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Diaper Rash: A Pain in the Butt

Diaper Rash: A Pain in the Butt

Diaper rash is most common in the first 2 years of life, but it can occur in a person of any age who routinely wears a diaper. The skin’s major function is to serve as a barrier to germs. Diaper rash occurs when the skin’s barrier is disrupted:

·         Excessive moisture in the diaper area leads to skin softening and breakdown

·         Friction further damages the skin’s outer layer (diapers, repeated wiping, product application)

·         The altered skin barrier allows the penetration of chemical irritants and microorganisms, such as bacteria and yeast


·         Most common among babies 8 to 10 months old

·         When babies are not kept clean and dry

·         When babies have diarrhea

·         When babies start to eat solid food (due to changes in the digestive process caused by new foods)

·         When babies take antibiotics (these medications encourage the growth of yeast)



·         Redness, bumps, or irritation in the area covered by the diaper

·         This type of diaper rash usually clears in three or four days with appropriate care

·         Good diapering practices (see below)

Yeast infection

·         Appear as a rash on the thighs, genitals, and lower abdomen (especially in the creases), but rarely on the buttocks

·         Diaper rash persisting greater than 3 days is frequently associated with yeast

·         Treated with topical anti-fungal medication, followed by the application of barrier creams

Bacterial infection

·         Symptoms include pus from draining wounds, fever, and a rash that does not go away after treatment or worsens. Another sign is if your baby is in pain or is hard to console

·         Have your baby seen by a medical professional


·         Produces a rash within 12 to 24 hours after exposure to the offending agent

·         Eliminate potential irritants by using commercial cleansing wipes or water on cotton cloth. Consider changing brand of disposal diapers. Use products with minimal additives (dyes, fragrances)

 Good Diapering Practices

·         Diapers should be changed as soon as they are soiled. Inspect for soiling every 2 hours. They should be changed more frequently in newborns or in a child with diarrhea

·         Be gentle when cleaning the diaper area. Use water and a soft washcloth or baby wipes that are alcohol and fragrance-free. If the rash is severe, use a squirt bottle of water to clean the area

·         With each diaper change, a barrier should be applied to protect the skin from irritants (urine and feces). A barrier with minimal ingredients is preferred

·         A paste barrier (such as zinc oxide) is preferred if diarrhea is present. If your baby has severe diaper rash, layer it on like you are frosting a cake. There is no need to remove the cream with each diaper change. It can be fully removed at the end of the day

·         Allow for diaper-free time whenever practical. Avoid use of plastic underpants over the diaper

·         Use a commercial cleansing wipe or water on cotton cloth to cleanse the diaper area

·         Rashes lasting longer than 14 days should be evaluated by a medical professional

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