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What causes diaper rash?


Diaper rash is a very common type of skin irritation in healthy babies. This can develop from many different sources.

Diaper rash may be very uncomfortable for the child and is always concerning for parents. The rash appears red, puffy, and irritated and is usually in the distribution of the buttocks, thighs, and genital region for boys and girls. The baby will have increased fussiness or crying due to pain from the rash.

It’s always important to change your child’s diaper frequently throughout the day. Never let your child sleep or sit in a soiled diaper. It may be better to use a baby wipe that is fragrance free or for sensitive skin. Sometimes the fragrance from scented baby wipes can cause irritation. An alternative is to simply use warm water and paper towels instead of baby wipes.

There are several different over-the-counter treatments for uncomplicated diaper rash. If the skin is very dry and irritated, using ointments like Desitin or “cod liver oil” is safe. For very dry skin, many parents will use Aquaphor or a thick moisturizer with each diaper change.

If the rash is caused by too much heat or moisture, then the opposite type of treatment is needed. For example, it may be necessary to dry out the skin by leaving the child out of the diaper whenever possible.  When you have just changed the baby’s dirty diaper or she is down for a nap, you can safely leave your baby open without a diaper on at all. Many parents will purchase disposable rectangular underpads. This way, the child will have “air time” to the skin without soiling your linens. Open air is the best cure for diaper rashes.

Some diaper rashes are actually caused by a fungal infection. These will be characterized by circular dots with redness, inflammation and swelling. Using the above treatments may not be enough to calm it down. Over-the-counter ketoconazole or athlete’s foot creams can be used safely. The medicine will need to be used twice a day for at least 3 weeks in a row. Fungal infections actually have roots and it’s important to kill the root to prevent redevelopment. Your pharmacist can show you the correct cream for this situation.

For severe cases of diaper rash caused by a fungal infection, prescription antifungal medication may be needed. The most common prescription is called Nystatin cream. This is safe and effective in most babies.

Finally, there are cases of bacterial infections that can cause swelling, pus, and fever. Those cases may require antibiotics.

Always talk with your doctor about any rashes that are concerning to you.

– Muhammad Emran, MD
Medical Director


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