Diaper rash is a common but uncomfortable skin rash that occurs in infants. Parents and caregivers need to know how to treat diaper rash to prevent the symptoms from getting worse.
Diaper rash is a red, painful rash that thrives in warm, moist environments. The rash may cause the skin to be scaly, bumpy, or raw. This condition accounts for about 20 per cent of all childhood visits to a dermatologist.
Some infants are particularly prone to diaper rash and may get it very frequently, especially if they have an underlying skin condition, such as eczema.
In this article, learn about the causes of diaper rash and how to treat it quickly and effectively.
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What Causes Diaper Rash?
Usually, diaper rash is the result of an irritation, infection, or allergy.
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.
Urine (pee) changes the skin’s pH levels, letting bacteria and fungi grow more efficiently. The substances that stop diapers from leaking also prevent air circulation, creating a warm, moist environment where bacteria and fungi thrive, causing a rash.
Babies with sensitive skin also can develop rashes. In addition, 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, sometimes leading 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 central part of the rash.
It often starts in the deep creases of the skin and can spread to the 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.
No matter how careful you are, your little one will probably get a diaper rash at some point. Most babies do.
Luckily, creams and ointments to take care of the problem and diapering know-how can help prevent it before it strikes.
So, plan. Learn how to treat diaper rash and prevent flare-ups. Your baby’s little bottom will thank you!
Diaper rash happens when:
- You leave a wet or dirty diaper on too long
- Your baby’s skin rubs or chafes against the diaper itself
- Your baby gets a yeast infection
- Your baby gets a bacterial infection
- Your baby has an allergic reaction to their diaper
Babies get a diaper rash more often when they:
- Get older — especially between 9 and 12 months old
- Sleep in poopy diapers
- Have diarrhea
- Start eating solid foods
- Are you taking antibiotics, or if you take antibiotics and are nursing
The best treatment for diaper rash is to keep your baby’s skin as clean and dry as possible. If your baby’s diaper rash persists despite home treatment, your doctor may prescribe:
- A mild hydrocortisone (steroid) cream
- An antifungal cream, if your baby has a fungal infection
- Topical or oral antibiotics, if your baby has a bacterial infection
Use creams or ointments with steroids only if your baby’s pediatrician or dermatologist recommends them — potent steroids or frequent use can lead to additional problems.
Diaper rashes usually require several days to improve, and the inflammation may come back repeatedly.
If the rash persists despite prescription treatment, your doctor may recommend that your baby see a specialist in skin conditions (dermatologist).
Lifestyle and Home Remedies
Generally, a diaper rash can be treated successfully at home with these practices:
Changing Diapers Often
When an infant has a diaper rash, parents and caregivers should be even more vigilant than usual about changing their diapers promptly.
Allowing an infant to remain in a wet or soiled diaper when they have a rash can worsen the symptoms.
Switching Diaper Brands or Laundry Detergents
If an infant develops a diaper rash frequently, their skin may be sensitive to a particular product.
For example, a specific brand of diaper or baby wipe could trigger the rash. In addition, if people use cloth diapers, the type of laundry detergent that they use could also be responsible for the rashes.
Eliminating harsh chemicals and scents may help to clear persistent or recurring rashes.
Allowing the Area to Breath
When an infant has a diaper rash, ensuring that they spend some time with no diaper or bottoms on can help the area dry out and heal.
People should also avoid putting infants in tight, synthetic, or rubber bottoms while they have diaper rash.
Dressing them in loose bottoms made of 100 per cent cotton can help keep the rash dry and allow the skin to breathe.
Making Sure That the Diaper Fits Properly
Diapers that are too tight can irritate diaper rash. In addition, parents and caregivers should check that all diapers fit correctly and ensure that they buy larger sizes as the infant grows.
Trying Diaper Creams and Ointments
There are many barrier creams and skin-soothing ointments available at grocery stores, pharmacies, and online.
Parents and caregivers should look for creams containing zinc oxide. They should apply a thick layer of one of these creams to the affected skin and allow the area to dry.
Avoiding Using Baby Wipes
Although keeping the infant’s diaper area clean is essential, baby wipes can irritate an existing diaper rash.
If an infant has a diaper rash, it is best to clean the diaper area gently using scent-free soap and water before patting it dry.
In situations where this is not possible, it is advisable to choose scent-free, natural wipes available in pharmacies or online.
Considering Removing Any New Foods
Introducing new foods is usually beneficial, but certain acidic foods, such as citrus fruits and tomatoes, may cause some infants’ urine and feces to become particularly caustic and irritating.
Parents and caregivers should be careful to introduce these foods in small quantities and monitor the infant to see if a new diaper rash develops simultaneously.
If it does, they should remove acidic foods from the infant’s diet until the rash has healed.
Using Unscented Soaps and Detergents
Certain bubble baths may cause diaper rash.
Skin irritants, including the scents in soaps and detergents, are responsible for many cases of diaper rash.
Common culprits include scented laundry detergents, some baby soaps and creams, and certain bubble baths, even though the manufacturers often promote them as child-friendly.
Avoiding Scrubbing the Area
Keeping the infant’s diaper area clean and dry is vital, especially when they have a rash, but people should remember that gentle cleaning is best.
Scrubbing this area of the body or rubbing it dry can further irritate the rash and damage the sensitive skin.
Trying an Oatmeal Bath
Research shows that colloidal oatmeal may reduce the inflammation and irritation that atopic dermatitis and inflammatory skin conditions can cause. Colloidal oatmeal may also reduce the pain and itching that comes with a diaper rash.
People can buy oatmeal bath treatments in many drug stores and online. People should follow the directions on the package and pat the infant’s skin dry afterwards.
Keeping the Diaper Area Clean and Dry.
The best way to keep your baby’s diaper area clean and dry is by changing diapers immediately after they are wet or soiled.
Until the rash is better, this may mean getting up during the night to change the diaper.
After you’ve gently cleaned and dried the skin, apply a cream, paste or ointment.
Certain products, such as zinc oxide and petroleum jelly, work well to protect the skin from moisture.
Don’t thoroughly scrub off this protective layer at the following diaper change, as that could hurt the skin more. However, if you do want to remove it, try using mineral oil on a cotton ball.
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To aid the healing of diaper rash, do what you can to increase air exposure to the diaper region. These tips may help:
- Air out your baby’s skin by letting them go without a diaper and ointment for short periods, perhaps three times a day for 10 minutes each time, such as during naps.
- Avoid airtight plastic pants and diaper covers.
- Use diapers that are larger than usual until the rash goes away.
Applying ointment, paste, cream or lotion. Various diaper rash medications are available without a prescription.
Talk to your doctor or pharmacist for specific recommendations. Some popular over-the-counter products include A + D, Balmex, Desitin, Triple Paste and Lotrimin (for yeast infections).
Zinc oxide is the active ingredient in many diaper rash products. They are usually applied to the rash throughout the day to soothe and protect your baby’s skin.
It doesn’t take much – a thin covering will do. In addition, the product can be applied over-medicated creams, such as an antifungal or asteroid, when necessary.
You could also apply petroleum jelly on top, which helps keep the diaper from sticking to the cream.
Ointments, pastes or creams may be less irritating than lotions. But ointments and pastes create a barrier over the skin and don’t allow it to receive air.
Creams dry on the skin and allow air through. Talk with your doctor about what type of product would be better for your child’s rash.
As a general rule, stick with products designed for babies. Avoid items containing baking soda, boric acid, camphor, phenol, benzocaine, diphenhydramine, or salicylates. These ingredients can be toxic for babies.
Until the rash clears up, bath your baby each day. Use warm water with mild, fragrance-free soap.
The following alternative treatments have worked for some people:
Witch Hazel (winter Bloom), a Flowering Plant.
A study showed that applying an ointment made with witch hazel to diaper rash helped. The study included 309 children.
Human Breast Milk.
Results are mixed on whether human breast milk applied to diaper rash is better than other treatments.
One study showed that applying breast milk to diaper rash is an effective and safe treatment. Infants with diaper rash were treated with either 1 per cent hydrocortisone ointment or breast milk.
The study included 141 infants. Treatment with breast milk was as effective as the ointment alone.
Another study compared human breast milk with a cream made from zinc oxide and cod liver oil.
Newborns with diaper rash were treated with cream or breast milk. The study included 63 newborns. Treatment with the cream was more effective.
Calendula and Aloe Vera.
A study comparing aloe vera and calendula in treating diaper rash in children found each to be an effective treatment of diaper rash.
Shampoo Clay (bentonite).
A study showed that shampoo clay effectively healed diaper rash and that it worked faster than calendula. The study included 60 infants.
Other natural remedies have been tried, including evening primrose and a mixture of honey, olive oil, and beeswax.
Further study is needed to prove their effectiveness in treating diaper rash. In addition, some of these substances may promote bacterial growth.
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 to 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.
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 the 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 clean the best.
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 the skin.
Some babies get a rash after switching to a new type of diaper.
While experts don’t recommend any particular brand, look for diapers free of dyes or fragrances if your child is sensitive.
Some babies are sensitive to baby wipes — water and a washcloth work just as well and maybe a gentler option.
When Should I Call the Doctor?
Talk to your doctor if the rash doesn’t go away, gets worse, or if sores appear on your baby’s skin.
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.
Preparing for Your Appointment
Generally, a diaper rash can be treated successfully at home.
Make an appointment with your baby’s doctor if the rash gets worse despite several days of home treatment, is severe or occurs along with a fever.
Here’s some information to help you get ready for your appointment.
What You Can Do?
List your baby’s signs and symptoms and for how long your baby has had them.
List critical information about your baby’s medical conditions and food intake.
For example, has your baby been treated for any illness or given any medications recently? Has the baby’s diet changed?
If your baby is breastfed, also note any medications they may have been exposed to through breast milk, as well as changes in the mother’s diet, such as an increase in tomato-based foods.
List all products that come into contact with your baby’s skin.
Your baby’s doctor will want to know what brand of diapers, laundry detergent, soaps, lotions, powders and oils you use for your baby.
If you suspect one or more products may be causing your baby’s diaper rash, you may wish to bring them to the appointment so your doctor can read the label.
List questions to ask your doctor.
Creating your list of questions in advance can help you make the most of your time with your doctor.
Below are some basic questions to ask your doctor about diaper rash.
- What is the most likely cause of my baby’s rash?
- What are other possible causes?
- What can I do to help my baby’s skin heal?
- What diaper ointments, pastes, creams or lotions would you recommend for my baby?
- When should I use an ointment or paste instead of a cream or lotion?
- Do you suggest any other treatments?
- What products or ingredients should I avoid using with my baby?
- Should I avoid exposing my baby to certain foods, either through breast milk or my baby’s diet?
- How soon do you expect my baby’s symptoms to improve?
- What can I do to prevent this condition from recurring?
- Is the rash a sign of some other internal problem?
What to Expect from Your Doctor?
Your doctor is likely to ask you several questions. Being ready to answer them may reserve time to go over any points you want to discuss in-depth. Your doctor may ask:
- When did you first notice your baby’s signs and symptoms?
- What type of diaper does your baby typically wear?
- How often do you or your baby’s child care provider change your baby’s diaper?
- What types of soap and wipes do you use to clean your baby?
- Do you apply any skincare products to your babies, such as lotions, powders, creams and oils?
- Is the baby breastfed? If so, is the mother taking antibiotics? Are there any changes to the mother’s diet?
- Have you introduced your baby to solid foods?
- What treatments have you tried so far for your baby’s rash? Has anything helped?
- Has your baby recently had any other medical conditions, including any illness that caused diarrhea?
- Has your baby recently taken any new medications?
What You Can Do in the Meantime?
In the time leading up to your appointment, avoid products that seem to trigger your baby’s rash.
Wash your baby’s bottom with water after each diaper change. Avoid soaps and wipes that contain alcohol or fragrance.
Give your baby as much diaper-free time as possible so that their skin can have a chance to stay dry and start healing.
When using diapers, change them frequently and apply a diaper rash cream, lotion, paste or ointment to act as a barrier between your baby’s skin and a dirty diaper.
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