Prevention and Treatment of Diaper Rash in Infants

Diaper rash is extremely common during the first year or so of life. There are a few simple things you can do to try to decrease the frequency of diaper rash in your baby. There are also a few safe, effective home remedies for the most common type of diaper rash. But, not all diaper rashes are created equal. This post will review the three most common types of diaper rash, give general recommendations for prevention and initial care, and describe when to seek treatment from your child’s health care provider.

Chafing Diaper Rash: Just as it sounds, this common rash is due to friction and affects areas such as the inner thighs, buttocks, and area of the abdomen where diaper may rub. This rash usually appears as mild redness or drying of the skin and tends to come and go.

Contact/Irritant Diaper Rash: This very common rash usually affects parts of the buttocks, lower abdomen, genitalia, and upper thighs and spares the skin folds. Skin contact with the diaper itself or with stool and urine cause redness and irritation.

Yeast/Candidal Diaper Rash: Candida is a type of yeast/fungus. Candida likes to grow in moist, warm areas. A candidal diaper rash is relatively common and should be considered as a potential cause of your child’s rash if it fails to respond to typical treatment measures. This rash tends to be beefy red and often includes small red pimples or bumps extending from the main portion of the rash. Infants will often have oral thrush at the same time that they are affected by candidal diaper rash, but not always.

Prevention:
Good diaper hygiene can help make all of these types of rash less likely to occur. In my opinion this includes:
  • Frequent diaper changes. The longer your child’s skin is exposed to stool or urine, the more likely they are to develop irritation and rash.
  • Give your baby some time each day to “air out” or go diaper free. If they are not yet mobile, let them play on a washable surface without a diaper for short periods of time.
  • Judicious use of gentle wipes or soft cloth with warm water for cleansing.
  • I generally don’t recommend using a diaper cream with every diaper change as a means of prevention. Overwashing or excessive use of products in and of itself can cause irritation.
Treatment:
 If you believe your child has a chafing or irritant diaper rash, continue above measures. If you have recently changed brands of diaper or wipe, consider this as potential cause of the rash and try switching back. In addition, you may choose any number of “barrier creams” that are available on the market and apply them with diaper changes until the rash resolves. These products essentially provide a barrier between the skin and whatever is causing the irritation.
Common barrier creams:
  • Petrolatum based ointments such as A&D ointment (contains petrolatum, lanolin, mineral oil, cod liver oil, beeswax), Vasoline, or Aquaphor
  • Zinc oxide containing types such as Desitin (contains zinc oxide, aloe vera, and beeswax), Balmex, or Mustela

Note: I don’t have any financial interest in any of these brands. Basically, I would say find a type or brand that works for your baby and stick with it.

If the above measures fail, or if your baby has rash consistent with candidal diaper rash, I recommend consulting with your child’s health care provider. They may prescribe anti-fungal diaper cream. In addition, if the rash has unusual appearance, contains boils, or there is significant skin breakdown/bleeding; or if your child has fever or is otherwise acting ill with the rash, please see your child’s physician.

Reference: Hurwitz Clinical Pediatric Dermatology. A Textbook of Skin Disorders of Childhood and Adolescence. 3rd edition.

3 thoughts on “Prevention and Treatment of Diaper Rash in Infants

  1. I’m a big believer airing out the diaper area – with my own kids during the warmer months, I often used to nap them in just a t-shirt on a towel. I remember in the NICU when I was a resident (DON’T TRY THIS AT HOME!), the nurses would lay the kids on their stomachs with their bottoms in the air and a fan on them. Kind of funny looking – but effective!

  2. Pingback: Atopic Dermatitis in Children: Information and Resources for Parents | My Two Hats

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