Kids Health Info

Nappy rash

  • The most common cause of nappy rash (sometimes called diaper dermatitis) in babies is irritation. Constant moisture and rubbing can cause damage to the skin. This is further irritated by bacteria, yeasts (e.g. candida or thrush), detergents, urine (wee) and faeces (poo).

    Nappy rash is made worse by:

    • runny, loose faeces (diarrhoea)
    • not changing the nappy often enough
    • plastic pants.

    Most children grow out of nappy rash when they are toilet trained.

    Signs and symptoms

    • The skin in the nappy area generally looks red and raw and can be spotty in appearance, particularly at the edges of the rash.
    • It can be sore or itchy when the area is wiped.
    • Your baby may be unsettled or irritable.

    Care at home

    • A good quality disposable nappy is best. Disposable nappies allow the moisture to be absorbed quickly and keep the skin dry. While cloth nappies are good for the environment, they do not take up moisture as well as disposable nappies.
    • Nappies should be changed often (about five to seven times a day in babies under 12 months old), reducing the amount of time that urine and faeces are in contact with the skin.
    • At each nappy change your baby's bottom should be gently wiped with cotton wool or 'Chux' type cloths, dampened with lukewarm water. Baby wipes can be irritating and should not be used.
    • A barrier cream should be thickly applied at each nappy change. This will prevent the moisture and irritants from reaching the skin. Zinc cream is the best, or white soft paraffin also works well. If the cream you use wipes off too easily, try another brand because the idea is to create a good barrier. These creams are available from your pharmacy, or may be prescribed by your doctor.
    • Try to let your child have as much time without the nappy on as possible.
    • Talcum powder should not be used on nappy rash.

    Many different rashes can occur in the nappy area and they may not all be due to nappies. Some conditions, such as eczema or a skin infection, can be found on any area of the body.  They will not respond to the treatment used for nappy rash. If the rash is not improving, see your local doctor, paediatrician or dermatologist.

    Treatment / preparations

    • You can make your own nappy rash remedy by mixing 10% of olive oil in zinc paste.
    • Persistant nappy rash that does not respond to nappy creams might need a medicated cream such as an antifungal (e.g. Canesten, Daktarin, Nystatin) or hydrocortisone (e.g. Sigmacort 1%). Do not use any stronger cortisone creams in this area unless your child's doctor tells you to.
    • Antiseptics should not be used on nappy rash.

    When to come back

    • See your doctor if the rash does not improve within one to two weeks.

    Key points to remember

    • Nappy rash can make your baby's skin red and sore. Babies may become irritable and unsettled, especially if the rash is 'red raw'.
    • Prevention is the most important thing. Keep your baby's skin clean and dry by changing nappies frequently.  Prevent urine and faeces from contacting the skin by using a barrier cream.
    • A good quality disposable nappy is best. Allowing nappy-free time can also be very helpful.

    For more information

     

    Developed by RCH Dept Dermatology, Pharmacy, Clinical Practice Guidelines Group. First published 2004. Updated November 2010.

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Disclaimer 
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.