Diaper Rash

When To Call

Call Doctor or Seek Care Now

• Bright red skin that peels off in sheets
• Fever and looks infected (spreading redness)
• Age less than 1 month old with tiny water blisters or pimples in a group
• Age less than 1 month old and looks infected (yellow scabs, spreading redness)
• Age less than 1 month old and looks or acts abnormal in any way
• Your child looks or acts very sick
• You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

• Any pimples, blisters, boils, yellow scabs, or open sores
• You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

• Rash is very raw or bleeds
• Rash has spread outside the diaper area
• Rash is not better after 3 days of using yeast cream
• You have other questions or concerns

Self Care at Home

• Mild diaper rash

Care Advice

What You Should Know About Diaper Rashes:

• Diaper rashes are very common in babies.
• Often caused by not cleaning stool off the skin soon enough.
• Stool is a strong irritant to the skin.
• Here's some care advice that should help.

Change More Often:

• Change diapers more often to prevent skin contact with stool.
• You may want to get up once during the night to change the diaper.

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: using soap often can interfere with healing.
• Do not use diaper wipes. Reason: they leave a film of bacteria on the skin.

Leave Bottom Open to Air:

• Expose the bottom to air as much as possible.
• Attach the diaper loosely at the waist to help with air exposure.
• When napping, take the diaper off and lay your child on a towel. Reason: dryness reduces the risk of yeast infections.

Anti-Yeast Cream:

• Most diaper rashes respond to 3 days of warm water cleansing and air exposure. If you've tried this or the rash is bright red, suspect a yeast infection.
• Buy an anti-yeast cream (such as Lotrimin AF). No prescription is needed.
• Use this cream 2 times per day.

Raw Skin - Treatment:

• If the bottom is very raw, soak in warm water for 10 minutes. Add 2 tablespoons (30 mL) of baking soda to the tub of warm water.
• Do this 2 times per day.
• Then, put an anti-yeast ointment (such as Lotrimin AF) on the rash.

Pain Medicine:

• To help with the pain, give an acetaminophen product (such as Tylenol).
• Another choice is an ibuprofen product (such as Advil). Avoid ibuprofen under 6 months of age.
• Use as needed.
• Age less than 3 months. Don't use pain medicines unless your doctor says it's okay. Have your child seen if the rash is causing a lot of pain.

Sore or Scab on End of the Penis Treatment:

• Use an antibiotic ointment (such as Polysporin). No prescription is needed.
• Do this 3 times per day.
• Reason: the sore is a bacterial infection that can cause painful urination.

Diarrhea Rash - Use Protective Ointment:

• If your child has diarrhea and a rash around the anus, use a protective ointment. Examples are Vaseline or Desitin.
• This forms a barrier between the skin and the stool.
• Otherwise, these generally are not needed.
• Caution: wash off the skin before putting it on.

What to Expect:

• With proper treatment, most diaper rashes are better in 3 days.
• If the rash does not respond, a yeast infection has probably occurred.

Call Your Doctor If:

• Rash isn't much better after 3 days of using yeast cream
• It starts to look infected (with sores and scabs)
• You think your child needs to be seen
• Your child becomes worse

Remember! Contact your doctor if you or your child develop any "Contact Your Doctor" symptoms.

Photos

Diaper Rash

This photo shows a red diaper rash in the area under the diaper.

Any diaper rash that lasts longer than a couple days can become infected with yeast. Note the red spots outside the main area of redness.

If a yeast infection is suspected, clotrimazole cream (such as Lotrimin; over-the-counter) should be applied 4 times per day.

Source: Self Care Decisions, LLC
Used with Permission from Schmitt Pediatric Guidelines LLC.