Diaper rash is any rash affecting the skin covered by a diaper. Other names for diaper rash are “diaper dermatitis” or “napkin dermatitis.”
Diaper rash is usually caused by wetness and friction. Urine and stool can cause even more irritation, and this causes the skin break down. Products used to clean the skin can sometimes add to the irritation.
Once the skin under the diaper becomes irritated, germs like bacteria and yeast can infect the skin and worsen the rash. In some cases, other skin conditions, like psoriasis, can be worsened or triggered by diaper rash.
Who gets diaper rash?
Diaper rash is most common in newborns and infants, but anyone who needs to wear a diaper can develop this rash. About one-half of all babies develop diaper rash at some point during the first year or two of their life.
Diaper rash is most common between 9 and 12 months of age, and is more common when the child is having frequent bowel movements or diarrhea. An illness, a medication like an antibiotic, or a change in diet can cause changes in bowel movements.
Preventing diaper rash
The two best ways to prevent diaper rash are to change diapers frequently and use super absorbent disposable diapers to keep the skin under the diaper as dry as possible.
Some other keys to preventing diaper rash are to use wipes, barrier diaper creams, pastes, and ointments. A daily short bath in lukewarm water can help prevent skin breakdown. When giving baths, use only gentle cleansers that are fragrance-free and avoid bubble baths.
Treating diaper rash
When your child has a diaper rash, you need to follow these directions. It is important to stick with the treatment plan for at least a week or two, because diaper rashes take time to heal.
Make sure to use super absorbent disposable diapers and not cloth diapers when there is a diaper rash. Sometimes babies are allergic to the dyes in diapers. If your baby gets a lot of rashes, try switching to a plain white, dye-free, disposable diaper.
If your doctor prescribes a medicated cream to treat the diaper rash, apply it directly to the skin after cleaning the skin gently. Only use the medicated cream as often as your doctor tells you to — usually two or three times a day. If you are given a steroid cream (such as hydrocortisone), you should not use it more than the doctor recommends; this cream is usually used for only a week or two.
It’s important to apply a barrier cream (with zinc oxide or petroleum jelly) over the medicated cream. Use the barrier cream as many times a day as possible. You cannot use too much barrier cream. Put the cream on thick so that the urine or stool can never touch the baby’s skin.
When changing the diaper, if the diaper cream is still there and not soiled by stool, you don’t have to wipe it all away. Simply apply more cream on top. When the cream is soiled by
stool, it can be gently wiped away with mineral oil on a cotton ball followed by gently cleaning the skin with a soft cloth and warm water. Barrier diaper cream should be applied to the skin in a thick layer after every diaper change.
It is best not to use packaged diaper wipes while your baby has a rash. Instead, use a soft white cloth with warm water to gently clean the skin. When changing diapers that only contain urine, simply pat the skin dry and reapply the barrier diaper cream. It is very important not to scrub the diaper area.
When to see the doctor
Rarely, diaper rash can be associated with more serious conditions. Go see your primary care provider or a pediatric dermatologist if: the diaper rash is not improving after several days of careful attention to the instructions above; blisters, pus bumps, or open sores develop; there are bruises or evidence of bleeding in the area; the child is in significant discomfort; the rash is spreading to other parts of the body; or if your child is losing weight, is feverish, or seems sick.