Diaper rash, also known as diaper dermatitis, is an irritating rash that occurs in the diaper area. Not unique to girls, most babies experience this rash at some point, with symptoms that range from mild redness to open sores. Rashes tend to be more common after the introduction of solid foods, particularly between 9 to 12 months of age, due to related changes in stool frequency and content. Babies can develop several different types of diaper rash, each with different causes and treatments. Although they can be uncomfortable for babies, most diaper rashes in children are not serious and will resolve with home care.
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Friction or Irritant
A common type of diaper rash is irritant contact dermatitis, caused by friction and chafing as the skin rubs against the diaper, or irritation from urine, feces or other chemicals from diapers, wipes, soaps or lotions. These irritants can lead to the formation of red, scaly patches on the baby girl’s bottom, genital area or thighs. This kind of rash tends to be confined to the area where the friction or contact with the irritant occurred, and resolves when the irritant is removed. Treatment may include allowing baby to go diaper free as much as possible, and applying over-the-counter diaper cream.
Diaper rash is also commonly caused by the yeast Candida, a fungus which grows well in the warm, moist environment under a diaper. Candida rashes are extremely red, raised, and uncomfortable, and may cover the entire genital area, including the folds of the labia. Antibiotic use in the nursing mother or baby increases the risk of yeast infections, as does ongoing skin contact with wet diapers. Candida rashes respond well to the application of antifungal creams.
Reactions to allergens, or substances that cause allergic reactions, is another cause of diaper rash. Also referred to as allergic contact dermatitis, this type of rash can be caused by allergy to substances such as fragrances, dyes and preservatives, and usually develops after a new product such as a laundry detergent, soap or baby wipe is introduced. Signs include large areas of itchy red, scaly and raised skin in the diaper area. Because this type of rash is an allergic reaction, the rash tends to be more widespread in the diaper area, and lesions can persist a few weeks after the trigger is removed. Eliminating the allergen is critical to the treatment plan, which may also include a steroid ointment.
Warnings and Next Steps
Treatment of diaper rash involves airing out the skin, keeping skin clean, and using an ointment or paste to protect the skin. While most diaper rashes can be treated at home, contact a pediatrician if your baby develops a fever, if her rash spreads beyond the diaper area, or if blisters or pus-filled sores develop. Also, see a pediatrician if your baby is less than 6 weeks old and has a diaper rash, or if the rash is not improving despite home treatment.
Reviewed by Kay Peck, MPH, RD