Mothers & Children

Nappy Rash (diaper dermatitis)

Regularly change your baby’s nappies to keep their skin clean and dry.

Caring for skin from birth to 18 months

Many babies develop nappy (diaper) rash, a common condition where the skin covered by the nappy becomes irritated, red and inflamed; it may also be spotty, sore or itchy. Nappy rash is usually caused by prolonged contact with soiled or wet nappies, excessive rubbing or friction in the groin area or overuse of creams, lotions and oils. The longer the skin is left wet, the worse the nappy rash will become as the excess moisture damages the skin surface. Once broken, the skin can be further aggravated by urine, faeces, soaps, detergents and infections.

Prevention and treatment

While most babies will develop mild nappy rash, there are steps you can take to relieve the symptoms and prevent them from worsening.

  • Regularly change your baby’s nappies to keep their skin clean and dry. Ideally, this means changing diapers around 5-7 times daily (for infants aged less then twelve months) as soon as possible after they have been soiled.While most babies will develop mild nappy rash, there are steps you can take to relieve the symptoms and prevent them from worsening.
  • Allow intervals with no nappy (nappy free time) where possible, preferably some time each day. This lets the air circulate, drying your child’s bottom and allowing the rash to heal.
  • When changing wet or soiled nappies, your infant’s bottom should be wiped with a warm, damp cloth, face-washer or cotton wool.
  • A barrier cream containing zinc oxide should then be applied; this stops moisture from reaching the affected skin.
  • Disposable nappies absorb moisture more effectively than cloth nappies and therefore may be useful for babies with this type of dermatitis, even if their use is only temporary until the condition resolves.
  • When using cloth nappies, choose washing detergents free of irritating chemicals and rinse the nappies thoroughly to remove any remaining traces.
  • Plastic pants should not be worn as they tend to trap excess sweat and moisture, creating a wet, humid environment which exacerbates the nappy rash.

Complications

If nappy rash doesn’t resolve within a few weeks with at-home care, you will need to visit your child’s doctor or dermatologist.If nappy rash doesn’t resolve within a few weeks with at-home care, you will need to visit your child’s doctor or dermatologist. A persistent rash may be a sign of other skin disease or dermatoses (such as eczema), which can only be diagnosed by a qualified physician. Inflammation which continues may also indicate further infection by fungi or bacteria. One example of this is the yeast candida, which commonly infects the damaged skin of nappy rash. Candida causes small bumps or blisters to erupt at the edge of the nappy rash and is most often treated with an antifungal cream (i.e. Canesten, Daktarin or Nystatin).

References

The Royal Children's Hospital Melbourne 2010, ‘Nappy rash’, retireved 28 February 2011, <http://www.rch.org.au/kidsinfo/factsheets.cfm?doc_id=5172>.

The Children’s Hospital at Westmead 2010, ‘Nappy rash’, retieved 28 February 2011, <http://www.chw.edu.au/parents/factsheets/nappyraj.htm>.

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