A case of diaper rash can be a frustrating experience for the child and entire family. If left unchecked, that minor irritation on your baby’s bottom could soon take a turn for the worse and become bloody and painful, causing your child to scream at the mere thought of a diaper change.
Furthermore, the child may start to hold his or her stool if it becomes painful to have a bowel movement or diaper change, which could lead to constipation.
What is Diaper Rash?
“Diaper rash” is a term used to describe irritation of the skin on the buttocks or genital area of an infant or toddler. The rash often presents as reddened areas on the butt cheeks or cleft (crack) of the child’s backside, the folds of skin, or near the genital area. The rash may appear as a darker shade or even purplish on darker skin tones.
These reddened areas may be flat, slightly raised, scaly, or bumpy in appearance, and they may even be warm to the touch. The rash tends to be very painful for the child, especially in cases of moderate-to-severe diaper rash.
If the rash worsens, the skin can begin to bleed and scab, causing significant pain and irritation to the child. Consult with your pediatrician or healthcare provider if your child’s diaper rash becomes severe or frequent.
Diaper Rash Causes
Many things can cause a diaper rash to develop. Some of the most common causes include the following:
- Diarrhea or Constipation – If your child has a bout of diarrhea, a diaper rash can develop within a day (or hours). The frequent, watery bowel movements cause the skin to break down at a rapid pace. Constipation issues can also cause lead to diaper rash because impacted stool often leads to encopresis, a condition in which watery stool leaks around a larger mass of impacted stool, causing skin irritation.
- Infrequent Diaper Changes or Excessive Sweating – Even normal stool, urine, or sweat can lead to skin irritation if the child remains in a saturated diaper for long periods. The key here is that when your child’s bottom remains moist for extended periods, it is at risk for diaper rash.
- Food Intolerance or Allergy – If your child is allergic or intolerant to a certain food, it could cause irritation to the digestive system, leading to diaper rash.
- Using Abrasive Fabric – wiping too hard or using an abrasive material to clean the child’s bottom could lead to skin irritation or diaper rash, and it can worsen an existing diaper rash.
- Product Sensitivity –Your child may be allergic to products applied to the diaper area, such as creams, ointments, powders, fabrics, detergents, etc.
- Medications – Some medications may cause diarrhea or digestive upset, which can lead to diaper rash.
- Friction – Excessive scraping, rubbing, or friction applied to the skin during bathing or diaper changes can lead to a diaper rash.
- Yeast or Bacterial Infections – When skin loses its integrity, it is at risk from foreign invaders, including yeast and bacteria.
Diaper Rash Prevention
Diaper rash can be unpleasant for the child and entire family, so it’s a good idea to take measures to prevent diaper rash from developing in the first place.
Here are some tips for diaper rash prevention:
- Avoid scented products. I have always used unscented baby wipes, diapers, soaps, and detergents when possible. Your child could be sensitive to anything with added scents or ingredients.
- Change your child’s diaper frequently. This is especially important if your child is having diarrhea or frequent bowel movements, as this tends to lead to diaper rash quickly.
- Be gentle when cleaning around the genital and anus. Use a dabbing motion with soft cloths, rather than a rubbing motion or rough cloths.
- Eliminate allergens! Dairy, wheat, eggs, fish, and nuts are major allergens that can affect a child. Eliminate them if possible and see if the rash start to heal. However, make sure the child is receiving proper nutrition, and if necessary, consult with a nutritional expert.
- Have diaper free time! This allows the child’s bottom to air out and dry. I’ll talk more about this in a moment.
- Use ointment or cream to keep the skin healthy and dry. What is the best cream or ointment for diaper rash? Creams such as Desitin, Aquaphor, or even off-brand creams can work well if they have zinc oxide in it, which helps dry the skin. A+D diaper rash ointment is also good at protecting the skin and has worked better for me than standard petroleum jelly.
Diaper Rash Treatment and Remedies
Because diaper rash can have many causes or may even be mistaken for other skin problems, it’s always important to have your child evaluated by your healthcare provider to confirm a diagnosis and to provide specific treatment advice.
Here are some general tips that may help treat a common type of diaper rash.
- Baking soda tub baths seem to help my children. I put about 2 tablespoons of baking soda in a tub of warm water and let my son sit in it for a few minutes after a diaper change, especially when it starts to get moderate or severe. This helps remove any coatings of stool on the bottom. I then allow his bottom to dry completely, add ointments or creams, and apply a new diaper.
- Use a warm, damp cloth to clean the child’s bottom during baths or diaper changes. While unscented wipes are fine when the baby’s bottom is healthy, you’ll want to switch to warm water and a soft cloth when diaper rash develops. Avoid scrubbing or causing friction as you clean, and instead use a soft dabbing motion.
- Allow their bottom to dry before placing a new diaper. I use a hair dryer (cool setting only) after changing their diaper to help the skin dry quickly, but make sure it is on fan mode or low heat to avoid burning their skin (and keep it out of their reach for safety reasons). You can also fan their bottom dry with the new diaper for a minute or so to dry it. In severe cases, you might want to leave their diaper off for an hour or so. When my eldest son had severe diaper rash from a G.I. illness, he wasn’t potty trained, so I put him on an inflatable mattress that was easy to clean as he dried off. Alternatively, I’d place him on towels for hours at a time to help his skin dry.
- Use A&D Ointment. Once the skin has had a chance to dry, I gently apply A&D diaper rash ointment over the rash with a cotton swap to help keep out moisture. Again, this has worked better than standard petroleum jelly.
- Use Creams with 40% Zinc Oxide. I also apply Desitin, Aquaphor, or even the store-brand diaper rash cream containing zinc oxide. However, it’s important to make sure you select a cream with the higher concentration of zinc oxide (40%) if your child has an existing case of moderate to severe diaper rash, as it offers the best protection. I sometimes apply this alone, or I might apply A&D first and then apply a generous amount of the zinc oxide cream over it. I sometimes alternate cream or ointment every other diaper change, but I often apply both ointment and cream when the rash becomes moderate or severe.
- Place a new diaper once you have applied the cream and/or ointment. Be sure to change the diaper regularly to keep the skin dry so that it can heal.
- Let it air out! I like to take my youngest son outside to play in our yard in a long shirt only (no diaper or underwear) so that his bottom can air out while also keeping his private area covered. The idea is to try to let the skin air out and to keep them in an area that would be easy to clean up in case they use the bathroom on themselves.
How Long Does it Take for Diaper Rash to Clear Up?
Following the regimen I described above, my child’s diaper rash would often show signs of improvement by the end of the next day. Within 2-3 days, a moderate diaper rash was usually gone.
In cases of severe diaper rash (with bleeding/scabs), it could take as long as a week or so to heal back to normal.
However, if your child’s diaper rash does not improve, continues to worsen, or keeps recurring, consult with your healthcare provider as soon as possible.