Diaper Rash
En Español (Spanish Version)

Definition
A diaper rash is a skin irritation under your baby’s diaper. The rash can be on the abdomen, genitals, and in the folds of the buttocks and thighs. Most babies develop a diaper rash at some time during infancy.

Thigh Folds on Baby

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Causes
A diaper rash develops when your baby’s skin is irritated. Irritation can be caused by:

  • Leaving dirty diapers on for too long
  • Too much moisture next to the skin
  • Diapers or plastic pants that are too tight
  • Allergic reaction to diaper material or detergent
  • Yeast or bacterial infection
  • Rubbing or chafing of the skin
  • Diarrhea
Risk Factors
Factors that may increase your baby's risk of diaper rash include:

  • Frequent stools
  • Infrequent changing of baby’s diaper
  • Treatment of babies or nursing mothers with antibiotics
  • Lactose intolerance
  • Sensitive skin
Symptoms
The main symptoms of diaper rash are bumps, redness, and scaly patches on the skin under the diaper. There may also be blister-like spots on the skin. Your baby may also be more fussy and irritable when the diaper is changed.

If the rash is not cared for, then it can become infected. It can become bright red with red bumps and blisters.

Symptoms of an infected rash may include:

  • Open sores, boils, or pus
  • Your baby is not sleeping or eating normally
  • Your baby develops a fever
  • The rash becomes worse or does not improve in 2 or 3 days
Contact your doctor if your child has signs of an infected rash.

Diagnosis
Most parents can recognize a diaper rash when they see it. A diaper rash doesn’t normally require a visit to the pediatrician.

Treatment
Diaper rashes usually clear up in three or four days with the following treatment:

  • Change diapers frequently.
  • Use plain water instead of baby wipes to rinse your baby’s skin.
  • Pat dry gently. Rubbing can irritate the rash.
  • Apply a protective ointment to the diaper area. The ointment should contain zinc oxide.
  • Expose your baby’s skin to the air as much as possible.
  • Do not use creams that have boric acid, camphor, phenol, methyl salicylate, or a compound of benzoin tincture.
  • Do not use talcum or cornstarch powders.
If the rash is severe, see your child's doctor. The doctor may suggest using a mild hydrocortisone cream to calm the skin if it is irritated. If the rash is yeast-related, then the doctor may recommend a medicated cream. Antibiotic ointments may be used for mild bacterial infections. These creams are available without prescription, but your pediatrician may want to discuss these options before starting treatment.

Severe infections may require oral antibiotics.

Prevention
To help prevent diaper rash:

  • Change your baby’s diaper frequently.
  • Use plain water to rinse your baby’s diaper area after changing.
  • Dry the diaper area well after changing. Let the area air out.
  • Allow your baby to go without a diaper when possible.
  • Avoid using fabric softeners on cloth diapers.
  • Use cloth diapers or super-absorbent disposable diapers to prevent irritation.
  • Talk to your baby's doctor about giving your baby probiotics when your baby is taking antibiotics.



RESOURCES:
American Academy of Family Physicians

American Academy of Pediatrics

CANADIAN RESOURCES:


References:
Diaper rash. American Academy of Family Physicians website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/diaper-rash.html . Updated March 2010. Accessed May 13, 2013.

Diaper rash. American Academy of Pediatrics website. Available at: http://www.healthychildren.org/English/ages-stages/baby/diapers-clothing/Pages/Diaper-Rash.aspx . Updated November 8, 2012. Accessed May 13, 2013.

Diaper rash. Children's Physicians Network website. Available at: http://www.cpnonline.org/CRS/CRS/pa_diaperra_hhg.htm . Updated November 8, 2010. Accessed May 13, 2013.

Diaper rash. Nemours' Kidshealth.org website. Available at: http://kidshealth.org/parent/infections/fungal/diaper_rash.html . Updated May 2011. Accessed May 13, 2013.

Kleigman RM, Jensen HB, Behrman RE, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, PA: Saunders Elsevier; 2007.

Last Reviewed May 2013



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