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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General advice only – this information should not replace the information provided to you by your health care professional. If symptoms are severe or persist, please speak to your health care professional. Information current as of date of publishing.
References:
[1] Better Health Channel, Nappy rash,https://www.betterhealth.vic.gov.au/health/healthyliving/nappy-rash
[2] Raising Children, Nappy rash,https://www.rch.org.au/kidsinfo/fact_sheets/Nappy_rash/
[3] Raising Children, Nappy rash,https://www.rch.org.au/kidsinfo/fact_sheets/Nappy_rash/
[4] Pregnancy, birth and baby, Nappy rash,https://www.pregnancybirthbaby.org.au/nappy-rash
[5] Raising Children, Nappy rash,https://www.rch.org.au/kidsinfo/fact_sheets/Nappy_rash/
[6]Better Health Channel, Nappy rash,https://www.betterhealth.vic.gov.au/health/healthyliving/nappy-rash
[7] Healthdirect, Nappy rash,https://www.healthdirect.gov.au/nappy-rash
[8] Pregnancy, birth and baby, Nappy rash,https://www.pregnancybirthbaby.org.au/nappy-rash