(diaper dermatitis) is a skin problem caused by the skin staying wet, rubbing
from the diaper, and contact with chemicals in the urine and stool. The skin
may look red, raw, scalded, or burned. While a diaper rash is uncomfortable,
generally it is not a serious problem.
Diaper rash is the most
common skin problem in babies and young children, but it can occur at any age
if diapers or incontinence briefs are worn. Diaper rash occurs most often in
babies between the ages of 9 and 12 months. It often occurs in babies who sleep
for many hours without waking so the wet diaper is on them longer.
An adult may develop a rash in the genital area if he or she cannot wash the
genital area well. If an adult does
not have complete bowel or bladder control (incontinence), he or
she may use incontinence briefs. These briefs can cause skin irritation or a
person may be allergic to the perfumes in the material. This type of rash is
very similar to a baby’s diaper rash. Home treatment measures may help the rash
Fungal or bacterial infections may be the cause of the diaper rash. The skin may be red and swollen with a mild rash or blister and peel in a severe rash. A diaper rash that
becomes raw, oozes fluid, or bleeds is harder to treat.
The most common causes of diaper rash include:
Not changing a wet or dirty diaper often enough. The skin becomes irritated from
contact with urine and stool, particularly when diarrhea is present.
Babies starting to eat solid foods. This may change their stools
and make diaper rash worse.
Rubbing of the skin by a diaper or
incontinence brief. The irritated area may include the thighs, genitals,
buttocks, or belly area.
A skin reaction to perfumes in disposable
diapers or incontinence briefs, to chemicals in skin-cleaning “diaper wipes,”
or to the detergents or fabric softeners used to clean cloth diapers.
Neglect occurs when a caregiver does not treat a
diaper rash at the time treatment is needed.
Abuse occurs when a
caregiver purposely does not treat a diaper rash because of anger directed at
the child or vulnerable adult.
Sometimes a diaper rash may occur with other skin problems,
such as psoriasis, atopic dermatitis, or seborrhea. The rash may be red and oozing. A crust may
form, and there will often be similar patches of rash on other parts of the
Most diaper rashes last about 24 hours and can be treated at
home. The rash clears up when the diapers are changed more often, careful
washing and cleaning of the skin is done, or nonprescription ointments are put
on the area. Treatment for diaper rash is the same for both children and
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
Call your doctor now to discuss the symptoms and
arrange for care.
If you cannot reach your doctor or you don’t have
one, seek care in the next hour.
You do not need to call an
You cannot travel safely either by driving
yourself or by having someone else drive you.
You are in an area
where heavy traffic or other problems may slow you down.
Home treatment is generally all
that is needed for most cases of diaper rash. At the first sign of a diaper rash, try
the following steps:
Keep the skin dry, and make sure the skin is not
in contact with urine and stool.
Change the diaper or incontinence brief every
time it is wet or soiled. During the daytime, check the diaper or brief every 3
hours. You may need to change the diaper or brief during the night to prevent
or clear up a rash. It is not unusual to change a diaper or brief 8 times in a
Use a superabsorbent disposable diaper.
Gently wash the diaper area with warm water and a
soft cloth. Rinse well and dry completely.
Do not use any soap unless the area is very
soiled. Use only a mild soap if soap is needed.
Do not use “baby
wipes” that have alcohol or propylene glycol to clean the skin while a diaper
rash is present. These may burn the skin and spread bacteria on the
You may use a blow-dryer set on warm setting to get the
diaper area fully dry on adults. Do not use a blow-dryer on babies or small
Leave diapers and incontinence briefs off as much
Protect the healthy skin near the rash with a cream
such as Desitin, Diaparene, A&D Ointment, or zinc oxide. Do not apply the
cream to broken skin, because it can slow the healing process.
If you use a
disposable product, fold the plastic area away from the body, and do not put
the diaper on too tightly. Do not use bulky or many-layered diapers or
Do not use plastic pants until the rash is
Give more fluids to make the urine less concentrated.
If the diaper rash does not get better after several days, try
the following steps.
Soak in a warm bath for 10 minutes, 3 times a
day, if the skin is very raw.
For babies and young children, add 2 Tbsp (30 mL) of baking soda
to a baby tub, a basin of warm water, or a bathtub. Remember, do not bathe a baby
until the umbilical cord has fallen off, and never leave a child
alone while he or she is in the bath.
Have older children and adults sit in a
bathtub with a few inches of warm water or use a sitz bath.
If you use a disposable product, change brands or
switch to a cloth product. Try a superabsorbent disposable diaper or brief with
absorbent gelling material (AGM), which pulls moisture away from the skin. Some
people are less likely to develop a rash with one diapering product than
If you use a cloth product, switch to a disposable
product. The cloth or the products used to clean the cloth diaper may be
causing the rash.
If you use cloth and do not want to switch to a
disposable product, change detergents.
Rinse diapers or briefs twice when
Use vinegar in the final rinse at a strength of 1 fl oz (30 mL) vinegar to 1 gal (4 L) of water.
When treating a diaper rash:
Do not use a nonprescription adult vaginal yeast
medicine on a baby or child. Check with your doctor before using any product
made for an adult on a baby or child.
Adults can use a
nonprescription adult yeast medicine to treat diaper rash. Follow the
instructions on the package.
Do not use baby powder while a rash is
present. The powder can build up in the skin creases and hold moisture. This
may help bacteria grow and cause an infection.
Do not use
cornstarch on a rash in the diaper area. Cornstarch also allows bacteria to
The following simple steps can help
prevent diaper rash.
Always wash your hands and your child’s hands well before and after each diaper
Change diapers or incontinence briefs as soon as possible
after they become soiled or wet. Check the diaper at least every 2 hours.
Diapers or incontinence briefs need to be changed at least 8 times every 24
Leave the diaper or incontinence brief off and allow the
area to air-dry for 5 to 10 minutes after each diaper change. Make sure a baby
is in a safe place during this time.
Wash cloth diapers with mild
detergent, and rinse them twice. Do not use bleach or fabric
If you use cloth diapers, do not use plastic pants, which
hold moisture on the skin.
If diarrhea is present, protect the
diaper area with a cream such as Desitin, Diaparene, A&D Ointment, or zinc
oxide. This will protect the skin from bacteria that might cause infection. For
more information, see the topic Diarrhea, Age 11 and Younger or Diarrhea, Age 12 and Older.
ByHealthwise Staff Primary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP – Emergency Medicine Elizabeth T. Russo, MD – Internal Medicine Kathleen Romito, MD – Family Medicine Specialist Medical ReviewerAdam Husney, MD – Family Medicine