Diaper Rash: Causes and Treatment

Any new parent knows the dread of opening your child’s diaper to find a mysterious rash inside. Diaper rash is an unfortunate and uncomfortable part of having a child in diapers, and it can occur at any age when your child is wearing them.

The first thing to know about diaper rash is that it sometimes just happens. Most babies will get it at least once, if not more times while they’re in diapers. Children, especially newborns, have extremely sensitive skin, and some are simply more prone than others to getting diaper rash. In fact, a newborn baby’s skin is about 30% thinner than an adult’s. About 20% of dermatology visits for babies are because of diaper rash.

Here’s everything you need to know about diaper rash, including what it is, how to identify it, the causes and how to fix it so your baby can return to their smiling, happy selves.

Diaper rash visual guide

What is Diaper Rash?

Diaper rash or diaper dermatitis is irritation of the skin in the diaper area. It is one of the most common skin problems during infancy; about 1 in 4 infants will experience rash at any given time. It can develop as early as the first few days of life and it is usually most frequent around the ages of 9 to 12 months old. Diaper rash mainly occurs when skin has been in prolonged contact with irritants present in poop and urine. Wetness on baby skin for a long period of time can contribute to the onset of diaper rash. Although diaper rash can be mild and recovery can happen within a few days, it can make babies feel uncomfortable and disrupt their sleep. If left untreated, diaper rash can become severe and develop secondary infections requiring prescription treatment.

What does diaper rash look like?

So you’ve opened your baby’s diaper and noticed something unusual you may not have seen before. The skin looks red and tender, and can have bumps or be flaky. If your baby has a slight or mild diaper rash, there may be some faint pinkness in a small area. The skin may also be dry. If it’s a moderate diaper rash, the skin may appear more inflamed and cover a larger area. There might be swelling or larger bumps. A severe diaper rash will have intense redness, plus lots of swelling and bumps over a large surface area. Your baby might even develop blisters, sores or other secondary infections if left untreated. Keep in mind your child’s skin tone as well when looking at diaper rash. Says Dr. Peter Lio, MD, a board-certified dermatologist and clinical assistant professor of dermatology and pediatrics at Northwestern University’s Feinberg School of Medicine, “Skin redness is less obvious in darker skin tones and may often appear more violet rather than red.”

Characteristics of Diaper Rash:

Diaper rash can be present on baby’s bottom, perianal region, genitals and/or inner thighs.

Dr. Peter Lio, MD, Board Certified Dermatologist and Clinical Assistant Professor of Dermatology & Pediatrics at Northwestern University Feinberg School of Medicine pointed out, “skin redness is less obvious in darker skin tones and may often appear more violet rather than red”.

What causes diaper rash?

In order to prevent diaper rash in the future, you’ll want to know what irritants are triggering to your baby. Poop: The number one cause of diaper rash is poop. Poop is very irritating to skin, and when it’s left on the skin too long, a rash will occur. Scientifically speaking, the prolonged exposure on your baby’s skin damages the skin barrier. In turn, that makes the skin not effective at protecting your baby’s most sensitive areas. The irritants in poop and urine also increase the pH, which adds to the discomfort. Frequent bowel movements or diarrhea may also increase it’s pH. Babies can even get yeast infections from soiled diapers as a secondary infection. Urine: The second leading cause of diaper rash is urine. Did you know that newborns can urinate up to 24 times a day when healthy? That’s a lot of diapers to change! But changing them frequently is important to help reduce urine irritants. Friction or chafing: Your baby’s skin is still developing during the first year of life, which makes him more susceptible to all sorts irritation. If a diaper is left on too long and is too wet, chafing can occur due to prolonged friction. Allergens: It might become obvious after a few bouts of diaper rash that you need diapers specially formulated for sensitive skin. Some babies can develop a skin rash from direct contact with certain allergens found in diapers, or even in their food. Any change in diet or medications like antibiotics might also contribute to diaper rash, as their poop consistency and frequency can change due to these factors. Diet and Medications: Changes in baby’s diet, food allergies and certain medications (such as antibiotics) can affect poop content, consistency and frequency, increasing the susceptibility for irritation in the diaper area.

How do you treat diaper rash?

Don’t panic if your baby has a diaper rash. The first step is to clean their bottoms immediately, and dry them very well. Be very gentle when cleansing, which you can do with alcohol-free and fragrance-free wipes or with soap and water. Next, apply a zinc oxide cream. You’ll want to lay it on thickly, like you are frosting a cake. If possible, let your baby go diaper-free for a little while.

How do you prevent diaper rash?

Practicing good hygiene is the best way to prevent diaper rash. That includes:

When should I call my doctor about diaper rash?

Sometimes, you need a little extra help with a bad diaper rash. Call your pediatrician if you’ve treated your baby’s diaper rash and it’s been two to three days with no improvement, your baby develops sores leaking puss, your baby has a fever or you suspect a yeast infection.

What are the main causes of diaper rash?

When caring for baby’s delicate skin, it is important to understand all the factors that can cause diaper rash and be selective about which diapering products to use. Using a system of diapers and wipes that are designed with baby’s skin health in mind is essential for both cleaning the skin and diapering. For recommendations on how to provide the best care for baby’s diapered skin, check out the Guide for Maintaining Healthy Diapered Skin.

Diaper rash visual guide