Diaper Rash

Symptoms

DEFINITION

  • Any rash on the skin covered by a diaper
  • Limited to diaper-wearing age group (birth to 3 years)

Main Complication

  • Secondary infection by yeast or bacteria

Cause

  • A chemical irritation of the skin from a mixture of stool and urine being left on it
  • Worse during bouts of diarrhea

See More Appropriate Topic (instead of this one) If

Should I Call?

WHEN TO CALL YOUR DOCTOR

Call Your Doctor Now (night or day) If
  • Your child looks or acts very sick
  • Bright red skin that peels off in sheets
  • Large red area with a fever
  • Age under 1 month old with tiny water blisters or pimples (like chickenpox) in a cluster
  • Age under 1 month old and infection suspected (yellow crusts, spreading redness)
  • Age under 1 month old and looks or acts abnormal in any way
  • You think your child needs to be seen urgently

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
  • You think your child needs to be seen
  • Pimples, blisters, open weeping sores, boils, yellow crusts, red streaks

Call Your Doctor During Weekday Office Hours If
  • You have other questions or concerns
  • Rash is very raw or bleeds
  • Has spread beyond the diaper area
  • Rash is not improved after 3 days of treatment for yeast

Parent Care at Home If
  • Mild diaper rash and you don't think your child needs to be seen

Care at Home

HOME CARE ADVICE FOR DIAPER RASH

  1. Change Frequently: Change diapers frequently to prevent skin contact with stool. It may be necessary to get up once during the night to change the diaper.
  2. Rinse with Warm Water:
    • Rinse the baby's skin with lots of warm water during each diaper change.
    • Wash with a mild soap (such as Dove) only after stools. (Reason: Frequent use of soap can interfere with healing).
    • Avoid diaper wipes. (Reason: They leave a film of bacteria on the skin).
  3. Increase Air Exposure:
    • Expose the bottom to air as much as possible.
    • Attach the diaper loosely at the waist to help with air circulation.
    • When napping, take the diaper off and lay your child on a towel. (Reason: Dryness reduces the risk of yeast infections).
  4. Anti-Yeast Cream: If the rash is bright red or does not respond to 3 days of warm water cleansing and air exposure, suspect a yeast infection. Apply Lotrimin cream (no prescription needed) 3 times per day.
  5. Raw Skin: If the bottom is very raw, soak in warm water for 10 minutes 3 times per day. Add 2 tablespoons of baking soda to the tub of warm water. Then apply Lotrimin cream.
  6. Sore or Scab on End of the Penis: Apply an antibiotic ointment such as Polysporin (no prescription needed) 3 times per day. (Reason: a bacterial infection that can cause painful urination.)
  7. Diarrhea Rash: If your child has diarrhea and a severe rash around the anus, use a protective ointment (barrier ointment) such as petroleum jelly, A&D or Desitin. Otherwise these are not needed. Caution: Wash off the skin before applying.
  8. Expected Course: With proper treatment these rashes are usually better in 3 days. If they do not respond, a yeast infection has probably occurred.
  9. Call Your Doctor If:
    • Rash isn't much better in 3 days on treatment for yeast
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

Photo Example

 

Diaper Rash

This photo shows a red diaper rash in the area under the diaper. Skin has become shiny.

Any diaper rash that lasts longer than a couple days can become secondarily infected with Candida (yeast). Note the red spots ("satellite lesions") outside the main area of redness.

If a yeast infection is suspected, Lotrimin cream (over-the-counter) should be applied 4 times daily.


Source: LMS Inc.

Copyright 2000-2009. Self Care Decisions, LLC. Used by Permission.
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Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Author and Senior Reviewer: Barton D. Schmitt, M.D. Clinical content review provided by Senior Reviewer and Healthpoint Medical Network.

Last Review Date: 6/1/2011

Last Revised: 8/1/20110

Content Set: Pediatric HouseCalls Symptom Checker

Version Year: 2012

Copyright 1994-2012 Barton D. Schmitt, M.D.

Is Your Child Sick?

Pediatric HouseCalls Symptom Checker is a parent guide for treating your child at home, calling your child's doctor or seeking immediate medical attention. Developed by Dr. Barton Schmitt, MD, FAAP, a board-certified pediatrician on staff at Children's Hospital Colorado. Dr. Schmitt has developed other health tools for parents, including the 3rd edition of Your Child’s Health (available in bookstores) and KidsDoc, a new iPhone and Android app for parents (available online).

Are You Sick?

David A Thompson, MD is the author of Adult HouseCalls Symptom Checker. He is a board-certified emergency medicine physician at Northwestern Memorial Hospital in Chicago. He has a national reputation in telephone triage, decision support tools, medical information technology and quality improvement. Adult HouseCalls Symptom Checker is a decision support tool for adults that has been reviewed and approved by adult physicians.

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