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.
Diaper rash is a common form of inflamed skin (dermatitis) that appears as a patchwork of bright red skin on your baby’s bottom.
Diaper rash is 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 can alarm parents and annoy babies. But it usually clears up with simple at-home treatments, such as air drying, more frequent diaper changes and ointment.
Diaper rash is characterized by the following:
- Skin signs. Diaper rash is marked by red, tender-looking skin in the diaper region — buttocks, thighs and genitals.
- Changes in your baby’s disposition. You may notice your baby seems more uncomfortable than usual, especially during diaper changes. A baby with a diaper rash often fusses or cries when the diaper area is washed or touched.
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 off the “good” bacteria that keep Candida from growing.
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, although it can last longer.
Cloth or disposable diapers?
Many parents wonder about what kind of diapers to use. When it comes to preventing diaper rash, there’s no compelling evidence that cloth diapers are better than disposable diapers or vice versa.
Because there’s no one best diaper, use whatever works for you and your baby. If one brand of disposable diaper irritates your baby’s skin, try another. If the laundry soap you use on cloth diapers seems to cause a diaper rash, switch products.
Whether you use cloth diapers, disposables or both kinds, always change your baby as soon as possible after he or she wets or soils the diaper to keep the bottom as clean and dry as possible.
Washing cloth diapers
If you use cloth diapers, careful washing can help prevent diaper rash. Washing methods vary and many routines work well. They key is to clean, disinfect and remove soap residue. Here’s one effective method:
- Pre-soak heavily soiled cloth diapers in cold water.
- Wash diapers in hot water with a mild detergent and bleach. Bleach kills germs. You could also add vinegar to the wash cycle to eliminate odors and rinse out soap residue.
- Double rinse the diapers in cold water to remove traces of chemicals and soap.
- Skip fabric softener and dryer sheets because they can contain fragrances that may irritate your baby’s skin.
How Can I Prevent Diaper Rash?
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:
- 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.
If you use cloth diapers, check the manufacturer’s directions on how to best clean them. 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. Some babies are sensitive to baby wipes — water and a washcloth work just as well and may be a gentler option.
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.