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Diaper rash (diaper dermatitis) is the most common skin problem in babies and young children. The skin may look red, raw, scalded, or burned. A diaper rash is uncomfortable. But in most cases, it's not a serious problem.
Diaper rash is usually caused by the skin staying wet, the diaper rubbing the skin, and skin contact with urine and stool. It often occurs in babies who sleep for many hours so the wet diaper is on them longer. Diaper rash may also be caused by a fungal infection or bacterial infection.
Adults may get diaper rash if they can't wash the genital area well or if they use incontinence briefs. These briefs can cause skin irritation. Or a person may be allergic to the perfumes in the material.
A diaper rash may also be a sign of abuse or neglect.
Most diaper rashes clear up within 2 to 3 days when treated at home. The rash usually clears up when diapers are changed more often, the skin is carefully cleaned, and over-the-counter ointments are put on the area. A diaper rash that becomes raw, oozes fluid, or bleeds is harder to treat.
Check Your Symptoms
The medical assessment of symptoms is based on the body parts you have.
- If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
- If your symptoms aren’t related to those organs, you can choose the gender you identify with.
- If you have some organs of both sexes, you may need to go through this triage tool twice (once as "male" and once as "female"). This will make sure that the tool asks the right questions for you.
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, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, herbal remedies, or 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 is generally all that's needed for most cases of diaper rash. At the first sign of a diaper rash, try the following steps:
- Keep the skin dry. Make sure that the skin isn't in contact with urine and stool.
- Change the diaper or incontinence brief every time it's 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's 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.
- Don't use any soap unless the area is very soiled. Use only a mild soap if soap is needed.
- Don't use "baby wipes" that have alcohol or propylene glycol to clean the skin if the person has a diaper rash. These wipes may burn the skin and spread bacteria on the skin.
- On adults, you may use a blow-dryer set on the warm setting to get the diaper area fully dry. But don't use a blow-dryer on babies or small children.
- Leave diapers and incontinence briefs off as much as you can.
- Protect the healthy skin near the rash with a cream such as A+D Ointment, Desitin, Diaparene, or zinc oxide. Don't put the cream on broken skin. It can slow the healing process.
- If you use a disposable product, fold the plastic area away from the body. Don't put the diaper on too tightly. Don't use bulky or many-layered diapers or incontinence briefs.
- Don't use plastic pants until the rash is gone.
- Give more fluids to make the urine less concentrated.
If the diaper rash doesn't get better after several diaper changes, 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, don't bathe a baby until the umbilical cord has fallen off. And never leave a child alone while the child 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 get a rash with one diaper 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 don't want to switch to a disposable product, change detergents.
- Rinse diapers or briefs twice when you wash them.
- 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:
- Don't use a nonprescription adult vaginal yeast medicine on a baby or child. Check with your doctor before you use 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.
- Don't use baby powder while a person has a rash. The powder can build up in the skin creases and hold moisture. This may help bacteria grow and cause an infection.
- Don't use cornstarch on a rash in the diaper area. Cornstarch also allows bacteria to grow.
When to call for help during self-care
Call a doctor if any of the following occur during self-care at home:
- New or worse signs of infection, such as warmth, redness, swelling, pus, or a fever.
- Symptoms occur more often or are more severe.
Preparing For Your Appointment
You can help your doctor diagnose and treat your condition by being prepared for your appointment.
Current as of: November 15, 2021
Author: Healthwise Staff
William H. Blahd Jr. MD, FACEP - Emergency Medicine
Elizabeth T. Russo MD - Internal Medicine
Kathleen Romito MD - Family Medicine
Adam Husney MD - Family Medicine