Diaper Rash: Causes, Symptoms, and Treatment

Diaper Rash Symptoms

Symptoms of a diaper rash include:

• Red, irritated skin in the buttocks or genital areas
• Lighter skin in the affected areas (for babies who are Brown or Black)
• Itchy skin or sores in the diaper area
• More than usual fussing and crying of your baby during a diaper change

Diaper rash bleeding

If your baby's diaper rash is bleeding or has crusty sores, call your pediatrician.

Diaper rash blisters

If the rash has blisters or oozes pus, call the doctor within 24 hours.

Diaper Rash Types

There are several types of diaper rash including:

Yeast diaper rash

This is caused by overgrowth of a fungus found naturally in the human digestive system. It usually looks like red or pink patches with sharp edges on your baby's bottom. It can also appear as tiny pimples or bumps in the folds of skin around the groin, legs, and genitals. In more serious cases, the skin may be cracked, sore, or bleeding.

Irritant dermatitis

This is the most common type of diaper rash. It often happens when your baby's skin is irritated by urine and poop in a diaper. Pink or red patches show up on the areas of the body covered by the diaper, like the bottom, but not usually in the skin folds.

Bacterial diaper rash

Also known as impetigo, this type of rash is caused by bacteria such as staph and strep. You can tell your baby has this by bright red skin around their anus or crusty yellow or oozing pimples in their diaper area.

Allergic diaper rash

Although this is rare, substances like perfumes or dyes in a soap, detergent, wipe, or even a diaper can cause an allergic reaction. You may see a red rash wherever the product came into contact with your baby's skin.

Diaper Rash Treatments

The first and best thing to do is to keep your baby's bottom clean and dry. Follow these steps when changing your baby:

• Rinse the diaper area with warm water and pat (not rub) it dry.
• Use soap only if the poop doesn't come off easily.
• If the area is really sore, try a squirt bottle to wash without rubbing sore skin.
• If possible, let your baby's bottom air-dry or use a towel. Don't use talcum powder, which can be harmful if your baby breathes it in.
• Apply a diaper cream or ointment.
• Rediaper your baby

Diaper rash cream

Creams form a barrier on your baby's skin and keep urine and poop from touching and damaging it. Creams tend to have less oil than ointments and so can spread easily.

Most diaper creams have zinc oxide, which forms a waterproof layer on the skin. Zinc oxide also improves skin healing.

Skip the steroid creams (hydrocortisone) you find in the drugstore unless the doctor tells you to use one. They can irritate your baby's bottom even more if you don't use them the right way.

Diaper rash ointment

Diaper ointments tend to be heavier and have more oil than diaper creams. They spread less easily than creams but are a stronger barrier against irritants. But they don't allow air to flow through the skin. 

White petroleum jelly (petrolatum) can be an effective diaper ointment. Many medicated skin care products come in ointment form.

Prescription treatments

If home care doesn't do the trick, your pediatrician may recommend:

• Antifungal cream if your baby has a fungal infection
• Topical or oral antibiotics if your baby has a bacterial infection
• A mild steroid cream to help heal the skin

Home Remedies for Diaper Rash

Instead of or along with commercial treatments, some people try home remedies for a diaper rash. But not all of them are effective—and some can make the problem worse. Your best bet is to check with your pediatrician before trying a home remedy.

Breast milk for diaper rash

Applying human breast milk to your baby's bottom is safe, but the jury's out on how effective it is. One study found it worked as well as a mild hydrocortisone ointment. But other research found that a cream that included zinc oxide worked better.

Cornstarch for diaper rash

Avoid using cornstarch on diaper rash. It can irritate the skin and even infect it. It's also ineffective because it actually holds moisture in.

Coconut oil for diaper rash

While there's no scientific evidence that coconut oil is effective for a diaper rash, it's a gentle, natural moisturizer. But moisturizing may not be enough to clear up a diaper rash. If you don't see improvements quickly, try diaper rash products that are petroleum- or zinc oxide–based.

Witch hazel for diaper rash

One study found that an ointment made with the herb witch hazel helped clear diaper rash. But never apply distilled witch hazel directly to rash areas. It's so acidic that it can irritate your baby's skin.

Baking soda bath for diaper rash

If your baby's bottom is very raw, soak it for 10 minutes in a mixture of warm water and 2 tablespoons of baking soda. Do it three times a day and apply an antiyeast ointment. But don't put baking soda, or products containing it, directly on the rash.

Diaper Rash Complications

The two main complications of diaper rash are:

Changes in skin color. In babies with darker skin, diaper rash might cause the affected area to look lighter than the skin around it. This usually clears up in a few weeks, although severe cases could take months or years to return to normal.

Infection. It's not common, but diaper rash can sometimes lead to a serious infection that doesn't respond to treatment.

Diaper Rash Prevention

These basic steps can help keep your baby from getting a diaper rash:

• Wash your hands before and after every diaper change to prevent the spread of bacteria.
• Check your baby's diaper often, and change it as soon as it gets wet or soiled.
• Use plain water to clean the diaper area. When you need to get poop off your baby's skin, use a mild cleanser.
• Check that the area is completely clean and dry before putting on a fresh diaper. Gently pat the area dry, rather than rubbing it.
• If you use wipes, choose mild ones. Avoid those with fragrances or alcohol. Or use a clean, soft washcloth.
• Apply a diaper cream or ointment with each diaper change if your baby gets diaper rash regularly.
• Make sure diapers aren't fastened too tightly to allow some airflow.
• Let your baby go diaper-free when possible. Airing out the diaper zone helps skin heal faster and reduces rashes. To avoid a mess, do it right after a bowel movement.

Diaper switches and laundry tips

Some parents find these changes lead to fewer diaper rashes:

• Change the type of diaper. If you use cloth, try disposables. Or try a different brand of disposable diaper.
• If you wash your own cloth diapers, change your detergent. Choose a mild, hypoallergenic detergent. Or add ½ cup of vinegar to the rinse cycle.

When to Call the Doctor About Diaper Rash

Let your baby's doctor know if:

• The rash gets worse or doesn't respond to treatment in 2-3 days.
• Your baby has a fever or seems sluggish.
• You see yellow, fluid-filled bumps (pustules) and honey-colored crusty areas. This might be a bacterial infection that requires antibiotics.
• You notice symptoms of a yeast infection, such as a swollen rash with white scales, small red pimples outside the diaper area, or redness in skin folds.

Your pediatrician can prescribe medicine to clear up the rash or any infection that results.