Diaper rash is irritation of the skin under a diaper. It’s very common and usually easy to treat. Moisture, friction, and contact with urine/stool break down the skin barrier; yeast can overgrow and worsen it.
Signs and symptoms
- Red, irritated skin on the buttocks, lower belly, thighs, and groin.
- Skin folds may be involved; with yeast (Candida), you’ll see bright red rash with small “satellite” bumps at the edges.
- Severe rashes can look raw or have small cracks.
Core care: the “ABCDE” approach
- Air: Give diaper-free time several times a day. Even a few minutes helps.
- Barrier: Apply a thick layer of zinc oxide paste or petroleum jelly at every change. Think “frosting on a cake”—you should still see a visible layer at the next change.
- Cleanse: Use lukewarm water and soft cloth or fragrance-free wipes. Pat, don’t rub. For sticky stool, a bit of mineral oil on a cotton pad helps.
- Diaper: Change promptly after wet/soiled diapers; consider super-absorbent disposable diapers during healing. Avoid tight diapers.
- Education: Rashes often improve in 2–3 days with consistent care; keep up barriers to prevent recurrence.
When yeast is involved
- Clues: Involves skin folds, bright red with sharp borders and satellite papules/pustules.
- Add an antifungal cream (clotrimazole or miconazole) twice daily under the barrier paste for 7–14 days.
- Continue thick barrier on top to protect.
When inflammation is severe
- A short course (3–5 days) of a mild steroid cream (e.g., 1% hydrocortisone) can reduce swelling and pain. Use sparingly and only as directed by your clinician, especially in infants.
What to avoid
- Scented wipes, fragranced lotions, and powders with talc or cornstarch (can clump and irritate; cornstarch may worsen yeast).
- Scrubbing the skin or trying to remove all barrier paste at each change—gently remove soiling and add more paste.
When to see a clinician
- No improvement after 3–5 days of good care or worsening rash.
- Blisters, open sores, yellow crust (possible bacterial infection), fever, or significant pain.
- Recurrent severe rashes—ask about triggers (new foods, antibiotics), possible allergies, or other conditions (e.g., eczema).
Prevention tips
- Regular, generous barrier paste use—especially overnight and after stools.
- Extra changes during diarrhea or while on antibiotics.
- Rinse/wash cloth diapers thoroughly and consider a barrier with every change.