers (or dyes from diapers), or baby wipes can affect sensitive skin, causing a rash.

Also, starting new foods can change the content and frequency of a baby's poop, which can sometimes lead to a diaper rash. And diarrhea can make an existing case of diaper rash worse.

Diaper rash that lasts for more than a few days, even with changes to the diapering routine, might be caused by a yeast called Candida albicans. This rash is usually red, slightly raised, and has small red dots spreading beyond the main part of the rash. It often starts in the deep creases of skin and can spread to skin on the front and back of the baby. Antibiotics given to a baby or a breastfeeding mom can cause this, as they kill the "good" bacteria that keep Candida from growing.

What Are the Signs & Symptoms of Diaper Rash?

Most diaper rashes are caused by irritation of the skin from contact with pee, poop, and sweat. Sometimes babies get a diaper rash from an allergy to a type of diaper or fragrances in laundry detergent, fabric softener, soap, or wipes.

Signs of diaper rash caused by irritation or allergy include:

• soreness
• redness where the diaper touches the skin
• peeling
• scaly skin
• fussiness

Rashes also can be caused by a skin infection due to yeast or bacteria. If the rash is due to an infection, signs may include:

• red bumps
• a red area with red bumps spreading from it
• red areas in the creases (where skin touches other skin)
• blisters or open sores
• pus-filled sores
• fluid seeping from red areas

How Is Diaper Rash Treated?

To help clear up diaper rash, check your baby's diaper often and change it as soon as it's wet or soiled. Gently clean the diaper area with soap and water and pat dry. Creams and ointments containing zinc oxide or petroleum help to soothe skin and protect it from moisture. They should be smeared on thickly (like cake icing) at each diaper change.

Some experts suggest letting your baby go without diapers for several hours each day to give irritated skin a chance to dry and "breathe." This is easiest if you place your baby in a crib with waterproof sheets or on a large towel on the floor.

Diaper rash usually goes away within 2 to 3 days with home care, but can last longer.

How to Prevent Diaper Rash

Keep your baby's skin as dry and clean as possible and change diapers often so that poop and pee don't irritate the skin.

Try these tips to prevent diaper rash:

• Change your baby's soiled or wet diapers as soon as possible and clean the area well.
• Occasionally soak your baby's bottom between diaper changes with warm water. You can gently scoop the water over your baby's bottom with your hand or squeeze it from a plastic bottle.
• Let your baby's skin dry completely before you put on another diaper.
• Pat the skin gently with a soft cloth when drying it — rubbing can irritate skin.
• Put the diaper on loosely to prevent chafing.
• Change diapers often — ideally every 2 hours or so — and after every poop.

Applying diaper cream or ointment with each diaper change can help some babies with sensitive skin, but not all babies need this.

For cloth diapers, only use detergents in the amount recommended, and run an extra rinse cycle after washing to remove traces of soap or detergent that can irritate your baby's skin. Avoid using fabric softeners and dryer sheets — even these can irritate skin.

Some babies get a rash after switching to a new type of diaper. While experts don't recommend any particular brand, if your child is sensitive, look for diapers free of dyes or fragrances, and try a wet washcloth instead of baby wipes.

When Should I Call the Doctor?

If the rash doesn't go away, gets worse, or if sores appear on your baby's skin, talk to your doctor. Also get medical care if your baby has a fever, pus is draining from the rash, or if your child is fussier than usual.

Depending on what type of rash your baby has, the doctor may choose to use an antifungal cream or an antibiotic cream, or may recommend other changes to your diapering routine. Sometimes, if those changes don't help a rash caused by an allergic reaction, the doctor may prescribe a mild steroid cream for a few days until the rash goes away.