Ask Your Family Doctor

Developed by the College of Family Physicians of Canada

What does diaper rash look like?

Diaper rash mostly causes mild redness and scaling where the diaper touches your baby's skin. In bad cases, the rash can cause pimples, blisters and other sores. If your baby's rash gets infected, the rash may be bright red and the skin may be swollen. Small red patches or spots may spread beyond the main part of the rash, even outside the diaper area.

What causes diaper rash?

Most diaper rashes are caused by skin irritation. This can be caused by diapers that rub against the skin, fit too tightly or are left on for too long. Contact between urine (pee) and stool (bowel movements) can cause a chemical "burn" to the skin. This can be worse with diarrhea. Your baby's skin can also be sore from the soap used to wash cloth diapers, or by some brands of diapers or baby wipes. Plastic pants that fit over diapers hold heat and wetness in the diaper area. Heat, moisture and raw skin make it easy for diaper rash to start and for germs to grow. When a rash gets infected, it's often a yeast infection, also called Monilia or Candida. Bacteria can also infect the skin. Infection can make diaper rash much worse.

How do I prevent and treat diaper rash?

The key to prevent and treat diaper rash is to keep your baby's diaper area clean, cool and dry. Change your baby's diaper often, and let him or her go without a diaper when needed. This lets the air dry his or her skin.

You might try placing your baby on an open cloth diaper during naptime. Check the diaper shortly after your baby falls asleep and replace it if it's wet. Babies often void (pee) right after falling asleep.

See below for other tips on how to prevent and treat diaper rash. If these things don't work, talk to your doctor. Your doctor may suggest using hydrocortisone cream for a short while.

Don't use creams that contain boric acid, camphor, phenol, methyl salicylate or compound of benzoin tincture. These things can be harmful. You can use a barrier cream to help protect your baby's skin.

Tips to prevent and treat diaper rash

	Check your baby's diaper every hour and change it often-as soon as it's wet or soiled.
	Clean your baby's bottom at each diaper change. Use plain warm (not hot) water with or without a very mild soap.
	Allow your baby's skin to dry before putting on a clean diaper.
	Use zinc oxide ointment (some examples are Zincofax, Penaten Cream, Zinaderm, Desitin Diaper Rash Ointment, Prevex-Baby Diaper Rash Cream) or petroleum jelly (an example is Vaseline) to protect your baby's skin from moisture.
	Avoid using plastic pants.
	Change the type of wipes, diapers or soap you're using.
	If you use cloth diapers, try boiling them for 15 minutes after you wash them to get all of the soap and germs out.

What if my baby has an infection?

If your baby also has an infection with the rash, the rash may not get better using these tips alone. Your doctor might give you a prescription for a special cream to rub on your baby's rash. You can try cream to treat yeast (antifungal cream). Ask your pharmacist. Sometimes if your baby has thrush (yeast in the mouth), this will have to be treated too.

What about powder?

Don't use talcum powder or cornstarch. Talcum powder can get into your baby's lungs. Cornstarch may make a yeast infection worse.

Call your doctor if

	The diaper rash occurs in the first six weeks of life
	Pimples and small ulcers form
	Your baby has a fever
	Your baby loses weight or isn't eating as well as usual
	Large bumps or nodules appear
	The rash spreads to other areas, such as the arms, face or scalp
	The rash doesn't get better after trying the tips on treating diaper rash for one week

Does my baby need special diapers?

Cloth diapers washed by a diaper service are less likely to cause diaper rash than those washed at home. This may be because diaper services use hotter water, which kills all germs and removes chemicals that can irritate your baby's skin. Boiling diapers for 15 minutes on the stove after washing them is one way to do this yourself.

Some disposable diapers have an extra-absorbent gelling material that seems to help keep the skin dry. Using this type of diaper may help prevent diaper rash in some babies.

Keep in mind that the best thing to do is to change diapers often.

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Revised 2007 The College of Family Physicians of Canada

This information provides a general overview on this topic and may not apply to everyone. To find out if this information applies to you and to get more information on this subject, talk to your family doctor. This health education material has been favorably reviewed by the Patient Education Review Committee of the College of Family Physicians of Canada: Dr Cathy MacLean, Halifax, NS (Scientific Editor) Dr C. Richard Fischer, Pickering, ON Dr Patrice Laplante, Fleurimont, QC Dr Richard Moffatt, Red Deer, AB Dr David Nunn, Kentville, NS Dr Cornelius Woelk, Winkler, MB The College of Family Physicians of Canada, one of the nation's largest medical groups, is committed to promoting and maintaining high standards for family physicians - the doctors who provide ongoing, comprehensive care for people of all ages. This patient education information was developed by The College of Family Physicians of Canada in cooperation with the American Academy of Family Physicians.

Support for this program has been provided by an educational grant to the Research and Education Foundation by Scotiabank.