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Diaper Rash

About the Disease

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.

When to see a doctor?

If your baby's skin doesn't improve after a few days of home treatment, talk with your doctor. Sometimes, you'll need a prescription medication to treat diaper rash. Have your child examined if the rash:

  • Is severe or unusual
  • Gets worse despite home treatment
  • Bleeds, itches or oozes
  • Causes burning or pain with urination or a bowel movement Is accompanied by a fever

Diaper rash can be traced to a number of sources, including:

  • Irritation from stool and urine - Prolonged exposure to urine or stool can irritate a baby's sensitive skin. Your baby may be more prone to diaper rash if he or she is experiencing frequent bowel movements or diarrhea because feces are more irritating than urine.
  • Chafing or rubbing - Tightfitting diapers or clothing that rubs against the skin can lead to a rash. Irritation from a new product. Your baby's skin may react to baby wipes, a new brand of disposable diapers, or a detergent, bleach or fabric softener used to launder cloth diapers. Other substances that can add to the problem include ingredients found in some baby lotions, powders and oils.
  • Bacterial or yeast (fungal) infection - What begins as a simple skin infection may spread to the surrounding region. The area covered by a diaper — buttocks, thighs and genitals — is especially vulnerable because it's warm and moist, making a perfect breeding ground for bacteria and yeast. These rashes can be found within the creases of the skin, and there may be red dots scattered around the creases.
  • Introduction of new foods - As babies start to eat solid foods, the content of their stool changes. This increases the likelihood of diaper rash. Changes in your baby's diet can also increase the frequency of stools, which can lead to diaper rash. If your baby is breast-fed, he or she may develop diaper rash in response to something the mother has eaten.
  • Sensitive skin - Babies with skin conditions, such as atopic dermatitis or seborrheic dermatitis (eczema), may be more likely to develop diaper rash. However, the irritated skin of atopic dermatitis and eczema primarily affects areas other than the diaper area.
  • Use of antibiotics - Antibiotics kill bacteria — the good kinds as well as the bad. When a baby takes antibiotics, bacteria that keep yeast growth in check may be depleted, resulting in diaper rash due to yeast infection.
  • Antibiotic use also increases the risk of diarrhea - Breast-fed babies whose mothers take antibiotics are also at increased risk of diaper rash.

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 key 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 breast-fed also note any medications he or she 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 through 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 a number of questions. Being ready to answer them may reserve time to go over any points you want to talk about 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 skin care products to your baby, such as lotions, powders, creams and oils?
  • Is the baby breast-fed? If so, is the mother taking antibiotics?
  • Are there any changes to the mother's own 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 his or her skin can have a chance to stay dry and start healing. When you do use 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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