Diaper Rash Patient Information Fact Sheet

What is diaper rash?
Most babies will get diaper rash at some time. It can be a rash with red spots or just soreness of the skin that is covered by the baby's diaper. If your baby develops diaper rash, the skin can become sore and uncomfortable. If the diaper rash is severe, blisters and small lumps may appear on the skin. The blisters may break causing areas of moist, broken skin, which can easily become infected. The most frequent infection is thrush, which is caused by a yeast called Candida albicans. Thrush may appear first in the baby's mouth and look as if patches of milk are stuck to the inside of the mouth. Thrush in the diaper area causes the skin to become very red and raw. Blisters and pimples may form on other parts of the body. If your baby has had diaper rash for more than a few days the skin is likely to be infected.

What causes diaper rash?
The main cause of skin irritation is prolonged contact with a wet or dirty diaper. Some babies have especially sensitive skin that easily becomes red and inflamed if the diaper rubs against it. If the rash is difficult to clear or keeps recurring, it may be a sign that the diaper needs to be changed more often. In some cases the rash is caused by skin conditions, such as eczema or psoriasis, which can be made worse by wearing diapers. Diaper rash is less common in babies wearing disposable diapers, because these are more effective than cloth diapers at keeping the diaper area dry. However, disposable diapers still need to be changed regularly. If cloth diapers are used, do not place plastic pants over them as this makes diaper rash more likely to occur.

How can diaper rash be prevented?
It is important to check regularly to see if your baby's diaper needs changing. This should be done every hour or so in newborn babies and every 2 hours in older infants. Generally you should change your baby's diaper after feeding and when you put them down to sleep. If your baby is dirty use the diaper to clean the dirtiest areas. Then clean the whole area thoroughly using a soft washcloth and warm water or baby wipes. When you have cleaned the area, leave your baby to kick in a warm place to allow the skin to dry before putting on a clean diaper.

What is the best treatment for diaper rash?
Barrier creams are often very effective in the early stages of diaper rash and help to protect the sore skin from contact with a wet or dirty diaper. Zinc oxide (Balmex, Desitin, Triple Paste) is the active ingredient in many diaper rash creams. Ask your pediatrician or pharmacist to recommend a barrier cream as some are not suitable for babies.

If the rash gets very sore or won't go away, or if the skin is broken and infected, ask your pediatrician for advice. Your baby may need a cream or medicine that can usually clear any irritation. An antifungal cream may be prescribed if thrush is present. Antifungal creams used to treat diaper rash may contain clotrimazole (Lotrimin AF) or miconazole (Lotrimin AF Powder). Some antifungal creams are available over the counter. If the diaper area is inflamed as well as infected the doctor may prescribe a cream containing an antifungal and a steroid. In more severe cases, leaving your baby to kick on a dry open diaper in a warm place as much as possible allows the air to get to the skin and will make the rash heal more quickly. In older infants, it is also helpful to leave the diapers off as much as possible.

Self-help measures

  • Change your baby's diaper often to keep the skin in the diaper area dry and clean
  • When you change your baby's diaper use a soft rag and warm water or baby wipes
  • Make sure your baby is clean and dry before putting him/her down to sleep
  • Use a barrier cream and diaper liners if your baby has diaper rash
  • If the rash lasts for more than three days ask your pediatrician to check your baby
  • Tell your doctor if your baby has a skin problem on any other area of their body

Last Reviewed: May 2013