Diaper Rash (Diaper Dermatitis)
Why does my baby have a diaper rash?
Diaper rash (or diaper dermatitis) is a rash caused by irritants (specifically, urine and poo). Our urine and poo are not meant to be sitting on our skin, and diapers do a good job of trying to absorb our waste and minimize irritation, but sometimes diapers stay on too long or we eat foods that make our waste more acidic.
NOTE: Adults who need diapers get diaper rash for the same reasons. This page applies just as well to anyone (old and young) who gets diaper rash.
HOW DO I prevent diaper rash?
Moisturize EVERY DAY, at least morning and night.
Thick, greasy ointments like Vaseline or Aquaphor work best, it helps the skin stay healthy and strong as a barrier from the world.
Creams are the next best option. My strong preference is either CeraVe cream or Vanicream cream.
NOTE: Lotions have more alcohol in them, which can dry your skin even more. To prevent or help with dry skin, use an ointment or cream, not a lotion.
Change diapers frequently.
The irritants in urine or poo are very irritating to the skin. Change diapers as soon as possible after they get wet or poopy.
Use more absorbent diapers.
Not all diapers are the same. I have 6 kids, and we have gone through about every brand with them. Some hold urine better, some are better at preventing “blowouts.” Some are better at absorbing urine and poo and protecting the skin.
My favorites are Huggies Snug & Dry, Pampers Baby Dry, and Luvs Pro Level (these are not as amazing, but far cheaper).
Go fragrance-free if your baby has sensitive skin.
Fragrance is one of the most common skin irritants.
Use only fragrance-free washes, shampoos, and moisturizers.
Switch your household laundry detergent, fabric softener, and/or dryer sheets to fragrance-free for 1 month - if it helps, stick with it.
HOW DO I TREAT diaper rash?
Be sensitive with wiping.
Wet wipes have a lot of preservatives to keep them from growing mold and bacteria. Preservatives can irritate diaper rash.
Ideally, only a damp washcloth would be used for wiping.
If disposable wipes are needed, use a very sensitive one (or Huggies or WaterWipes).
Use steroid (cortisone) ointments.
Nothing works better to calm down the redness and irritation of diaper rash than steroids.
An over-the-counter hydrocortisone ointment works best (instead of cream). Apply a thin layer of hydrocortisone ointment twice daily to the diaper rash. This is safe for bottoms of all ages until the rash clears.
WARNING: Overuse of topical steroids like hydrocortisone can cause skin thinning, stretch marks, and easy bleeding or bruising.
Cover the rash with barrier cream.
Apply a 40% zinc barrier cream after rubbing in the hydrocortisone. This is much better than the 10% zinc barrier cream.
NOTE: 40% zinc is very thick. Hard to get out of the tube and hard to get off your fingers. BUT it is also very good at protecting bottoms until they heal up. I usually have to wipe the zinc cream off my finger using the new clean diaper AND wash my hands.
ADDITIONAL TIPS AND TRICKS FOR diaper rash:
These tips are not universally helpful for every diaper rash, but when the above steps are not enough, here are a few more things to try.
Vinegar soaks: These are immensely helpful for any scratched, broken, or damaged skin. Safe for all ages. See my page on Vinegar Soaks.
Go fragrance-free while treating a diaper rash.
Fragrance is one of the most common skin irritants.
Use only fragrance-free washes, shampoos, and moisturizers.
Switch your household laundry detergent, fabric softener, and/or dryer sheets until the rash improves - if it helps, stick with it.
Diaper rash makes it easier to get a yeast infection.
Apply antifungal cream or Manuka honey twice daily to any red bumps or broken skin.
I recommend miconazole or clotrimazole.
Bleach baths: You are essentially turning your bath into a chlorinated swimming pool - this not only helps minimize bacterial/fungal overgrowth on irritated skin, but bleach baths can really reduce discomfort. It is safe for all ages and skin types.
What if the diaper rash isn’t getting better?
Usually, the steps above clear diaper rashes. But sometimes other rashes happen in the diaper area that look like diaper rash but are not. Other times, a diaper rash is too severe and needs prescription topical and sometimes oral medications. Look for a board-certified dermatologist in your area. If you are in or near Utah, see one of my excellent colleagues at the University of Utah or me virtually with Honeydew.
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