What is diaper rash?
Diaper rash, sometimes known as ‘nappy rash’, is the most common skin condition among young infants, affecting one in every four babies. Also known as irritant diaper dermatitis, it is a form of dermatitis that is marked by patches of inflamed skin on the things, genitals and buttocks.
How common is diaper rash?
Seeing your baby experience diaper rash can be distressing for any parent. However, it’s important to remember from the outset that this condition is very common among young infants.
The severity of diaper rash and its frequency has decreased somewhat since the introduction of super-absorbent disposable diapers, and skin care products that are less likely to cause allergic reactions. That said, it is still estimated that diaper rash affects up to 25% of diaper-wearing infants at any given time, and can affect babies of all ages.
The unique structure of babies’ skin
The skin of infants and young babies is unique compared to that of older children and adults in terms of structure, composition, and function.
The top layer of skin in babies is 20% thinner and the outermost skin layer is 30% thinner, which increases dryness. However, in contrast to adults, infant skin has a higher growth rate, which means their skin heals faster.
Baby skin is more likely naturally to lose water from inside the body through the epidermis and reduce hydration of the top layer of the epidermis. As the ratio between a baby's body surface to baby's body weight is higher, substances like creams are more easily absorbed and can affect a baby skin’s more heavily.
The skin of the diaper area features several folds and creases, presenting challenges in terms of keeping the area clean. This means it’s important to have the right diaper-changing routine, skincare materials and techniques to ensure your baby’s skin is as well taken care of as possible.
Diaper rash: Symptoms and causes
Symptoms of diaper rash can be categorized as mild, moderate, or severe, with mild presenting as slightly red, irritated skin in the diaper area. More severe cases could see skin become raw, bleed, and/or present with open sores.
The good news is that diaper rash is usually mild and can often be dealt with at home.
Symptoms of diaper rash
Common signs to watch out for include:
Inflamed skin in the area the diaper covers, such as the buttocks, genitals and thighs
Tender, itchy skin in the same areas
Open sores
Crying, fussiness, or signs of discomfort during a diaper change
Causes of diaper rash
Diaper rash can be down to various things, including – in some cases – a diaper allergy (more on this later). Some common causes are:
Not changing diapers frequently enough – when a baby sits in a diaper that is soiled or wet for any amount of time, this can start to irritate the skin. Be sure to change your baby’s diaper as often as required to reduce the risk of getting diaper rash.
Tight-fitting diapers – these can chafe or rub at the skin, which can cause irritation.
Reactions to products – using a new product could cause a reaction. Check the ingredients in your wet wipes, lotions, oils, and powders, and your bleach, detergent, and fabric softener if using cloth diapers.
Yeast or bacterial infections – Diapers naturally lock in warmth and moisture, which makes the area underneath a breeding ground for bacteria. This means a simple infection can easily spread. Look for rashes in the creases of the skin to determine whether it could be a yeast or bacterial infection.
Sensitive skin – some babies will naturally have more sensitive skin than others, which can make them prone to getting diaper rash. This may mean you see rashes in areas other than that covered by the diaper as well.
Weaning – introducing new foods changes the content and frequency of stools, which can lead to diaper rash.
Antibiotics – these kill the bacteria that keep yeast in check, which can cause diaper rash. This can occur if a breastfeeding mother is taking antibiotics as well as if the baby is taking them. Antibiotics can also cause diarrhea, which can increase the risk of diaper rash.
Fast facts
It is not unusual for every child to have at least one episode of diaper rash by the time they are toilet-trained.
It is often during teething or weaning that a baby can become more prone to diaper rash.
When the skin becomes moistened, it is especially vulnerable to chafing due to friction from the diaper.
Age, formula feeding, and other factors may affect the chances of having a rash.
Lack of barrier cream use, frequency of diaper changes and previous episodes of diaper rash can also play a part.
Antibiotic use and diarrhea are also considered risk factors in the development of diaper rash.
Diaper allergy
Diaper allergies are less common than diaper rash, although they may present with some or all of the same symptoms. These can be caused by an allergy to something in the diaper, such as one of the materials or dyes.
Signs that may indicate contact dermatitis include skin in the diaper area that is red, itchy or scaly. Areas of the skin that are regularly in contact with the irritant can become sensitive. Preservatives in some baby wipes can also cause an allergic reaction.
Symptoms similar to diaper rash can also arise from an allergy to certain detergents, wet wipes, soaps, lotions, fabric softeners, or fragrances within these things. Skin conditions such as eczema or psoriasis can cause or be mistaken for diaper rash too. If your baby has a rash that does not go away after a few days, you should take them for a check-up with their doctor.
How to cure diaper rash
If you are ever worried about diaper rash and want to know how to ‘fix’ it, nurses and doctors are available and you can consult a medical professional for help. But there are a few things you can do to try and treat and cure diaper rash yourself:
Looking after the diaper area
Gentle and effective cleansing of the diaper area can halt the diaper rash cycle in babies by restoring better skin moisture levels and eliminating irritants.
NICE has set out a few key steps in managing diaper rash, for parents and caregivers to follow:
Air the skin- Leave diapers off for as long as possible to help skin drying of the diaper area
Change diapers frequently - Clean the skin and change the diaper every 3–4 hours, or as soon as possible after wetting or soiling, to reduce skin exposure to urine and faeces. Use water, or fragrance-free and alcohol-free baby wipes to protect the skin barrier.25 Apply a barrier cream (type and application depends on the severity of symptoms).
Not necessary to bathe daily - Avoid excessive bathing (such as more than twice a day) which may dry the skin excessively. Pat dry after cleaning. Avoid soap, bubble baths, lotions, talcum powder, or topical antibiotics which can have an irritant effect and destabilize the skin's pH.26 If the diaper rash does not resolve after following these steps, a referral to a doctor should be considered.
Practicing good hygiene is also important
Try to make sure that you are:
Washing hands before and after each diaper change to prevent contamination
Wiping from the front to the back
Keeping babies’ hands clean, relating to their hand-to-mouth behaviours, can help reduce or prevent oral transmission of pathogens. Parents should pay particular attention to the skin on the facial area, which may be irritated easily by milk, food, and saliva
The best wipes for diaper rash
Cloth wipes or cotton wool and water have traditionally been considered the gold standard for cleaning a baby’s diaper area.
However, recent studies have consistently demonstrated across a range of clinical settings how some baby wipes provide effective cleaning while also being tolerable and mild, supporting their use even on delicate neonatal skin. Additionally, parents reported that baby wipes were more convenient to use than cotton wool and water.
The best wipes for diaper rash are those that are water-based, as recommended by experts. Choose wipes that contain no fragrance or alcohol to reduce the risk of causing further irritation. WaterWipes® contain only a drop of fruit extract and are otherwise 99.9% water.
WaterWipes® are gentle on the most sensitive skin
WaterWipes® are so gentle on the skin and can be used on premature babies. 96% of Dermatologists agree that WaterWipes® are the #1 wipe choice for sensitive skin*.
*Source: 272 dermatologists at AAD, USA, 2024
WaterWipes® are recommended by nurses and other healthcare professionals worldwide and have become the preferred wipe in some NICUs throughout the world.
What to do for severe diaper rash
For severe diaper rash, which can be defined as a rash that does not get better after a few days, you may want to consult your doctor. You should always let your baby’s doctor know if:
The rash does not respond to treatment within two to three days
The rash continues to get worse despite treatment
Your baby seems sluggish or develops a fever
The rash is swollen with white scales
You notice excessive redness in the creases of the skin
There are small red pimples outside of the area covered by the diaper
There are honey-colored crusty areas
There are yellow bumps (pustules) filled with fluid
There are several options your doctor may consider, depending on the type and severity of the rash.
If the rash continues to recur after treatment, your doctor may refer your baby to a skincare specialist called a dermatologist for a more in-depth look at further treatments.
Diaper rash FAQs
What can be mistaken for diaper rash?
Conditions such as seborrheic dermatitis and pediatric psoriasis can start as diaper rash or present with similar symptoms. Certain allergy reactions can also present as diaper rash. Meanwhile, there are genetic conditions such as acrodermatitis enteropathica that can be mistaken for diaper rash. If you’re unsure, visit your baby’s doctor.
Are baths good or bad for diaper rash?
A daily bath can help soothe diaper rash and relieve the symptoms. Use warm water and soap that is mild and fragrance-free to avoid causing further irritation.
Can wipes cause diaper rash?
Studies have shown that wipes do not cause diaper rash themselves. However, some fragrances and preservatives in certain wipes can be allergens, which can lead to diaper rash. For the best results, choose fragrance-free, water-based wipes.
How we wrote this guide
The information in this article is based on expert advice found in trusted medical and government sources such as the Healthline, WebMD and Mayo Clinic. You can find a full list of sources used for this article below. The content on this page should not replace professional medical advice. Always consult medical professionals for full diagnosis and treatment.
