Here is everything you need to know on how to spot, treat and prevent nappy rash.
How serious is it?
rashes are mild and can be treated with a simple skin care routine. Your baby will usually feel no pain or discomfort.
However, some nappy rashes are more severe and can be caused by an underlying condition or bacterial infection. A severe rash is painful and distressing for your baby. It usually requires treatment with medication.
Mild nappy rash
If your child has mild nappy rash, a small part of their nappy area will be covered in a pink or red rash, usually made up of small spots or blotches. However, they should feel well and will only experience a stinging sensation when passing urine or faeces.
Severe nappy rash
If your baby's nappy rash is severe, they may have more advanced and painful symptoms that make them distressed or uncomfortable.
Symptoms may include:
- bright red spots
- dry, cracked and broken skin
- swellings, ulcers and blisters on the skin
The rash will cover a larger part of the nappy area and may spread down the legs or up to the abdomen (tummy). Your baby may cry more often than usual and be irritable.
Contact your GP immediately if your child develops severely inflamed (swollen and irritated) skin or a fever. This may be a sign of infection.
What causes nappy rash?
When a baby soils or wets itself, the nappy cannot always absorb the waste products. This means that your child's delicate skin will come into contact with urine and faeces. When a nappy is left on for a long time, the urine and faeces can turn into the chemical ammonia. Ammonia can irritate your baby's skin, causing it to become sore and inflamed.
Nappy rash can also be caused by a fungal infection. If your baby's skin is warm and damp for long periods of time, it can cause a fungus, known as candida, to grow. Like ammonia, candida can irritate your baby's skin. Sometimes, your baby's rash starts as a reaction to the ammonia, then is further complicated by a fungal infection.
In rare cases, your baby's nappy rash may be caused by an underlying condition. Some of these conditions are listed below.
Eczema makes your baby's skin dry and sore. The sore skin may appear in other parts of the body beyond the nappy area. If your baby often has nappy rash despite regular nappy changes, and you have a family history of eczema, the nappy rash may be the first signs of eczema.
Seborrheic dermatitis causes red, scaly skin. It usually occurs when your baby is between two weeks and six months old. You may also notice reddened skin on your baby's scalp, ears, eyebrows, armpit and neck. Normally, seborrheic dermatitis lasts for a few weeks, and does not reoccur or disturb your baby.
Sometimes, your baby's nappy area can become infected with bacteria. This can cause a bright red, painful rash that will need to be treated with antibiotics.
Sometimes, your baby's rash may be caused by an allergic reaction to a particular substance (allergen).
An allergen causes the body's immune system to react abnormally, leading to irritation and inflammation in the affected body part.
Many different types of allergen can cause your baby to have an allergic reaction, including:
How should I treat nappy rash?
Mild nappy rash
If your baby has a mild nappy rash, they will not normally need any medication or specialist treatment. Instead, there are steps you can take to safely treat the rash at home.
Leave your baby's nappy off as long as possible
Not putting a nappy on your baby will help them to stay dry and avoid contact with faeces or urine. It is usually most convenient to leave your baby's nappy off when they are asleep. You can lay them on an absorbent towel or somewhere where you can easily manage any soiling or wetting.
Avoid using soaps when cleaning your baby's skin
Only use water to clean your baby's nappy area in between changes. Use a soft material, such as cotton wool or a soft towel, when drying. Dab the affected area carefully and avoid rubbing their skin vigorously.
Avoid bathing your baby more than twice a day. Experts think this may dry out their skin and cause a more severe nappy rash.
Apply a barrier cream every time you change their nappy
Using a barrier cream or ointment after each nappy change will reduce the contact that your baby's skin has with urine and faeces. Zinc cream, zinc oxide ointment and petroleum jelly are all suitable barrier creams. Ask your pharmacist for advice about which cream is most suitable for your baby.
Change your baby's nappy frequently
To lower the risk of your baby getting nappy rash, change your baby's nappy as soon as they wet or soil it. If your baby has nappy rash, make sure you change their nappy more frequently than you normally would.
Consider changing the type of nappy you are using
If you are using disposable nappies, use one that is highly absorbent. However, these are often more expensive than other nappies. If you cannot use high-absorbency nappies, make sure you change the nappy frequently; ideally, as soon as your baby wets or soils it.
Severe nappy rash
If your baby has severe nappy rash, they usually need medication to treat the condition. Your GP will first check that you have been carrying out the skin care routines advised for a mild nappy rash (see above).
Once your GP is satisfied that the correct skin care routines are being followed, they usually prescribe some topical medicines to treat the rash. 'Topical' means that the medicine is applied directly to the affected area (in this case, the nappy area).
Corticosteroids help to reduce inflammation of the skin and relieve any itching and redness. Hydrocortisone cream is often prescribed. You have to apply it to your baby's skin once a day. You can stop using hydrocortisone as soon as the rash has cleared, but do not use it for more than seven days in a row.
An anticandidal medicine helps to treat any fungal infection that may be causing your baby's rash. Some commonly prescribed anticandidal medicines include:
How can I prevent nappy rash?
The best way to prevent nappy rash is to follow good skin care routines. You can do this by following the same guidelines for treating a case of mild nappy rash. This means:
- leaving the nappy off as much as possible
- changing the nappy regularly
- using only water to wash your baby's bottom
- applying a barrier cream after each nappy change
Other ways you can help to prevent a rash include:
- drying your baby's bottom by patting (not rubbing) it with a towel
- not using tight-fitting plastic pants over nappies
- not using powders (such as talcum powder) when changing nappies
Laura Doyle, mum of 4. Kyle 9, Noa Belle 4, Briar 2 and Milla 12 months. Breastfeeder, co-sleeper, coffee drinker. Staying positive and inspired by the chaos of it all. Writer and blogger at www.lovelifeandlittleones.com.