Nappy rash
Simple nappy rash
Simple nappy rash is a type of contact dermatitis, usually due to the skin’s sensitivity to urine and faeces. It is characterised by a red, burn-like rash inside the nappy area. The skin is slightly rough, red and scaly, and the skin folds in the groin and thigh are not usually affected.
Simple, uncomplicated nappy rash may clear up using normal nappy hygiene measures and a moisturising or barrier cream, while severe rash may require a low-potency steroid cream — your doctor can advise you on this.
Fungal nappy rash
If a fungal thrush infection is present, the rash is usually bright red and shiny with sharply outlined patches, often with small white pustules or spots around the edge of the nappy areas. The groin and thigh folds may also be red, with the rash radiating from the skin folds, and the skin feels coarse. Treatment with an antifungal cream may be necessary.
Infected nappy rash
Sometimes bacteria can infect skin damaged by simple nappy rash. The skin becomes red (sometimes with red streaks), swollen and sore, and there may be a discharge of pus. Treatment with antibiotics may be necessary.
When should you seek medical advice?
You should seek medical advice if the:
- rash extends beyond the nappy area;
- rash has pus and is weeping, or there are little vesicles (small blisters containing clear fluid);
- redness is particularly severe;
- baby seems significantly distressed;
- nappy rash has not responded to previous treatment or has spread; or
- thrush infection is in other places, such as the mouth or mother’s nipples.
What can you do?
You can help by:
- changing the nappies frequently;
- having nappy-free times so that the skin is exposed to air;
- rinsing cloth nappies extensively;
- avoiding commercial baby wipes and using a ‘pH neutral’ soap or cleanser — normal soaps are alkaline and may irritate the area;
- using an emollient / barrier cream, such as a cream containing zinc oxide or dimethicone, at each nappy change;
- using highly-absorbent disposable nappies at night;
- avoiding tight-fitting, plastic over-pants; and
- checking that your child is not allergic to lanolin or silicone.
Last Reviewed: 27 May 2009
