DIAPER RASH

Symptom Definition

  • Any rash in the skin area 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

WHEN TO CALL YOUR DOCTOR FOR DIAPER RASH

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 less than 1 month old with tiny water blisters or pimples (like chickenpox) in a cluster.
  • Age less than 1 month old and looks or acts sick at all in any way

Call Your Doctor Within 24 Hours (between 9am and 4pm) If

  • You think your child needs to be seen.
  • Rash is very raw or bleeds.
  • Pimples, blisters, open weeping sores, boils, yellow crusts, red streaks.

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns.
  • 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.
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HOME 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 sleeping, take the diaper off and lay your child on a towel (reason: dryness reduces the risk of yeast infections).
  4. Yeast Infections:  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) 4 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 or ointment.
  6. Sore or Scab on End of the Penis:  Apply an antibiotic ointment 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 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 or develops any of the "Call Your Doctor" symptoms.
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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.

Pediatric HouseCalls Online. Copyright © 2000-2004 Barton Schmitt, M.D. FAAP

Reviewed 8/2004

Revised 8/2002

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