Nappy Rash
What is nappy rash?
Nappy rash is a very common condition in babies and toddlers that results in damaged or irritated skin in the area covered by a baby’s or toddler’s nappy. It can range from mild to severe and cause your baby pain and distress. Fortunately, you can take steps to prevent nappy rash, and treatment is usually effective.
What are the symptoms of nappy rash?
Nappy rash has several tell-tale signs, which may include:
inflamed red or raw-looking skin around the genital area and anus. In children with darker skin, inflammation may appear brown, purple or grey
swollen or raised skin
blisters or ulcers (breaks in the skin)
a rash that has spreads into the tummy and buttocks
If your child has nappy rash, they may also cry and fuss, especially when urine comes into contact with the rash.
What causes nappy rash?
The main cause of nappy rash is wearing a wet or dirty nappy for too long. Wee and poo contain ammonia, which can irritate your baby’s skin. When the nappy becomes wet or dirty, it can also cause friction and damage and irritate the skin further. Other factors that may contribute to nappy rash include:
skin conditions such as eczema, psoriasis or impetigo
the presence of thrush (Candida albicans)
plastic pants that prevent air circulation and keep the nappy area damp
cloth nappies as these are less breathable than disposable nappies
alcohol or chemicals present in disposable baby wipes
soaps, detergents, fragrances left on baby’s skin after bathing or on cloth nappies after washing
acidic fruits and vegetables such as oranges, strawberries, and tomatoes which can make urine extra acidic
Breastfed babies are less likely to experience nappy rash as their poo is less irritating to the skin.
How is nappy rash treated?
Fortunately, there are a lot of things you can do at home to treat your baby’s nappy rash. These include:
change nappies regularly and often
clean your baby’s bottom with water instead of a wipe
avoid scented baby wipes or wipes that contain alcohol
avoid talcum powder or antiseptics
use disposable nappies that absorb urine and breathe better
use a barrier cream to protect your baby’s skin after each nappy change
avoid putting plastic pants over cloth nappies
ensure cloth nappies are washed thoroughly and dry in a tumble dryer which makes them softer
keep baby’s bottom dry as much as possible
give your baby nappy-free time
More severe cases of nappy rash may require weak corticosteroid creams or ointments like hydrocortisone 1%. If your baby has thrush, you may also need to use an anti-fungal cream. Check with your doctor, child health nurse or pharmacist before using corticosteroid or anti-fungal treatments.
What are the complications of nappy rash?
When treated early, most nappy rashes will resolve in a few days. However, if your baby has an active nappy rash, they are more likely to develop thrush. This appears as bright red patches with defined borders in the nappy area. Sometimes you will see dots or pustules on the outside edge of these thrush patches, all of which can be painful for your baby. If you think your baby has thrush, you should see your doctor.
When should you see a doctor?
If your baby’s nappy rash doesn’t improve within a week, or you are concerned about the condition of your baby’s bottom, you should visit your doctor. You should also visit your doctor if:
barrier cream is not making a difference
you think the rash is getting worse or spreading
your baby is particularly irritated by the rash
there are changes to your baby’s feeding or settling patterns
your baby seems sick or has developed a fever
there are blisters, sores, or the skin is broken
you have a son and the end of his penis is red, swollen or has a scab
you think your baby has thrush
How to prevent nappy rash
Preventing nappy rash is always the best option and an ongoing task until your child no longer wears nappies. The best way to prevent nappy rash is by keeping your baby’s skin clean and dry by changing nappies regularly. You should also:
use protective barrier creams on your baby’s skin
avoid putting plastic pants over cloth nappies
give your baby nappy-free time
Your local MediADVICE Pharmacist is available to help you manage your health and the health of your family. Speak to your MediADVICE Pharmacist about your baby’s nappy rash so we can recommend products and medications that may be suitable for you.
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