Nappy rash and irritation
What is nappy rash?
Nappy rash is a common skin condition affecting the skin of a baby’s nappy area. Most babies experience some nappy rash in the first 18 months, whether they wear disposable or re-usable nappies.
It can be caused by irritation to the skin from:
- The nappy rubbing and chafing
- Being left too long between nappy changes and being in contact with wee and poo
- Sensitivity to their soap, detergent, bubble bath or baby wipes
Nappy rash usually clears up on its own and will not be a problem once the baby is potty trained.
What does nappy rash look like?
Identifying a nappy rash is usually fairly easy. The rash is located on skin underneath the nappy area. The skin is red and irritated. It may appear all over your baby's bottom or genital area, or only in certain places. It may or may not involve the folds of the skin.
Treating and preventing nappy rash
Prevention is the most effective way to treat nappy rash. However, the following correct skin care techniques may help to alleviate or shorten the duration of the symptoms and rash.
- Check the nappy frequently, and change it when wet. Babies may need as many as 10 or 12 nappy changes a day when they are young. Even older babies need changing at least 6 to 8 times a day.
- The skin should be cleaned, but avoid any rough scrubbing which could lead to further skin irritation.
- Wipe from front to back using just water or baby wipes.
- Use a gentle perfume-free soap or even just plain water when cleaning the area. Make sure the nappy area is quite dry before putting on a fresh nappy.
- Avoid wipes with fragrance or alcohol.
- After cleaning, let your baby's bottom get some air, leaving the nappy off for several hours if possible.
- Keep the nappies a bit loose so some air can come in and the area can breathe. Avoid plastic pants, which hold the moisture in.
- Consider changing the brand or type of nappy.
- Use a protective barrier cream or ointment on the area after each nappy change. In general, those with zinc oxide give the best protection from irritation (but are a bit stickier). However, the less sticky petroleum products often work well.
- If the rash appears to be caused by a candida infection, seek medical advice about using antifungal creams.
Severe nappy rash needing medical treatment
It is usually not necessary to see a doctor for a simple nappy rash. Keeping the nappy area clean and dry should prevent most nappy rashes. However, even the best prevention is sometimes not enough.
Seek medical advice immediately if any of these conditions develop:
- The rash does not get better despite treatment in four to seven days.
- The rash is getting significantly worse or has spread to other parts of the body.
- Your baby develops severely inflamed skin, or a fever.
- The rash also appears to have a bacterial infection, with symptoms such as a pus-like drainage or yellowish coloured crusting. This could be impetigo and needs to be treated with antibiotics.
- If the rash doesn’t clear up or the baby has a persistent bright red, moist rash with white or red pimples, spreading to the folds of the skin, it may be thrush. Seek medical advice from your health visitor, GP or pharmacist about using age-appropriate anti-fungal cream.
- You are not certain what may be causing the rash.
- You suspect the rash could be from an allergy. The doctor can help you pinpoint the possible allergen.
- The rash is accompanied by diarrhoea continuing for more than 48 hours.
- If the child (or adult) appears to have a candida infection, the doctor may recommend antifungal creams or medication.
- If the child has impetigo (a bacterial infection), antibiotics may be prescribed.
- Your doctor may recommend a short course of mild topical steroid cream or ointment if the rash does not appear to be a fungal infection.