Diaper Rash

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Diaper rash is a reddening of the skin in the diaper area (genital area, buttocks, groin, and upper thighs). Diaper rashes are very common in the first two years.

What Causes Diaper Rash?

• Most diaper rashes are caused by prolonged contact of skin with urine and bowel movements.
• There are normally bacteria and yeast on the skin surface in the diaper area. When the skin becomes irritated from the normal ammonia in urine or normal bacteria in bowel movements, the protective skin barrier is disrupted.
• Once the skin barrier is broken, diaper rash can develop.
• Continual exposure to urine and bowel movements will cause the diaper rash to become worse (redder, blistery, and raw).
• east infections (see below) in the diaper area can occur if the skin barrier remains broken for prolonged periods.
• Diarrhea, caused by viruses and bacteria, can cause further irritation of the diaper rash.
• Food allergy or food intolerance can cause a diaper rash.

When Can I Expect To See Improvement?

With proper treatment, diaper rashes show improvement in 3-5 days.

Treatment For Diaper Rash

• Change diapers frequently
• The key to successful treatment is keeping the area dry, clean and protected so it can heal itself.When a diaper rash is present, check the diapers frequently. If they are wet or soiled, change them.
• Even normal bowel movements can make a diaper rash worse.
• Until the rash has improved, awaken your baby once during the night to change the diaper.
• Make sure that your baby's bottom is completely dry before putting on a new diaper.

Increase air exposure

• Air is the best healing agent!
• Leave your baby's bottom exposed to the air as much as possible. Practical times are during naps or after bowel movements. Put a towel or diaper under your baby to protect against further mess.
• When the diaper is on, fasten it loosely so that air can circulate between it and the skin.
• Cut the elastic around the legs to allow more air into the diaper area.
• Avoid airtight plastic pants till the rash is better.

Rinse the skin gently with warm water

• Use a mild soap (Dove, Ivory, Lever) only after bowel movements. The soap will help remove the film of bacteria left on the skin. Washing the skin with soap after every diaper change may worsen a diaper rash.
• After using a soap, rinse well. A nasal bulb syringe or a squirt bottle can be used.
• If the skin is raw, use warm water soaks for 10 minutes 3-4 times a day.
• Domeboro’s solution (over the counter) is very effective in soothing a raw diaper rash.

Steroid Cream

• 1% hydrocortisone cream (over the counter steroid cream) can be added to lessen the redness. If the skin is raw, this cream may sting.
• Do not use any prescription steroid creams in the diaper area, as they can cause damage to your baby’s skin.

Barrier Ointments

• Barrier ointments are necessary to protect a baby’s skin until the diaper rash has healed.
• The most common barrier ointments contain zinc oxide and A&D ointment. Triple paste, Desitin, and Balmex are all common barrier ointments.
• After following the instructions above for cleaning the skin in the diaper area, apply a thick layer of barrier ointment to the rash.
• Apply the barrier ointment as frequently as necessary to keep the skin continually protected.
• It is not necessary to wash off all the ointment with each diaper change. Be gentle so as not to further irritate the diaper rash.

How Do I Tell If A Yeast Infection Is Present and How Do I Treat?

• If the diaper rash is bright red or does not start getting better after 3 days of warm water cleaning and air exposure, your child probably has a yeast infection.
• Apply an over the counter antifungal cream (Lotrimin) 3-4 times a day with each diaper change.
• If the rash has not improved in 4-5 days, call the office.

What If A Rash Developed After A New Food Or Juice Was Introduced?

Eliminate that food or juice for one month and then try again. Apple juice can cause diarrhea and result in a terrible diaper rash.

How Do I Prevent Diaper Rash?

• Changing the diaper immediately after your child has a bowel movement and rinsing the skin with warm water are the most effective things you can do to prevent diaper rash.
• If you use cloth diapers and wash them yourself, you will need to use bleach (such as Clorox) to sterilize them. During the regular cycle, use any detergent. Then refill the washer with warm water, add 1 cup of bleach, and run a second cycle. Unlike bleach, vinegar is not effective in killing germs.
• Cornstarch powder reduces friction and can be used to prevent future rashes after this one is healed. When applying cornstarch powder, place on your hand first and then on your baby’s skin. Your baby can inhale any powder that is poured directly on the skin.

Call Our Office If:

• The rash looks infected (pimples, blisters, boils, sores).
• Your child is acting sick.
• The rash is not better in 5 days.
• The diaper rash covers the entire diaper area.
• You have other concerns or questions.