Kids Health Information : Nappy rash

The most common cause of nappy rash (sometimes called diaper dermatitis) in children is irritation. Constant moisture from urine (wee) and faeces (poo) and friction from materials (e.g. cloth and disposable nappies) cause damage to the skin.

In some cases, the skin can be further irritated by bacteria, yeasts (e.g. candida or thrush), detergents or nappy wipes.

Most of the time nappy rash can be easily treated and cleared within a couple of days.

Signs and symptoms of nappy rash

• The skin in the nappy area generally looks red and raw, and can be spotty in appearance.
• It can be sore or itchy when the area is wiped.
• Your baby may be unsettled or irritable.

Care at home

Using good-quality disposable nappies is the best way to treat nappy rash. Disposable nappies allow the moisture to be absorbed quickly, which helps keep the skin dry. While cloth nappies are good for the environment, they do not absorb moisture as well as disposable nappies.

• Prevention is important – aim to keep the skin clean and dry. Changing nappies frequently will minimise the amount of time that urine and faeces are in contact with the skin. As a guide, if your child is under 12 months old, change their nappy about five to seven times a day.
• At each nappy change, wipe your baby’s bottom gently with cotton wool, paper towel or clean Chux-type cloths, dampened with lukewarm water. Baby wipes can be very irritating and should not be used.
• A thick barrier cream should be applied thickly at each nappy change. This will prevent the moisture and irritants from reaching the skin. Zinc paste is best. If the cream you use wipes off too easily, try another brand because the idea is to create a good barrier. These creams
  are available from your pharmacy, or may be prescribed by your doctor.
• Try to let your child have as much time without the nappy on as possible.
• Do not use talcum powder or antiseptics on nappy rash.

When to see a doctor

See your doctor if the rash does not improve within one week or is severe. Persistent nappy rash that does not respond to nappy creams might need a medicated cream, such as an antifungal (e.g. Canesten, Daktarin, Nystatin to treat candida infections) or hydrocortisone (e.g. Sigmacort 1% to
treat the redness). These creams should only be used on the advice of your doctor or pharmacist.

Some conditions, such as eczema or a skin infection, can be found on any area of the body, including the nappy area. They may not respond to the treatment used for nappy rash. Your GP, paediatrician or dermatologist will be able to diagnose your child’s rash and
recommend the appropriate treatment.

Key points to remember

• Nappy rash can make your child’s skin red and sore, and cause your child to be irritable and unsettled.
• Prevention is important. Keep your child’s skin clean and dry by changing nappies frequently, and use a barrier cream.
• A good-quality disposable nappy is best if your child has nappy rash, and do not use baby wipes. Allowing nappy-free time can be very helpful.
• See a GP if the rash does not improve within one week, or if the rash is severe or spotty and more sore than usual.

For more information

• Kids Health Info fact sheet: Eczema
• Kids Health Info fact sheet:
  Penis and foreskin care
• The Royal Children’s Hospital:
  Department of Dermatology publications
• See your GP or Maternal and Child Health Nurse.

Common questions our doctors are asked

How much barrier cream should I use?

Apply a thick layer so that you cannot see the skin through
the cream. You should reapply with every nappy change and bath.

My baby’s candida just doesn’t seem to be getting better.
What can I do?

Candida can take longer to clear up than regular nappy rash,
and it can often come back. Make sure you keep using the treatment that your
doctor has prescribed until the infection has completely cleared up. Don’t stop
the treatment if the nappy rash seems to be improving but it is still there.
See your doctor again if the treatment isn’t working.

We prefer to use cloth nappies. What is the best way to deal
with nappy rash without using disposable nappies?

We recommend the use
of good-quality disposable nappies when babies have a nappy rash because they
are more absorbent than cloth nappies. It is important to keep moisture away
from your child’s skin when they have nappy rash. If you don’t want to use
disposable nappies, use an absorbent cloth nappy insert, and try to change your
baby’s nappy as soon as it becomes wet or soiled. When washing cloth nappies,
make sure they are rinsed thoroughly so that detergent or bleach residue doesn’t
irritate your baby’s skin.

Developed by The Royal Children’s Hospital Dermatology and Pharmacy departments, and Clinical Practice Guidelines Group. We acknowledge the input of RCH consumers and carers.

Reviewed March 2018.

This information is awaiting routine review. Please always seek the most recent advice from a registered and practising clinician.

Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit
www.rchfoundation.org.au.

Nappy Rash: Causes, Prevention, and Treatment

Most babies develop a nappy rash at some stage. Usually it is mild and does not bother your baby. However, it can be more severe and sore in some cases. It can usually be managed with the suggestions below.

Nappy Rash

In this article

• What causes nappy rash?
• How can I heal or prevent nappy rash?
• What other treatments may be used?

What causes nappy rash?

Nappy rash is a skin inflammation. Most cases are due to a reaction of the skin to urine and poo. Babies have sensitive skin which is vulnerable to irritation.

Nappy rash

Dailyboth, CC0, via Wikimedia Commons

By Dailyboth, CC0, via Wikimedia Commons

In addition, a germ called candida commonly thrives on the inflamed skin. (This is the germ that also causes the infection commonly known as thrush which most often occurs in the mouth (oral thrush) or around the genital area.) Candida can cause a more inflamed rash which is a brighter or darker red. Sometimes the rash can also become infected with other types of germs called bacteria. This will also make the rash more red and sore.

Nappy rash candida

Elaine C. Siegfried1,†* and Adelaide A. Hebert2,†, CC BY 4.0, via Wikimedia Commons

By Elaine C. Siegfried1,†* and Adelaide A. Hebert2,†, CC BY 4.0, via Wikimedia Commons

Nappy rash can occur or worsen when your baby is teething. It is unclear why teething can lead to nappy rash although it is thought that it is due to your baby producing more saliva. This changes the nature of the baby’s poo, making it more likely to cause a reaction when it touches the skin.

Most nappy rashes are mild or moderate and are not serious. Occasionally, skin conditions such as eczema, psoriasis, infections and some rare skin diseases cause unusual nappy rashes.

How can I heal or prevent nappy rash?

Leave the nappy off as much as possible

This allows fresh air to get to the skin. Obviously, you cannot leave the nappy off all the time. However, the more fresh air, the better. Try letting the baby lie without a nappy on a towel or disposable absorbent sheet for a period of time each day. However, do change the towel or sheet as soon as it becomes wet.

Change the nappy often

Ideally, change the nappy as soon as it is wet or soiled. The aim is to prevent your baby’s skin being in contact with urine and poo (faeces) for long periods of time. This is especially important if your baby is teething and has offensive, runny poo.

Wipes are as effective as water

Studies have shown that using baby wipes has the same effect on your baby’s skin as using cotton wool and water. However, it is best to use wipes which are free from fragrance or alcohol.

After washing, make sure the baby’s bottom is properly dry

Do this before putting on a new nappy. Dry by patting, not by rubbing, with a towel.

Do not use powder such as talcum powder

This may irritate the skin. Also avoid soaps, bubble baths and lotions.

Use barrier creams or ointments

Available to buy from pharmacies, barrier creams or ointments may help to protect the skin from moisture. They literally form a barrier between your baby’s skin and the poo or urine. Ideally, rub on a thin layer of barrier cream or ointment just before putting on each nappy. Do not apply too much, as this may reduce the ‘breathability’ of the nappy. The recommended ointments are:

• Zinc and castor oil ointment.
• Metanium®.
• White soft paraffin ointment.
• Bepanthem® ointment.

Don’t use tight-fitting plastic pants over nappies

They keep in moisture and may make things worse.

What other treatments may be used?

The above measures are likely to clear a mild rash. If the rash becomes worse, a healthcare professional may advise using one of the following in addition to the above measures:

• A mild steroid cream or ointment such as hydrocortisone can be used to treat nappy rash. Steroids treat inflammation. Apply sparingly as often as prescribed (before using a barrier cream or ointment) for a few days until the rash has cleared. A steroid cream or ointment should not usually be used for more than seven days.
• An antifungal cream which kills thrush (candida). This is typically applied 2-3 times a day. Unlike a steroid cream, continue to use an antifungal cream for 7-10 days after the rash has cleared, to make sure all the candidal germs have gone. If you are prescribed an antifungal cream, use this without a barrier cream. In this way you clear up the infection first. THEN use the barrier cream to help clear up the nappy rash.
• A combination cream containing an antifungal agent and a mild steroid is often given.

Sometimes the inflamed skin of a nappy rash becomes infected with other types of germs (bacteria). This may be suspected if the rash becomes worse, despite use of the above treatments. In these cases an antibiotic medicine may be needed.

Also, as mentioned, occasionally a nappy rash is due to an unusual or more serious skin condition. Therefore, if a nappy rash does not improve with the usual treatment described above then see your doctor.

• Napkin dermatitis; DermNet NZ

• Blume-Peytavi U, Lavender T, Jenerowicz D, et al; Recommendations from a European Roundtable Meeting on Best Practice Healthy Infant Skin Care. Pediatr Dermatol. 2016 May33(3):311-21. doi: 10.1111/pde.12819. Epub 2016 Feb 26.

• Nappy rash; NICE CKS, July 2022 (UK access only)

Diaper rash in newborns: causes and prevention

Contents

• 1 Causes of diaper rash in newborns: how to prevent and treat them
  • 1.1 Diaper rash in newborns: what is it?
  • 1.2 Causes of diaper rash in newborns
  • 1.3 Types of diaper rash in newborns
  • 1.4 How can diaper rash be prevented?
  • 1.5 How to properly care for the skin of a newborn?
    • 1.5.1 Skin hygiene practices
    • 1.5.2 Moisturizing the skin
  • 1.6 The importance of choosing diapers and clothing to prevent diaper rash in newborns
  • 1.7 When to see a doctor for diaper rash in newborns?
  • 1.8 Medicines for diaper rash in newborns
    • 1.8.1 Creams and ointments
    • 1.8.2 Antibacterials
    • 1.8.3 Allergy medicines
    • 1.8.4 Vitamins and probiotics 9 0008
  • 1.9Folk remedies for the treatment of diaper rash in newborns
  • 1. 10 Diaper rash in newborns: myths and reality
    • 1.10.1 Myth No. 1: diaper rash occurs only in the diaper area
    • 1.10.2 Myth No. 2: diaper rash occurs only due to poor hygiene
    • 1.10.3 Myth #3: Diaper rash can only be treated with ointments
    • 1.10.4 Reality: Prevention of diaper rash is easier than cure
  • 1.11 Conclusions
  • 1.12 Related videos:

  90 005 1.13 Q&A:

  • • 1.13.0.1 What is diaper rash in newborns?
    • 1.13.0.2 What causes diaper rash in newborns?
    • 1.13.0.3 How can diaper rash be prevented in newborns?
    • 1.13.0.4 How can diaper rash be treated in newborns?
    • 1.13.0.5 When can diaper rash in a newborn indicate a serious problem?
    • 1.13.0.6 Can diaper rash in a newborn affect its development?

Diaper rash in newborns can occur due to many reasons: friction, diaper size mismatch, poor hygiene, allergic reactions, etc. It is important to know how to prevent and treat diaper rash to keep your baby comfortable and healthy.

Diaper rash is a fairly common problem in newborn babies, causing discomfort and skin irritation. That being said, treating diaper rash can be a tedious and lengthy process, so special attention should be paid to preventing this problem.

Diaper rash in newborns usually occurs in places where wet skin rubs for a long time. These can be places in the diaper, folds of the neck, armpits or elbows. Diaper rash can also be caused by an allergic reaction to foods or skin creams.

Prevention of diaper rash in newborns is possible with proper hygiene and skin care of the baby. To do this, it is recommended to change the diaper and wash the areas of the body where the skin folds, at least twice a day. The use of special skin creams containing zinc and other antibacterial substances can also prevent diaper rash in newborns.

Diaper rash in newborns: what is it?

Diaper rash in newborns is a skin condition that manifests as irritation, redness and burning where it comes into contact with urine and feces. Diaper rash can occur anywhere where the skin is often damp.

However, diaper rash in newborns can be prevented. To do this, it is necessary not only to properly care for the child, but also to select high-quality and comfortable children’s products in order to ensure comfort and hygiene for your baby.

Causes of diaper rash in newborns

Diaper rash is a skin irritation that manifests itself in the form of redness, small rashes and weeping areas. They can occur in newborns for several reasons:

• Sputum and urine are the main causes of diaper rash in newborns. Prolonged skin contact with wet surfaces or urine causes irritation and premature babies, whose skin is very sensitive, are especially prone to diaper rash.
• Improper hygiene – If you do not clean and treat your baby’s skin thoroughly, this can lead to the development of diaper rash. It is necessary to maintain hygiene, change diapers and wash the baby often.
• Sweat and rubbing – When the child moves around, sweat is produced, which causes friction and skin irritation. Therefore, the child needs a sufficient degree of freedom of movement to reduce the possibility of friction.

Knowing the main causes of diaper rash in newborns, you can prevent their occurrence in the future, as well as respond promptly when they occur.

Types of diaper rash in newborns

There are different types of diaper rash in newborns, depending on the place of their manifestation and the cause. The most common types of diaper rash:

1. Intertrigo in the groin area. Usually, such diaper rash occurs due to prolonged contact with urine and stool. Wet nappies, diapers, and mistakes in baby care can lead to diaper rash in this area.
2. Diaper rash on the neck and back of the head. Such diaper rash can appear as a result of the fact that the baby sweats a lot. This usually happens in hot weather or when the child is in a heated room.
3. Intertrigo on the buttocks. This type of diaper rash occurs due to the fact that the baby lies in one place for a long time in a diaper or diaper, which leads to mechanical irritation of the skin.

Each type of diaper rash requires its own approach and method of treatment.

How can diaper rash be prevented?

Change the diaper regularly. Try to change the baby’s diaper as soon as it becomes wet or dirty. A wet or dirty diaper for too long is one of the main causes of diaper rash.

Keep baby’s skin dry. Ensure that the baby’s skin is sufficiently dry after each diaper change. This can be done with a soft cloth or special tools.

Use creams and ointments. You can use special creams and ointments to prevent diaper rash. They form a protective layer on the skin, preventing irritation and diaper rash.

Additional measures. Regularly ventilate the room where the child is. This will help to avoid high humidity and reduce the risk of diaper rash. You can also provide soft underwear and well-ventilated clothing to avoid irritating your baby’s skin.

Monitor skin condition. Check your baby’s skin regularly for signs of diaper rash and irritation. If you notice any changes or problems, seek medical attention.

How to properly care for the skin of a newborn?

The skin of a newborn is very sensitive and requires special care. It is necessary to monitor its cleanliness and hydration in order to avoid the occurrence of diaper rash.

Skin Hygiene Rules

• Wash your baby’s skin daily with warm water, no soap.
• After bathing, dry your skin gently with a soft towel.
• Pay particular attention to the corners and folds of the leather, as moisture and dirt may remain there.
• Change diapers regularly to avoid prolonged skin contact with urine and feces.

Moisturizing the skin

Moisturizing the skin will help to avoid dryness and flaking, which is one of the causes of diaper rash.

• Use special baby skin care creams to help hydrate the skin.
• If necessary, use massage oil to strengthen the protective properties of the skin.
• Remember that less is more: avoid over-saturating the skin with creams so as not to clog its pores.

By following these simple rules of skin hygiene and moisturizing, you can prevent diaper rash and ensure healthy skin for your baby.

Importance of choosing diapers and clothing to prevent diaper rash in newborns

Diaper rash in newborns occurs due to skin contact with sputum that remains in the diaper or on clothing after urination or bowel movements. Therefore, the right choice of diapers and clothes is one of the main ways to prevent diaper rash in babies.

Newborn clothing also plays an important role in preventing diaper rash. It should be soft and delicate to the touch, not have rough seams, not squeeze the skin and not interfere with increased ventilation. It is good if the clothes are made of natural, hypoallergenic fabrics.

The right choice of diapers and clothes not only prevents diaper rash in babies, but also creates a comfortable environment for their development and growth, ensures cleanliness and hygiene of children’s skin. Therefore, you should not save on high-quality diapers and clothes for the baby.

When to see a doctor for diaper rash in newborns?

Diaper rash in newborns is a fairly common problem that does not always require medical attention. However, there are cases when you should consult a doctor.

If diaper rash does not disappear within a few days, or if it worsens, you should contact your pediatrician. Also, if a rash, blisters, or rash appears on the skin, you should immediately consult a doctor.

If your child is in severe pain, cannot feed or sleep, or has a fever, see a doctor right away. These signs may indicate a serious infection or other condition that requires medical attention.

In general, if you’re concerned about diaper rash in your newborn, or if you notice any unusual signs, it’s best to see a doctor to make sure your baby is getting the right treatment and care.

Medicines for diaper rash in newborns

Creams and ointments

At the first sign of diaper rash in a child, you should contact your pediatrician. The doctor will prescribe a special cream or ointment that can protect the skin from irritation and inflammation. Among them, one can single out products based on zinc, dexpanthenol, calendula oil and other components.

Antibacterials

If the baby’s skin is severely damaged and infected, diaper rash treatment should include antibiotics. They will help get rid of germs that can cause complications. But it is necessary to take such funds only as prescribed by a doctor and under his supervision.

Allergy medications

It is not uncommon for diaper rash to occur due to an allergic reaction to food, diapers, or cosmetics. In this case, it is necessary to take antihistamines. They will reduce the reaction of the body and reduce the manifestation of symptoms of diaper rash.

Vitamins and probiotics

Vitamins and probiotics are recommended for full treatment and prevention of complications. Vitamin E has antioxidant properties and accelerates skin regeneration, while probiotics boost immunity and help fight infection.

Folk remedies for the treatment of diaper rash in newborns

Diaper rash in newborns is a common phenomenon that causes discomfort in the baby and anxiety in parents. For the treatment of diaper rash, you can use folk remedies that will help eliminate symptoms and speed up healing.

• Baths with chamomile and St. John’s wort – to prepare the baths, you need to take 1 tablespoon of dried chamomile flowers and St. John’s wort and pour boiling water over them. Then let it brew for 20-30 minutes and strain. The resulting broth is added to a bath of water and the baby is bathed. Chamomile and St. John’s wort have anti-inflammatory and antiseptic effects, help heal diaper rash and relieve itching.
• Rosehip or calendula oil treatment – vegetable oils have a moisturizing and softening effect, help even out skin tone and accelerate the healing of wounds and diaper rash. Oils are applied to clean skin after a bath and additionally during swaddling.
• Starch baths – starch has an antiseptic and anti-inflammatory effect, helps to relieve irritation and itching of the skin. To prepare the bath, add 3-4 tablespoons of starch to the water and mix thoroughly. Then the bath is done, as usual, and the baby is bathed. Starch baths can be done daily until complete recovery.

Home remedies help relieve the symptoms of diaper rash and speed up healing, but remember that it is important to practice good hygiene and change your diaper regularly to avoid recurring diaper rash. If the skin condition worsens, it is necessary to contact the pediatrician to prescribe medication.

Diaper rash in newborns: myths and reality

Myth #1: Diaper rash only occurs in the diaper area

Diaper rash can also occur in other skin areas in newborns, such as the neck, armpits and skin folds. This is due to the release of urine and feces, which provoke skin irritation.

Myth #2: Diaper rash is only due to poor hygiene

While hygiene plays an important role in preventing diaper rash in newborns, it can be due to other factors. For example, improperly selected clothes or diapers, the presence of allergic reactions to the components of cosmetics for children, etc.

Myth #3: Diaper rash can only be treated with ointments

Topical treatment with ointments and creams is an important part of a comprehensive approach to treating diaper rash in newborns. However, it is important to consider that first of all it is necessary to eliminate the cause of their appearance. Special bathing, the use of gauze pads, special panties, etc. may be prescribed.

Reality: prevention of diaper rash is easier than cure

Diaper rash in newborns can cause a lot of discomfort and pain to the baby. To prevent their occurrence, you should provide proper skin care, choose the right clothes, ventilate the room, take hygiene measures and monitor the condition of the child’s skin.

• Regular bathing of the child
• Properly chosen clothes
• Constant monitoring of cleanliness and dryness of the skin
• Use of special creams and ointments to protect the skin

Conclusions studies show that diaper rash in newborns is a common problem, especially in the first weeks of life. The predominant cause is prolonged contact of the baby’s skin with the urine and feces of the mother’s vagina during childbirth, which causes irritation and inflammatory reactions on the baby’s skin.

If diaper rash does occur, treatment should be started immediately. To do this, you can use special creams, antifungal and anti-inflammatory ointments. But the most important thing is to avoid the reappearance of diaper rash and take care of the baby’s skin to prevent possible complications.

• Findings from a study on the causes of diaper rash
• Measures to prevent diaper rash
• Immediate treatment of diaper rash
• Taking care of baby’s skin prevents complications

Related videos:

Q&A:

What is diaper rash in newborns?

Intertrigo is a skin condition that manifests itself as redness, irritation and inflammation. In newborns, it can appear in the diaper area, in skin folds, or on other parts of the body.

What causes diaper rash in newborns?

Diaper rash in newborns can be caused by several factors, including baby’s sensitive skin, improper diaper use, excessive sweating, inadequate hygiene, use of skin care products that are too harsh. Also, diaper rash can be associated with too long contact of the skin with urine or feces.

How can diaper rash be prevented in newborns?

There are several ways you can help prevent diaper rash in newborns. It is important to choose the right diapers, allow the baby’s skin to “breathe”, change diapers as often as possible, maintain skin hygiene and avoid using harsh skin care products. It is also important to monitor the proper nutrition of the child in order to avoid excessive sweating.

How can diaper rash be treated in newborns?

Treatment of diaper rash in newborns may include the use of special creams and ointments to help reduce inflammation and redness of the skin. It is also important to monitor the general condition of the child and prevent infection. In case of severe inflammation and pain, it is recommended to seek medical help.

When can diaper rash in a newborn indicate a serious problem?

In case of severe diaper rash that does not go away within a few days, or if additional symptoms occur, such as fever or severe pain, you should consult a doctor. This may indicate an infection or other serious problem.

Can diaper rash in a newborn affect its development?

Diaper rash in a newborn usually does not affect its development if it is treated in time. However, if diaper rash is left untreated, it can lead to discomfort and pain, which can hinder your baby’s development and lead to other problems.

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