Diaper rash
Diaper rash is red, sore skin in the area covered by a diaper (nappy) or cloth. It is very common in babies and is caused mainly by the skin staying in contact with urine and stool. It is usually mild and gets better in a few days with simple care. Sometimes a yeast (fungal) or bacterial infection develops on top and needs a cream from a health worker.
Symptoms
- Red, sore or shiny skin on the bottom, genitals or thighs
- The baby cries or is fussy when the diaper is changed or the area is washed
- Small red spots or bumps
- A bright red rash with small spots at the edges and in the skin folds (often yeast)
- Yellow crusts, blisters or pus spots (possible bacterial infection)
Causes
- Wet or dirty diapers left on too long
- Rubbing of the diaper or cloth against the skin
- Diarrhoea
- Yeast infection, especially after antibiotics
- Soaps, wipes or washing powder that irritate the skin
- Starting new foods, which changes the stool
Prevention
- Change wet or dirty diapers as soon as possible
- Wash the area gently with clean warm water and pat dry; avoid perfumed wipes and soaps
- Let the baby spend some time each day without a diaper
- Use a thin layer of barrier cream or ointment (zinc oxide or petroleum jelly) at changes
- Wash cloth nappies well and rinse out all the soap
- Do not use tight plastic pants over the diaper
Treatment
- Change diapers often and keep the skin clean and dry
- Diaper-free time several times a day
- Barrier cream (zinc oxide) or petroleum jelly at every change
- An antifungal cream such as clotrimazole or nystatin if a health worker thinks it is a yeast rash
- An antibiotic cream if there is a bacterial infection — prescribed by a health worker
- Do not use strong steroid creams, talcum powder or home remedies on the rash
Common questions
Are cloth nappies or disposable diapers better?
Both can be used. What matters most is changing them often, cleaning the skin gently and letting it dry. Wash cloth nappies well and rinse out all the soap.
Can I use powder on the rash?
It is better not to. The baby can breathe in talcum powder, and it does not protect the skin as well as a barrier cream such as zinc oxide or petroleum jelly.