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.
