Diaper Rash

Overview

Diaper rash (diaper dermatitis) is the most common skin problem in babies and young children. The skin may look red, raw, scalded, or burned. A diaper rash is uncomfortable. But in most cases, it's not a serious problem.

Diaper rash is usually caused by the skin staying wet, the diaper rubbing the skin, and skin contact with urine and stool. It often occurs in babies who sleep for many hours so the wet diaper is on them longer. Diaper rash may also be caused by a fungal infection or bacterial infection.

Adults may get diaper rash if they can't wash the genital area well or if they use incontinence briefs. These briefs can cause skin irritation. Or a person may be allergic to the perfumes in the material.

A diaper rash may also be a sign of abuse or neglect.

Most diaper rashes clear up within 2 to 3 days when treated at home. The rash usually clears up when diapers are changed more often, the skin is carefully cleaned, and over-the-counter ointments are put on the area. A diaper rash that becomes raw, oozes fluid, or bleeds is harder to treat.

Self-Care

Home treatment is generally all that's needed for most cases of diaper rash. At the first sign of a diaper rash, try the following steps:

• Keep the skin dry. Make sure that the skin isn't in contact with urine and stool.
  • Change the diaper or incontinence brief every time it's wet or soiled. During the daytime, check the diaper or brief every 3 hours. You may need to change the diaper or brief during the night to prevent or clear up a rash. It's not unusual to change a diaper or brief 8 times in a 24-hour period.
  • Use a superabsorbent disposable diaper.
• Gently wash the diaper area with warm water and a soft cloth. Rinse well, and dry completely.
  • Don't use any soap unless the area is very soiled. Use only a mild soap if soap is needed.
  • Don't use "baby wipes" that have alcohol or propylene glycol to clean the skin if the person has a diaper rash. These wipes may burn the skin and spread bacteria on the skin.
  • On adults, you may use a blow-dryer set on the warm setting to get the diaper area fully dry. But don't use a blow-dryer on babies or small children.
• Leave diapers and incontinence briefs off as much as you can.
• Protect the healthy skin near the rash with a cream such as A+D Ointment, Desitin, or zinc oxide. Don't put the cream on broken skin. It can slow the healing process.
• If you use a disposable product, fold the plastic area away from the body. Don't put the diaper on too tightly. Don't use bulky or many-layered diapers or incontinence briefs.
• Don't use plastic pants until the rash is gone.
• Give more fluids to make the urine less concentrated.

If the diaper rash doesn't get better after several diaper changes, try the following steps.

• Soak in a warm bath for 10 minutes, 3 times a day, if the skin is very raw.
  • For babies and young children, add 2 Tbsp (30 mL) of baking soda to a baby tub, a basin of warm water, or a bathtub. Remember, don't bathe a baby until the umbilical cord has fallen off. And never leave a child alone while the child is in the bath.
  • Have older children and adults sit in a bathtub with 8 to 10 centimetres (3 to 4 inches) of warm water, or use a sitz bath.
• If you use a disposable product, change brands or switch to a cloth product. Try a superabsorbent disposable diaper or brief with absorbent gelling material (AGM), which pulls moisture away from the skin. Some people are less likely to get a rash with one diaper product than another.
• If you use a cloth product, switch to a disposable product. The cloth or the products used to clean the cloth diaper may be causing the rash.
• If you use cloth and don't want to switch to a disposable product, change detergents.
  • Rinse diapers or briefs twice when you wash them.
  • Use vinegar in the final rinse at a strength of 30 mL (1 fl oz) vinegar to 4 L (1 gal) of water.

When treating a diaper rash:

• Don't use a non-prescription adult vaginal yeast medicine on a baby or child. Check with your doctor before you use any product made for an adult on a baby or child.
• Adults can use a non-prescription adult yeast medicine to treat diaper rash. Follow the instructions on the package.
• Don't use baby powder while a person has a rash. The powder can build up in the skin creases and hold moisture. This may help bacteria grow and cause an infection.
• Don't use cornstarch on a rash in the diaper area. Cornstarch also allows bacteria to grow.

When to call for help during self-care

Call a doctor if any of the following occur during self-care at home:

• New or worse signs of infection, such as warmth, redness, swelling, pus, or a fever.
• Symptoms occur more often or are more severe.

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