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The most common cause of nappy rash (sometimes called diaper dermatitis) in children is irritation. Constant moisture from urine (wee) and faeces (poo) and friction from materials (e.g. cloth and disposable nappies) cause damage to the skin.
In some cases, the skin can be further irritated by bacteria, yeasts (e.g. candida or thrush), detergents or nappy wipes.
Most of the time nappy rash can be easily treated and cleared within a couple of days.
Using good-quality disposable nappies is the best way to treat nappy rash. Disposable nappies allow the moisture to be absorbed quickly, which helps keep the skin dry. While cloth nappies are good for the environment, they do not absorb moisture as well as disposable nappies.
See your doctor if the rash does not improve within one week or is severe. Persistent nappy rash that does not respond to nappy creams might need a medicated cream, such as an antifungal (e.g. Canesten, Daktarin, Nystatin to treat candida infections) or hydrocortisone (e.g. Sigmacort 1% to
treat the redness). These creams should only be used on the advice of your doctor or pharmacist.
Some conditions, such as eczema or a skin infection, can be found on any area of the body, including the nappy area. They may not respond to the treatment used for nappy rash. Your GP, paediatrician or dermatologist will be able to diagnose your child’s rash and
recommend the appropriate treatment.
How much barrier cream should I use?
Apply a thick layer so that you cannot see the skin through
the cream. You should reapply with every nappy change and bath.
My baby’s candida just doesn’t seem to be getting better.
What can I do?
Candida can take longer to clear up than regular nappy rash,
and it can often come back. Make sure you keep using the treatment that your
doctor has prescribed until the infection has completely cleared up. Don’t stop
the treatment if the nappy rash seems to be improving but it is still there.
See your doctor again if the treatment isn’t working.
We prefer to use cloth nappies. What is the best way to deal
with nappy rash without using disposable nappies?
We recommend the use
of good-quality disposable nappies when babies have a nappy rash because they
are more absorbent than cloth nappies. It is important to keep moisture away
from your child’s skin when they have nappy rash. If you don’t want to use
disposable nappies, use an absorbent cloth nappy insert, and try to change your
baby’s nappy as soon as it becomes wet or soiled. When washing cloth nappies,
make sure they are rinsed thoroughly so that detergent or bleach residue doesn’t
irritate your baby’s skin.
Developed by The Royal Children's Hospital Dermatology and Pharmacy departments, and Clinical Practice Guidelines Group. We acknowledge the input of RCH consumers and carers.
Reviewed March 2018.
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