Diaper Rash: Prevention, Treatment, and When to Worry

At some point, almost every baby gets diaper rash. You'll change a diaper and find red, irritated skin staring back at you. It can range from a few pink patches to angry, raw-looking areas that make your baby cry during diaper changes.

The good news? Most diaper rash is easily prevented and treated at home. This guide will help you understand what you're dealing with, how to fix it, and when you need extra help.

What Causes Diaper Rash?

The diaper area is basically a perfect storm for skin irritation: warm, moist, enclosed, and regularly exposed to irritants. Here's what's happening: AAP

Moisture:

• Wet diapers keep skin damp
• Prolonged wetness weakens skin's protective barrier
• Makes skin more vulnerable to friction and irritants

Irritants:

• Urine and stool contain chemicals that irritate skin
• Digestive enzymes in stool are especially irritating
• Diarrhea makes rashes worse quickly

Friction:

• Diaper rubbing against skin
• Worse in creases and folds
• Tight diapers increase friction

Reactions:

• New diaper brand, wipes, or detergent
• Lotions, powders, or creams
• New foods (can change stool composition)

Infection:

• Yeast (Candida) thrives in warm, moist areas
• Bacteria can enter broken skin
• These require different treatment than regular rash

Types of Diaper Rash

Not all diaper rash is the same. Identifying the type helps you treat it correctly: AAP

Irritant dermatitis (most common):

• Red, irritated patches where diaper contacts skin
• Usually spares creases and folds
• Caused by wetness and irritants
• Responds well to basic treatment

Yeast (Candida) diaper rash:

• Bright red rash, often in creases
• May have satellite spots (small red dots around main rash)
• May look "beefy" red
• Often appears after antibiotic use
• Doesn't improve with standard diaper cream
• Requires antifungal treatment

Bacterial infection:

• May have yellow crusting or oozing
• Bright red with well-defined borders
• May have blisters or pustules
• Requires antibiotic treatment

Allergic reaction:

• Red, inflamed wherever product contacted skin
• Appears after using new wipes, diapers, or products
• Resolves when product is eliminated

Seborrheic dermatitis:

• Yellow, greasy scales
• Often in creases
• May have cradle cap on scalp too
• Different treatment approach

Prevention: Your Best Defense

Most diaper rash can be prevented with consistent care: AAP

Change diapers frequently:

• Every 2-3 hours during the day
• As soon as possible after bowel movements
• Don't let baby sit in wet or dirty diapers

Clean gently:

• Use warm water and soft cloth, or gentle, fragrance-free wipes
• Pat dry—don't rub
• Let skin fully dry before putting on new diaper

Use barrier cream:

• Apply a thin layer of barrier cream at every change
• Zinc oxide and petroleum jelly work well
• Creates protective layer between skin and irritants
• Don't need to remove completely at each change—just wipe stool and add more

Proper diaper fit:

• Not too tight (increases friction)
• Not too loose (causes chafing)
• Make sure elastic doesn't dig into skin

Air time:

• Let baby go diaper-free when possible
• Even a few minutes during changes helps
• Lay baby on waterproof pad during diaper-free time

Watch for sensitivity:

• If rash appears after changing products, return to old brand
• Fragrance-free everything when possible
• Consider fragrance-free laundry detergent for cloth diapers

Home Treatment for Basic Diaper Rash

When rash appears, intensify your preventive efforts: AAP

Step 1: Change even more frequently

• Every 1-2 hours, or immediately when wet/dirty
• Nighttime changes may be needed too

Step 2: Gentle cleansing

• Warm water is gentler than wipes during active rash
• If using wipes, choose alcohol-free, fragrance-free
• Don't rub—dab gently

Step 3: Dry thoroughly

• Pat completely dry
• Consider letting air dry for a minute or two
• Don't put diaper on damp skin

Step 4: Apply barrier cream generously

• Thick layer of zinc oxide cream (Desitin, Balmex) or petroleum jelly
• Cover entire affected area
• Apply at every single change
• You want it thick—like frosting

Step 5: Maximize air exposure

• Diaper-free time several times daily
• Even during diaper changes, wait a minute before covering
• At night, consider sizing up in diapers for better airflow

What to expect:

• Mild rash: Improvement in 2-3 days
• Moderate rash: May take 5-7 days
• Should steadily improve, not worsen

Treating Yeast Diaper Rash

If standard treatment isn't working after 3 days, or the rash has the telltale signs of yeast (bright red, in creases, satellite spots), you likely need antifungal treatment: AAP

Over-the-counter antifungals:

• Clotrimazole (Lotrimin)
• Miconazole (Monistat)
• Apply thin layer before barrier cream
• Continue for 2 weeks even after rash looks better

Application method:
1. Clean and dry the area
2. Apply thin layer of antifungal cream
3. Let dry briefly
4. Apply thick layer of barrier cream on top
5. Put on diaper

When to see the doctor:

• If you're unsure whether it's yeast
• If OTC antifungals aren't helping after a week
• Baby may need prescription-strength treatment

Prevention of yeast rash:

• Especially important after antibiotics
• Probiotics may help (ask pediatrician)
• Keep area dry and well-protected

When to Call the Doctor

Most diaper rash doesn't need medical attention, but contact your pediatrician if: AAP

The rash:

• Doesn't improve after 3-4 days of home treatment
• Gets worse despite treatment
• Has blisters, pustules, or open sores
• Has yellow crusting or pus (sign of bacterial infection)
• Spreads beyond the diaper area
• Is very painful or bleeding

Your baby:

• Has fever along with the rash
• Is unusually fussy or crying
• Is eating less or seems unwell
• Is under 6 weeks old with any significant rash

You notice:

• The rash appeared suddenly after a new product
• Rash seems related to diarrhea or antibiotic use
• It looks different from typical diaper rash

Diaper Rash During Diarrhea

Diarrhea creates the perfect conditions for severe diaper rash. The frequent, acidic stools irritate skin quickly. AAP

Extra protection measures:

• Change immediately after every stool
• Apply very thick layer of barrier cream
• Consider a protective paste (like Triple Paste or zinc oxide paste)
• Wipe very gently—stool on irritated skin is painful

Healing during diarrhea:

• Rash may not fully heal until diarrhea resolves
• Focus on preventing it from getting worse
• Liberal barrier cream is your best tool

Diaper Rash and Starting Solids

Many babies develop diaper rash when starting solid foods. This is because: AAP

• New foods change stool composition
• Acidic foods (citrus, tomatoes) can irritate
• Increased stool frequency
• Different digestive enzymes in stool

What helps:

• Introduce new foods slowly
• Note which foods seem to trigger rashes
• Increase barrier cream use when trying new foods
• Don't eliminate foods unless there's a clear pattern

Cloth Diapers and Diaper Rash

Cloth diapers aren't necessarily better or worse for diaper rash—proper care matters most: AAP

Advantages:

• No chemicals or fragrances to react to
• May be changed more frequently (easier to tell when wet)
• Breathable fabrics

Challenges:

• Must be changed promptly (no stay-dry layer)
• Detergent residue can irritate
• Need proper washing to remove all bacteria

Tips for cloth diapering:

• Change frequently
• Use fragrance-free detergent
• Run extra rinse cycle
• Use cloth-safe barrier cream (some can cause repelling)
• Consider disposables during active rash for easier treatment

Products That Actually Help

Effective barrier creams: AAP

• Zinc oxide (40% concentration best): Desitin Maximum Strength, Boudreaux's Butt Paste
• Petroleum jelly: Plain Vaseline, Aquaphor
• Combination products: Triple Paste, A+D ointment

What about cornstarch or powder?

• Powder can clump in creases and irritate
• Cornstarch may feed yeast
• Generally not recommended
• If you use powder, keep away from baby's face (inhalation risk)

Natural options:

• Coconut oil has some antifungal properties
• May work for mild rash
• Use what works for your baby

The Bottom Line

Diaper rash is an almost universal experience, but with good prevention and prompt treatment, it doesn't have to be a major issue:

Prevention:

• Change diapers frequently
• Keep skin clean and dry
• Use barrier cream at every change
• Give air time when possible

Treatment:

• Change even more frequently
• Thick barrier cream application
• Maximum air exposure
• Look for signs of yeast

See the doctor if:

• Not improving after 3-4 days
• Signs of infection (pus, blisters, fever)
• Spreading beyond diaper area
• Your baby seems unwell

Your baby's bottom will thank you, and Clara is here for any other questions about keeping your little one comfortable.