Diaper Rash

Diagnosis

Diaper rash is usually diagnosed by looking at the baby’s skin and asking about recent diapering, feeding and cleaning habits. A health care provider will check the rash’s appearance — whether it’s just in the diaper area, involves skin folds, has blisters or pus, or looks like bright red patches with defined edges — and ask about symptoms such as fussiness, fever, or poor feeding.
If the rash looks unusual, is severe, or isn’t improving with home care, the provider may consider whether a yeast (fungal) infection, bacterial infection, eczema, or another skin condition is present and may take a swab or sample or recommend further evaluation.

Treatment

The goal of treatment is to keep the skin clean and dry, protect it from irritants, treat any infection when present, and relieve discomfort.

Home care and first-line measures

• Change diapers frequently to minimize wetness and irritation.

• Clean gently at each change using warm water or fragrance-free wipes; avoid scrubbing.

• Pat the area dry or let it air-dry briefly before putting on a fresh diaper.

• Apply a barrier ointment or paste (zinc oxide or petroleum jelly) at each change to protect skin from moisture.

• Give diaper-free time when possible to increase airflow and speed healing.

When to use over-the-counter products

• Use a thick zinc-oxide or petrolatum-based cream as a protective barrier after cleaning and drying.

• If irritation is mild, these measures plus frequent diaper changes are usually enough and improvement is expected in a few days.

Prescription treatments your doctor may recommend

• Mild hydrocortisone cream (0.5%–1%) twice daily for 3–5 days for severe inflammatory irritation (use only as directed by the provider).

• Topical antifungal cream (for example, for candidal/yeast rash) applied twice daily when a fungal infection is suspected.

• Oral antibiotics only if a bacterial infection is diagnosed and systemic therapy is warranted.

• Referral to a dermatologist if the rash persists despite appropriate treatment or is atypical.

How long it takes to improve

• Many diaper rashes start improving within a few days with good home care.

• Persistent or recurrent rashes may need targeted prescription therapy and follow-up.

Self-care tips and prevention

• Use super-absorbent disposable diapers or change cloth diapers more frequently.

• Avoid wipes with alcohol or fragrance; plain water or mild, fragrance-free wipes are preferred.

• Avoid powders that may irritate or be inhaled.

• If switching products (diaper brand, wipes, laundry detergent), change one item at a time to spot the trigger.

• For breastfed infants with recurrent candidal rash consider maternal factors (recent antibiotics, diet changes) and discuss with the pediatrician.

Alternative or home remedies (use with caution)

• Some caregivers try breast milk, aloe, or zinc-cod liver oil creams; evidence is mixed and some natural products may promote infection if not used properly.

• Always check with your child’s provider before trying home remedies, especially on broken skin.

When to contact a health care professional

Contact the doctor if any of the following occur:

• Rash worsens or does not improve after 5–7 days of appropriate home care.

• The rash spreads beyond the diaper area or involves deep cracks, blisters, or open sores.

• The baby has a fever, appears unusually irritable, or won’t feed.

• You suspect a yeast infection (bright red rash with satellite bumps) or a secondary bacterial infection (yellow crusting, oozing, or rapidly worsening redness).

Preparing for an appointment

• Note when the rash began and what you’ve already tried (products, ointments, frequency of diaper changes).

• List all products that contact the baby’s skin (diaper brand, wipes, soaps, detergents, lotions).

• Be ready to describe feeding (breast or bottle), recent antibiotics for baby or nursing mother, and any new foods introduced.