Doctors’ Notes


Diaper Rash

Just when you thought changing your baby’s diaper couldn’t get any more fun — surprise! It’s a diaper rash! The bad news is they can get pretty nasty. The good news is they rarely cause serious problems.

Diaper rash (also known as diaper dermatitis) is very common in infants. Babies have more sensitive skin than older children. Throw friction, wetness from stool and urine, wiping, and confinement in diapers into the mix, and it’s a perfect environment for irritation and rashes to develop.

Most diaper rashes are caused by a combination of these factors. Sometimes the irritated skin can develop small breaks that allow fungal skin infections to take hold. Other less common causes are allergies to diaper components, bacterial infections, and eczema.

How Do I Prevent Diaper Rash?

First and foremost, avoiding direct contact with wet diapers can help. Giving babies breaks from being in a diaper allowing the area to “air out” gives their skin some time to heal.  During diaper changes, consider using only a cloth and warm water instead of wipes. Baby wipes sometimes contain alcohol and perfumes that can make a diaper rash even worse. During bath time, use mild, fragrance-free soaps, which can be gentler on sensitive skin.

Are Some Diapers Better Than Others?

The choice of cloth versus disposable diapers is one that involves many factors, including cost and environmental impact. However, modern disposable diapers are usually more absorbent than cloth ones, and can keep moisture from being in direct contact with the skin. There isn’t enough evidence to support using specific brands of disposable diapers. Regardless of the type of diaper you choose, frequent changing and airing out will be helpful.

How Do I Treat Diaper Rash?

Aside from prevention, barrier ointments or pastes are the best option to start with. These make a physical barrier between your baby’s skin and the moisture, friction, and irritation that can lead to rashes. There are many different kinds out there, and there isn’t enough evidence to support specific brands. A few that parents frequently use are Triple Paste (“Butt Paste”), Desitin, A&D, and Balmex. They all have zinc oxide, which can be helpful for the healing process. Good old-fashioned Vaseline (petroleum jelly) also works well! Apply a good, thick layer to the affected skin with each diaper change, and ease off once the rash goes away.

We don’t generally recommend baby powder for rashes; while it can cut down on friction, it can also pose an inhalation hazard to babies.

What if the Rash Isn’t Going Away?

A few things should be triggers to call the office. First, if you’ve been trying all of the above and the rash is still there after a few days, it may not be a straightforward irritant rash. Also, if the rash is bright red, located right around the genitals, and has small red spots around it, please call the office; that could be a sign of a fungal infection called candidiasis, which is a common cause of diaper rashes in babies. But don’t worry; it’s usually very easy to treat with antifungal ointments.

As always, call us with any questions!

Dr. Todd Sanderson was a Kids Plus Doc from 2011 to 2013.