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Topic Overview

Diaper rash
(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
go away.

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.

A diaper rash may also be a sign of
abuse or neglect.

  • 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
body.

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
adults.

Check the person’s symptoms to decide if and when
you should see a doctor.

Check Your Symptoms

Do you have a concern about diaper rash?
Yes
Diaper rash concern
No
Diaper rash concern
How old are you?
Less than 12 years
Less than 12 years
12 years or older
12 years or older
Are you male or female?
Male
Male
Female
Female
Are there symptoms of a more serious infection in the diaper area?
Yes
Symptoms of infection
No
Symptoms of infection
Do you think your child has a fever?
Yes
Fever
No
Fever
Do you think you may have a fever?
Yes
Possible fever
No
Possible fever
Are there symptoms of a fungal infection in the diaper area?
Yes
Symptoms of fungal infection
No
Symptoms of fungal infection
Are there white patches in the mouth?
Yes
White patches in mouth
No
White patches in mouth
Is your child having trouble eating or swallowing?
Yes
Difficulty eating or swallowing
No
Difficulty eating or swallowing
Are you having trouble swallowing?
Yes
Trouble swallowing
No
Trouble swallowing
Has there been a rash in any of the skin folds, such as the neck, underarms, or belly button, for more than 2 days?
Yes
Rash in skin folds for more than 2 days
No
Rash in skin folds for more than 2 days
Do you think the diaper rash may be caused by abuse or neglect?
Yes
Diaper rash may be caused by abuse or neglect
No
Diaper rash may be caused by abuse or neglect
Does the skin look red and raw, like it was scalded or burned?
Yes
Skin looks red and raw
No
Skin looks red and raw
Is diaper rash causing a lot of pain during urination?
Yes
Diaper rash is causing painful urination
No
Diaper rash is causing painful urination
Are any areas of red, raw skin larger than 1 in. (2.5 cm) across?
Yes
Areas of raw skin larger than 1 in. (2.5 cm) across
No
Areas of raw skin larger than 1 in. (2.5 cm) across
Do you think that a medicine may be causing the diaper rash?
For example, antibiotics can lead to a fungal infection and rash in the diaper area.
Yes
Medicine may be causing diaper rash
No
Medicine may be causing diaper rash
Have you tried home treatment for the rash for more than 2 days?
Yes
Home treatment for more than 2 days
No
Home treatment for more than 2 days
Is the rash getting better with home treatment?
Yes
Diaper rash is getter better with home treatment
No
Diaper rash is getter better with home treatment
Is the rash on any other parts of the body?
Yes
Rash on other parts of the body
No
Rash on other parts of the body
Has this type of rash occurred before?
Yes
Has had same rash before
No
Has had same rash before

Many things can affect how your body responds to a symptom and what kind
of care you may need. These include:

  • Your age. Babies and older
    adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
    disease, you may need to pay closer attention to certain symptoms and seek care
    sooner.
  • Medicines you take. Certain
    medicines, herbal remedies, and supplements can cause symptoms or make them
    worse.
  • Recent health events, such as surgery
    or injury. These kinds of events can cause symptoms afterwards or make them
    more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
    use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be
able to take care of this problem at home.

  • Try home treatment to relieve the
    symptoms.
  • Call your doctor if symptoms get worse or you have any
    concerns (for example, if symptoms are not getting better as you would expect).
    You may need care sooner.

Signs that diaper rash may be a fungal infection include:

  • A red rash in the skin creases. The rash usually
    has clear borders and tiny red or pus-filled pimples beyond the borders of the
    rash.
  • A rash in other skin folds, such as the neck, underarms, or
    belly button.
  • White patches in the mouth.
  • White discharge from the vagina.

Symptoms of a more serious infection in the diaper area may include:

  • Increased pain, swelling, heat, or redness around
    the rash.
  • A fever.
  • Clear, fluid-filled blisters that
    leave red, raw areas when they break open.
  • Pus in or draining from
    the rash.  
  • Being fussy, upset, and hard to console.

These symptoms usually last more than 2 days (48 hours) without
getting better. A milder diaper rash usually will start to improve
sooner.

Make an Appointment

Based on your answers, the problem may not improve without medical
care.

  • Make an appointment to see your doctor in the
    next 1 to 2 weeks.
  • If appropriate, try home treatment while you
    are waiting for the appointment.
  • If symptoms get worse or you have
    any concerns, call your doctor. You may need care sooner.

Seek Care Today

Based on your answers, you may need care soon. The
problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms
    and arrange for care.
  • If you cannot reach your doctor or you don’t
    have one, seek care today.
  • If it is evening, watch the symptoms and
    seek care in the morning.
  • If the symptoms get worse, seek care
    sooner.

Seek Care Now

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
    ambulance unless:

    • 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

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
      24-hour period.
    • 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
      skin.
    • 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
      children.
  • Leave diapers and incontinence briefs off as much
    as possible.
  • 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
    incontinence briefs.
  • Do not use plastic pants until the rash is
    gone.
  • 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
    another.
  • 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
      washing.
    • 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
    grow.

Symptoms to watch for during home treatment

Call your doctor if any of the following occur during home treatment:

  • A rash in the diaper area looks like a rash on other
    parts of the body.
  • Signs of infection
    develop.
  • Symptoms become more severe or frequent.

Prevention

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.
  • 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
    hours.
  • 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
    softeners.
  • 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.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your
doctor diagnose and treat your condition by being prepared to answer the
following questions:

  • How long has the rash been
    present?
  • Has the rash changed since you first saw
    it?
  • What home treatment have you tried? Did it help?
  • Have you had problems with a rash in the diaper area before? If
    yes, when and how was it treated?
  • Has there been any recent
    diarrhea?
  • Are any prescription and nonprescription medicines being
    taken? Have antibiotics been taken recently?
  • Has there been a
    change in diet?
  • Are you using a new type of diaper or incontinence
    brief?
  • Have you recently changed bathing or laundry
    products?
  • Is there a history of family skin disorders or allergies?
  • Does a caregiver have any yeast infection, particularly a vaginal
    yeast infection?
  • Are any
    health risks present?

Credits

ByHealthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP – Emergency Medicine
Elizabeth T. Russo, MD – Internal Medicine
Kathleen Romito, MD – Family Medicine
Specialist Medical Reviewer Adam Husney, MD – Family Medicine

Current as ofMarch 20, 2017