Nappy rash

Causes of nappy rash

Many things can combine to cause nappy rash in your child.

The main cause is wearing a wet or dirty nappy for too long. Prolonged dampness, friction and ammonia substances released from wee can irritate your child’s skin.

Plastic pants often make nappy rash worse because they stop air circulating normally and keep the nappy area damp.

Soaps and detergents left on cloth nappies after washing can also contribute to nappy rash.

Sometimes children also have other conditions like eczema, psoriasis, thrush or impetigo, which might make nappy rash worse.

Symptoms of nappy rash

The skin on your child’s bottom will look red and sore. Some areas of skin might be raised or swollen, and there might be breaks in the skin. These breaks are called ulcers.

The rash can cause discomfort and pain, which can make your baby irritable.

When to see a doctor about nappy rash

You should take your child to the GP if:

• the rash hasn’t improved after one week, even when you use the treatment steps below
• blisters, crusts or pimples appear
• your child is upset and isn’t sleeping
• your child has an unexplained fever
• the rash is spreading
• the end of your son’s penis is red and swollen, or has a scab on it.

Nappy rash treatment

Simple measures are often the best. Nappy rash will usually get better or go away within a few days of taking the following steps.

Change your baby’s nappies frequently 
Frequent nappy changes keep the nappy area dry and give your child’s skin a chance to heal. Check your child every hour or so to see whether his nappy is wet or soiled. Change wet or soiled nappies straight away. Disposable nappies are better for nappy rash because they absorb more moisture.

Let your baby’s bottom ‘air’ 
Give your baby’s bottom some air for as long as possible every day. You can leave baby lying on an open nappy or a towel (naked from the waist down) even while she’s sleeping. You can also try fastening her nappy loosely, to allow air to circulate freely.

Clean your baby’s skin 
Use lukewarm water and cotton wool or a light cotton cloth to gently wash your baby’s skin after each nappy change.

Avoid using disposable wipes because they can irritate your baby’s skin, and some babies might be allergic to the preservatives in them.

When you bath your baby, use a gentle, soap-free wash and avoid soaps or bubble baths. After bathing, pat your baby’s skin dry and apply a simple moisturiser.

Use an appropriate protective cream after each nappy change 
Apply a simple, cheap barrier cream with every nappy change. Barrier creams include zinc and castor oil or Vaseline. You can get these creams from a supermarket or your pharmacy without a prescription. Put the cream on thickly to stop wee or poo touching your baby’s skin. If you’re putting it on thickly enough, you’ll still be able to see some of the cream at the next nappy change.

Talcum-based powders aren’t recommended for nappy rash. If a baby accidentally breathes in a puff of talcum powder, it can cause breathing difficulties.

Medications 
For severe nappy rash or nappy rash that won’t go away with simple measures, your doctor might recommend using corticosteroid creams or ointments like hydrocortisone 1%. The doctor might also recommend ointments containing also antibacterial and antifungal drugs. 

Nappy rash prevention

Always keep your child’s nappy area clean and dry. Change your child’s nappy frequently and give his bottom air as often as you can.

Protective barrier creams like Vaseline or zinc and castor oil can help keep your child’s skin in good condition.