Diaper Rash: Diagnosis and Treatment

The best treatment for diaper rash is to keep your baby’s skin as clean and dry as possible. If your baby’s diaper rash persists despite home treatment, your doctor may prescribe:

  • A mild hydrocortisone (steroid) cream
  • An antifungal cream, if your baby has a fungal infection
  • Topical or oral antibiotics, if your baby has a bacterial infection

Use creams or ointments with steroids only if your baby’s pediatrician or dermatologist recommends them — strong steroids or frequent use can lead to additional problems.

Diaper rashes usually require several days to improve, and the rash may come back repeatedly. If the rash persists despite prescription treatment, your doctor may recommend that your baby see a specialist in skin conditions (dermatologist).

Lifestyle and home remedies

Generally, a diaper rash can be treated successfully at home with these practices:

  • Keeping diaper area clean and dry. The best way to keep your baby’s diaper area clean and dry is by changing diapers immediately after they are wet or soiled. Until the rash is better, this may mean getting up during the night to change the diaper. After you’ve gently cleaned and dried the skin, apply a cream, paste or ointment. Certain products, such as zinc oxide and petroleum jelly, work well to protect the skin from moisture. Don’t try to scrub off this protective layer completely at the next diaper change, as that could hurt the skin more. If you do want to remove it, try using mineral oil on a cotton ball.
  • Increasing airflow. To aid the healing of diaper rash, do what you can to increase air exposure to the diaper region. These tips may help:
    • Air out your baby’s skin by letting him or her go without a diaper and ointment for short periods of time, perhaps three times a day for 10 minutes each time, such as during naps.
    • Avoid airtight plastic pants and diaper covers.
    • Use diapers that are larger than usual until the rash goes away.
  • Applying ointment, paste, cream or lotion. Various diaper rash medications are available without a prescription. Talk to your doctor or pharmacist for specific recommendations. Some popular over-the-counter products include A + D, Balmex, Desitin, Triple Paste and Lotrimin (for yeast infections). Zinc oxide is the active ingredient in many diaper rash products. They are usually applied to the rash throughout the day to soothe and protect your baby’s skin. It doesn’t take much – a thin covering will do. The product can be applied over medicated creams, such as an antifungal or a steroid, when necessary. You could also apply petroleum jelly on top, which helps keep the diaper from sticking to the cream. Ointments, pastes or creams may be less irritating than lotions. But ointments and pastes create a barrier over the skin and don’t allow it to receive air. Creams dry on the skin and allow air through. Talk with your doctor about what type of product would be better for your child’s rash. As a general rule, stick with products designed for babies. Avoid items containing baking soda, boric acid, camphor, phenol, benzocaine, diphenhydramine, or salicylates. These ingredients can be toxic for babies.
  • Bathing daily. Until the rash clears up, give your baby a bath each day. Use warm water with mild, fragrance-free soap.

Alternative medicine

The following alternative treatments have worked for some people:

  • Witch hazel (winter bloom), a flowering plant. A study showed that applying an ointment made with witch hazel to diaper rash helped. The study included 309 children.
  • Human breast milk. Results are mixed on whether human breast milk applied to diaper rash is better than other treatments. One study showed that applying breast milk to diaper rash is an effective and safe treatment. Infants with diaper rash were treated with either 1 percent hydrocortisone ointment or breast milk. The study included 141 infants. Treatment with breast milk was as effective as the ointment alone. Another study compared human breast milk with a cream made from zinc oxide and cod liver oil. Newborns with diaper rash were treated with the cream or the breast milk. The study included 63 newborns. Treatment with the cream was more effective.
  • Calendula and aloe vera. A study comparing aloe vera and calendula in the treatment of diaper rash in children found each to be an effective treatment of diaper rash.
  • Shampoo clay (bentonite). A study showed that shampoo clay was effective in healing diaper rash and that it worked faster than calendula. The study included 60 infants.
  • Other substances. Other natural remedies have been tried, including evening primrose and a mixture of honey, olive oil, and beeswax. Further study is needed to prove their effectiveness for treating diaper rash. Some of these substances may promote bacterial growth.

Preparing for your appointment

Generally, a diaper rash can be treated successfully at home. Make an appointment with your baby’s doctor if the rash gets worse despite several days of home treatment, is severe or occurs along with a fever.

Here’s some information to help you get ready for your appointment.

What you can do

  • List your baby’s signs and symptoms, and for how long your baby has had them.
  • List key information about your baby’s medical conditions and food intake. For example, has your baby been treated for any illness or given any medications recently? Has the baby’s diet changed? If your baby is breast-fed also note any medications he or she may have been exposed to through breast milk, as well as changes in the mother’s diet, such as an increase in tomato-based foods.
  • List all products that come into contact with your baby’s skin. Your baby’s doctor will want to know what brand of diapers, laundry detergent, soaps, lotions, powders and oils you use for your baby. If you suspect one or more products may be causing your baby’s diaper rash, you may wish to bring them to the appointment so your doctor can read the label.
  • List questions to ask your doctor. Creating your list of questions in advance can help you make the most of your time with your doctor.

Below are some basic questions to ask your doctor about diaper rash.

  • What is the most likely cause of my baby’s rash?
  • What are other possible causes?
  • What can I do to help my baby’s skin heal?
  • What diaper ointments, pastes, creams or lotions would you recommend for my baby?
  • When should I use an ointment or paste instead of a cream or lotion?
  • Do you suggest any other treatments?
  • What products or ingredients should I avoid using with my baby?
  • Should I avoid exposing my baby to certain foods, either through breast milk or through my baby’s diet?
  • How soon do you expect my baby’s symptoms to improve?
  • What can I do to prevent this condition from recurring?
  • Is the rash a sign of some other internal problem?

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to talk about in-depth. Your doctor may ask:

  • When did you first notice your baby’s signs and symptoms?
  • What type of diaper does your baby typically wear?
  • How often do you or your baby’s child care provider change your baby’s diaper?
  • What types of soap and wipes do you use to clean your baby?
  • Do you apply any skin care products to your baby, such as lotions, powders, creams and oils?
  • Is the baby breast-fed? If so, is the mother taking antibiotics? Are there any changes to the mother’s own diet?
  • Have you introduced your baby to solid foods?
  • What treatments have you tried so far for your baby’s rash? Has anything helped?
  • Has your baby recently had any other medical conditions, including any illness that caused diarrhea?
  • Has your baby recently taken any new medications?

What you can do in the meantime

In the time leading up to your appointment, avoid products that seem to trigger your baby’s rash. Wash your baby’s bottom with water after each diaper change. Avoid soaps and wipes that contain alcohol or fragrance.

Give your baby as much diaper-free time as possible, so that his or her skin can have a chance to stay dry and start healing. When you do use diapers, change them frequently and apply a diaper rash cream, lotion, paste or ointment to act as a barrier between your baby’s skin and a dirty diaper.

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Source: mayoclinic