A diaper rash is any rash that affects the area of skin a diaper would cover.
These rashes usually occur due to moisture and irritation from the diaper itself. However, some diaper rashes can indicate an underlying medical condition.
Most diaper rashes are relatively mild, but some can be quite severe, causing painful red welts and sometimes causing the skin to crack.
According to the American Academy of Pediatrics, a quarter of babies experience diaper rash. Knowing which type of diaper rash a baby has can help guide treatment.
This article will cover the causes, symptoms, and treatments associated with several types of diaper rash.
There are many different types of diaper rash. The sections below will look at each of these in more detail.
Irritant contact dermatitis
Irritant contact dermatitis is the most common type of diaper rash. It develops when something in the diaper, or sometimes the diaper itself, irritates the skin.
This type of dermatitis tends to get worse when a baby sits in a wet or dirty diaper for a long period of time.
Irritant contact dermatitis can cause red bumps or spots to appear in the area. If it gets severe enough, there may also be welts that can crack open and bleed. Open sores make it easier for fungi and bacteria to get into the skin, increasing the risk of a secondary infection.
Changing the baby’s diaper more frequently and using a diaper rash cream until the rash clears up can help treat irritant contact dermatitis.
Candidiasis, or yeast, infections
A group of fungi called Candida normally live in the skin and diaper area. When they grow in excess, however, it can cause a painful diaper rash called candidiasis, or a yeast infection.
The rash may look red and inflamed, and it may include white, fluid filled blisters or swollen spots with a white, scaly outer layer.
Sometimes, a child gets a yeast infection following severe diaper rash that cracks open and bleeds.
Applying a diaper rash cream can help treat some yeast infection rashes. It is also important to keep the area clean and dry.
If symptoms get worse or do not improve within a few days, a doctor may recommend using an antifungal cream.
Eczema can cause painful spots to develop around the diaper area. A parent or caregiver might notice that the skin looks very dry and irritated. There may be red patches or hard, scaly areas of skin.
Many babies with eczema will also have it on other areas of the body. It is rare for it to occur only in the diaper area and nowhere else.
Moisturizing the area can help soothe eczema, but it may also keep the diaper area moist, increasing the risk of other types of diaper rash. A doctor may therefore recommend a steroid cream or another treatment, depending on the severity of the eczema.
Bacterial skin infections
Bacterial infections of the diaper area can cause red, swollen, and inflamed skin.
Without treatment, these infections could also spread to other areas of the body and become life threatening.
Babies with bacterial infections may develop a fever or seem sick. However, some may show no other symptoms besides the diaper rash.
In most cases, a doctor will prescribe antibiotics. Because bacterial infections can enter the body if diaper rash becomes severe and causes open wounds, preventing diaper rash may also prevent secondary infections.
Intertrigo is a type of inflammatory skin condition that is more severe in skin folds and warm, wet places, such as the folds of the thighs or a baby’s buttocks.
Intertrigo sometimes gets secondary yeast or bacterial infections that require additional treatment. Babies who get intertrigo diaper rashes may also get other inflammatory rashes as adults.
In most cases, it is possible to manage intertrigo by removing the source of the irritation. For babies, this usually means more frequent diaper changes.
Psoriatic diaper rash
Psoriatic diaper rash is a type of psoriasis. Psoriasis is a chronic skin condition that causes the body to attack healthy cells, leading to thick, scaly patches of skin.
These scales may itch, and they often look pink or gray. Children may also have psoriatic patches elsewhere on the body, particularly the scalp.
Psoriasis does not get better with diaper rash treatment. However, some people may notice that certain irritants, such as a wet diaper, can trigger flares of psoriasis. Therefore, preventing diaper rash from developing is still important when a baby has psoriasis.
Numerous remedies can help treat psoriasis, including steroid creams and prescription drugs. Some people may also find relief from phototherapy.
To help treat and prevent diaper rash, a person can:
- Change diapers more frequently to prevent babies from sitting in moisture.
- Choose diapers that fit well and do not rub or chafe. Diapers that are too small may irritate the diaper area.
- Thoroughly dry the baby before putting on a new diaper and before applying diaper rash ointment.
- Use a diaper rash cream containing zinc oxide or petroleum jelly.
- Change diaper brands. Some children do better with fragrance-free diapers or with specific brands.
- Use unscented diaper wipes or wet washcloths to clean the baby.
- If the baby has severe diaper rash, use a squirt bottle to clean the diaper area, instead of rubbing the rash with a wipe.
- Try keeping the baby out of their diaper as much as possible.
- Avoid using baby powder.
- If the child is old enough to potty train, support them to wear underwear as often as possible.
Most cases of diaper rash occur due to irritant contact dermatitis and will go away on their own or with home treatment.
If these steps do not help, however, a doctor can prescribe medication and offer advice.
Parents and caregivers can see a doctor about severe diaper rash that cracks open and bleeds or does not get better with home treatment.
A doctor should be able to diagnose the cause of the diaper rash by examining the baby. If they suspect an underlying medical condition, they may recommend blood work or other tests.
If the diaper rash has a bacterial infection, a doctor may prescribe broad-spectrum antibiotics or take a culture to see which bacteria are present.
Diaper rash can cause discomfort in babies. Severe diaper rash may even cause dangerous infections. However, trying a few simple management strategies can reduce the risk of a baby experiencing severe diaper rash.
Even with these interventions, however, some children continue to get diaper rash. A doctor or pediatrician can help with assessing the cause and make recommendations for preventing diaper-related pain and irritation.