You hate seeing baby uncomfortable in any way, so diaper rashes can be a real pain in the, well, you know where. But since diaper rashes are so common, almost all babies will get one at some point. Read on to learn how to spot baby diaper rash and how to treat and prevent it.
What Is Diaper Rash?
Just like it’s name implies, diaper rash is a rash that appears in baby’s diaper area. “Diaper rash is identified by red, irritated skin around the diaper area,” says Jody Levine, MD, a New York City dermatologist and pediatrician. If the skin around baby’s butt, genitals and legs along his diaper line is red, raw or burned-looking, there’s a good chance you’ve got a case of diaper rash on your hands. Baby is likely to cry during a diaper change, due to heightened sensitivity.
Wet and dirty diapers touching baby’s skin can be irritating, which is why, not surprisingly, diaper rash mostly happens to infants and toddlers under 2 years old who haven’t been potty trained yet. Though diaper rash can pop up at any time, the odds are pretty good that you’ll be treating diaper rash (or multiple cases of it) when baby is between 9 and 12 months. “This is around the age when babies are sitting for long periods of time and they also begin to eat solids, so the composition of their poop is more acidic,” Levine says.
What Causes Diaper Rash?
The most obvious cause of diaper rash is exposure to urine and poop—and the appearance of diaper rash doesn’t necessarily mean you’re not changing baby’s diaper often enough. “Anytime moisture sits on the skin for a period a time, it can cause the skin to get irritated,” says Laurie Belosa, MD, a pediatrician at Tribeca Pediatrics in New York City. “Even if you’re changing diapers religiously, whether they’re disposable diapers or cloth diapers, they can still cause irritation because it’s a sensitive area, which can lead to a diaper rash.”
Not using enough protective ointment to create a good barrier between baby’s skin and the diaper is another common cause of diaper rash, but allergies, illnesses, foods and medications can all be culprits, too. Here are a few more triggers that could be causes of diaper rash:
• Diaper rash from diarrhea. “A baby of any age who has the runs will be more likely to have a diaper rash,” Levine says. Old wives’ tales also link diaper rash and teething, since it’s been said that teething causes diarrhea in babies—but there’s no science to support this. “However, as a mom of five, I can say from experience that I’ve seen my babies have increased watery stools during teething that, like all watery stools, have the potential to lead to a diaper rash,” Levine says.
• Diaper rash from sensitivities. Baby’s soft skin can be extra-sensitive to certain ingredients found in soaps, lotions and wipes, which could cause contact dermatitis and rashes, Levine says. She recommends steering clear of products with whitening agents and dyes.
• Diaper rash from friction. When baby starts crawling, you may notice diaper rash developing more often. It makes sense, since once baby’s on the move, those wet diapers are probably rubbing against her skin more, leading to chafing and rashes.
• Diaper rash from foods. “Acidic foods, like certain fruits and fruit juices, can trigger diaper rash because they can change the pH level of the urine,” Levine says.
• Diaper rash from antibiotics. If baby’s been ill and your doctor put him on a dose of antibiotics, there’s a good chance you can expect a diaper rash shortly down the road. “Antibiotics can kill off both bad and good bacteria to allow yeast to flourish, which contributes to diaper rash,” Levine says.
Types of Diaper Rash
There are actually different types of diaper rash with different causes. “A regular diaper rash causes baby’s skin to become very irritated and chafed, and that’s just from irritation,” Belosa says. But other types of diaper rash can result from bacteria or fungal growth. It can be nerve-wracking trying to figure out what type of rash baby has. Keep in mind that your run-of-the-mill baby diaper rash will:
• Look mildly red
• Typically affect only the area touched by the diaper rather than the folds of baby’s skin
• Usually clear up in a day or two if you slather on plenty of diaper cream, give baby’s bottom time to air out and change wet or soiled diapers right away
However, if baby’s rash doesn’t clear up in about two days, it could mean he’s developed one of these other types of baby diaper rash:
Bacterial diaper rash
Known as impetigo, this type of rash happens when bacteria such as staph and strep infect baby’s diaper region. “Urine can cause changes in the skin's pH level, and this can make bacteria grow more easily in the diaper area,” Levine says. To figure out if baby’s diaper rash is caused by bacteria, look for little red diaper rash blisters about the size of a pencil point that may or may not have pus. Since impetigo is highly contagious, call the doctor right away. Your pediatrician will need to prescribe an antibiotic cream to clear up baby’s rash. To avoid spreading it to other family members, wash baby’s clothes, linens and soft toys in hot water, and make sure everyone in your family religiously washes their hands (especially after a diaper change).
Yeast diaper rash
The materials that help prevent most diapers from leaking can also prevent air circulation, says Levine, which can turn baby’s bottom into a moist, warm setting that’s perfect for fungi to grow. In fact, the same kind of candida fungus that causes thrush in baby’s mouth can also be the culprit behind her diaper rash. The difference between a diaper rash and yeast infection? A yeast diaper rash—also called a fungal diaper rash or thrush diaper rash—starts out as small red bumps in the folds of baby’s skin and can grow into angry-red, raised welts that spread to other areas, like the butt and legs. A yeast diaper rash won’t go away with diaper cream alone, so you’ll likely need baby’s doctor to prescribe an antifungal cream, such as Nystatin.
Diaper Rash Treatment: How to Get Rid of Diaper Rash
Once you spot a diaper rash, start with the basics of diaper rash treatment. “The best way to get rid of diaper rash is to air out that area as best as you can, leave the diaper off and just give that area some time to breathe,” Belosa says. Try laying down a waterproof pad in baby’s room and let him go diaper-free for several hours a day to give his irritated skin exposure to air.
Belosa also recommends the use of a diaper rash cream, both to soothe diaper rash and to prevent it in the future. “There are two different kinds of diaper rash cream,” Belosa says. “Something like A+D or a petroleum-based jelly, you can use preventatively. That’s just to create a barrier on the skin against all the pee and poop baby is making. And then there are stronger creams like Desitin or Triple Paste. Those have stronger ingredients for when you’re really trying to get rid of that diaper rash.”
If you see baby developing a diaper rash, make sure you’re applying diaper rash cream with every diaper change. Look for a cream made with zinc oxide, which forms a powerful barrier against wetness and also helps heal irritated skin. If you’re stuck, try our Best of Baby 2017 Award Winner: Burt’s Bees Diaper Rash Ointment.
That said, sometimes, depending on the severity of the diaper rash, an over-the-counter cream might not be enough. “It all depends on the type of rash,” Belosa says. “If a diaper rash isn’t getting better after a few days, we recommend bringing baby in [to see the doctor]. There are regular diaper rashes and then there are fungal diaper rashes, which need to be treated with prescription medicine.”
Home remedies for diaper rash
Sometimes a reliable diaper rash treatment can be found right in your kitchen pantry. If you’re looking for all-natural options, try these diaper rash remedies:
• Coconut oil. Applying coconut oil for diaper rash can help moisturize the skin while creating a protective barrier. Plus, it’s antifungal to prevent those nasty yeast diaper infections.
• Baking soda. It’s antibacterial, antifungal and helps neutralize the acids in poop and pee—a triple threat! Try using a baking soda bath for diaper rash treatment by mixing two tablespoons with warm water in a baby bathtub and letting baby soak in it for about five minutes. Then let his skin dry completely before putting a fresh diaper back on.
• Essential oils. Many moms have found that using certain essential oils for diaper rash can be very helpful. A few drops of witch hazel extract, which has anti-inflammatory properties, can be diluted with equal parts water and brushed onto baby’s skin with a cotton ball to help soothe the rash. Calendula, a natural antibacterial, is another possible remedy and can be found in many diaper rash creams.
• Breast milk. According to the Mayo Clinic, applying breast milk on a diaper rash may be an effective remedy, although findings have been mixed. One study found breast milk to be as effective as 1 percent hydrocortisone ointment, while another study found that diaper rash cream with zinc oxide and cod liver oil yielded better results than breast milk.
How long does it take diaper rash to heal?
Diaper rash can take up to four to seven days to heal, Levine says, although it can often clear up in a couple of days. Call a doctor if baby’s diaper rash doesn’t get better, if it gets worse or spreads beyond the diaper area, if the area appears to be infected (oozing with pus or crusting), or if it’s associated with diarrhea, she adds. Some rashes in the diaper area may be symptoms of another illness and call for further treatment.
How to Prevent Diaper Rashes
At the end of the day, the best way to deal with diaper rash is to prevent one from happening in the first place. Here, some top tips for preventing diaper rash:
• Keep it clean. If baby has the runs, try putting her in the tub right after she goes, so acidic poop doesn’t have time to burn her skin. Be sure to wash baby’s whole diaper area thoroughly with nonallergenic, mild soap and then gently pat dry.
• Choose fragrance free. Certain ingredients in baby’s cleaning products can cause problems. The key is to lessen the amount of harsh chemicals coming into contact with baby’s sensitive skin, so switch to non-fragrance, hypoallergenic soaps, lotions, detergents and wipes.
• Go for probiotics. To treat and prevent yeast diaper rashes, you might try adding some powdered probiotics (aka healthy bacteria) to baby’s bottle, since yeast infections may be triggered when unhealthy bacteria starts to outnumber the healthy kind. You can also give baby unflavored yogurt (the sweetened stuff often has lots of added sugar), since it’s loaded with a type of healthy bacteria called acidophilus, which can help boost baby’s immunity and ward off infections.
And don’t fret. If baby is prone to getting diaper rash, take heart that there’s an end in sight. Once baby is potty trained and has moved into underpants, the rashes should disappear.
Updated August 2017