Key points to remember about nappy rash

• it can be common for babies to develop red angry skin in the nappy area, especially in older babies who sleep through the night without a nappy change
• disposable nappies now make nappy rash less common
• if it occurs it can be treated effectively
• it is better to try to prevent the rash developing
• keep your baby's skin as dry as possible
• give your baby some nappy-free time
• rinse nappies well
• use protective creams and ointments
• if the rash does not clear, see your doctor

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What causes nappy rash?

Wetness from urine and faeces

Wetness is the main cause of nappy rash. The longer the nappy is wet or dirty the higher the risk.

 

Thrush

Thrush is an infection which thrives in warm moist areas. It is almost always present in significant nappy rashes and can occur on top of other rashes. It can be treated effectively with cream.

 

Chemical irritation

• wee (urine) and poo (faeces) contain irritating substances which may lead to a rash if they are in contact with the skin for too long
• too much soap can irritate the skin and dry it out
• detergents and soaking solutions can irritate if they remain in the cloth nappy - wash and rinse nappies well

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How can nappy rash be prevented?

• change nappies as soon as possible after they become wet or soiled and preferably once during the night
• clean your baby with good quality baby wipes or warm water and a cloth
• let your baby have some 'nappy free' time daily, though not in the sun
• avoid using plastic pants
• wash and rinse all cloth nappies thoroughly
• after each nappy change, apply a thin layer of protective cream to your baby's skin; for example, zinc and castor oil
• try good quality disposable nappies

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What to do if a rash develops

See your family doctor if a rash develops and lasts for more than a few days. It may mean that there is an underlying skin infection present such as thrush or a bacterial infection. Thrush is a fungal infection, which thrives in warm moist areas. It is almost always present in significant nappy rashes and can occur on top of other rashes.

 

Your doctor will usually prescribe a cream to treat the infection.

 

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What about difficult to treat nappy rash?

When a nappy rash is difficult to treat, it may indicate that there is an underlying skin condition such as seborrhoeic dermatitis or psoriasis. This needs to be diagnosed and treated by a doctor.

 

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Acknowledgements

Starship Foundation and the Paediatric Society of New Zealand acknowledge the co-operation of The Children's Hospital at Westmead, Sydney Children's Hospital at Randwick, and Kaleidoscope - Hunter Children's Health Network in making this fact sheet available to patients and families.

 

The nappy rash image on this page has been reproduced, with permission, from the website of the New Zealand Dermatological Society Incorporated. Published online at: http://www.dermnetnz.org.

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Endorsement

This fact sheet was endorsed by PSNZ - 22/11/2007

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Fact sheets are subject to copyright. In the interests of information sharing they may be copied but acknowledgement must be given to PSNZ and Starship Foundation.
© The Paediatric Society of New Zealand and Starship Foundation 2005 - 2010

The Paediatric Society of New Zealand http://www.paediatrics.org.nz

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