Diaper rash: what causes it, and when to call the doctor
Most diaper rash is irritation from skin sitting against wet or soiled diapers, and it usually settles within a few days with frequent changes, gentle cleaning, some air, and a thick barrier cream. Call your pediatrician if the rash is not improving after 2 to 3 days, if there are blisters, pus or crusting, if your baby has a fever, or if the rash appears in the first 6 weeks of life.
Almost every baby gets it at some point. It is a plumbing problem more than anything else.
Around this age
MedlinePlus puts the common window at roughly 4 to 15 months, though a rash can turn up any time a baby is in diapers. Bouts often cluster around teething, a cold, a course of antibiotics, a change of diaper brand, or the week solid foods arrive and stools change.
The AAP describes several kinds. Irritant rash is the usual one: red, sore skin on the parts that touch the diaper, often sparing the skin folds. Yeast rash is beefy red, tends to sit in the creases, may have small spots scattered at the edges, and often follows antibiotics. Bacterial infection can show as yellow crusting, pus or pimples. Some rashes are a reaction to a wipe, a cream, or the diaper itself.
Diarrhea makes rash more likely, because acids in the stool are harder on skin. So does a diaper that is tight, or one left on a little longer than usual during a long car ride or a long night.
What families usually do
Change diapers often, and soon after they are wet or soiled. Less contact time is most of the treatment.
Clean gently with water and a soft cloth, or fragrance-free wipes. Pat rather than rub. Let the skin dry fully before the next diaper goes on.
Put on a thick layer of barrier cream or paste with zinc oxide or petrolatum, thick enough to still be there at the next change. The AAP says that if the layer is not soiled, there is no need to scrub it off, and gently wiping the mess off the top of it is enough.
Give some diaper-free time on a towel or waterproof mat. Air does more than most products do.
Fasten the diaper loosely, and try a more absorbent diaper for a few days if you have one.
Skip anything fragranced while the skin is angry, and hold off on new products you have not used before.
For a rash that looks like yeast, or one that is not budging, your pediatrician can tell you whether an antifungal or another treatment fits. The AAP notes that over-the-counter antibiotic ointments can irritate diaper rash rather than help it.
When to call your pediatrician
The sources give clear signs to check in about:
- the rash gets worse, or has not gone away after 2 to 3 days of home care
- blisters, open sores, pus, or crusting
- the rash spreads beyond the diaper area
- your baby has a fever alongside the rash
- your baby is younger than 6 weeks old
- the area looks very painful or swollen
Sources
- Diaper Rash — MedlinePlus, National Library of Medicine (NIH)
- Common Diaper Rashes & Treatments — HealthyChildren.org (American Academy of Pediatrics)
This is educational information from public sources, not a replacement for advice from your child’s healthcare professional.
In Withya, a note about when the rash started and what you have tried sits in Care, where the other adults in your child’s day can read it without being told twice.
