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Diaper Rash

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

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.

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.

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.

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.

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.

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.

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.

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. Cranberry juice may be used by adults and children over 12 months of age. Do not use other juices, which may make the urine more irritating to the skin.

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

By Healthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Specialist Medical Reviewer H. Michael O'Connor, MD - Emergency Medicine
Last Revised February 21, 2012

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