Diaper Rash: Causes, Prevention & Treatment Options

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Almost every baby will have a case of diaper rash before the age of three. Diaper rash typically begins as a red, irritated rash in the diaper area. Diaper rash causes include irritation, wet diapers left on too long, too many poops, loose poops (from sickness or from taking antibiotics), and diapers that are too tight and small. If the early diaper rash phase is left untreated, then the diaper rash can progress and result in an overgrowth of yeast that appears as satellite red bumps and pustules surrounding a juicy red rash.  Read on for information about what causes diaper rash, how to prevent diaper rash, and how to treat diaper rash.

What is Diaper Rash?

There is a range of diaper rash, and it can show up very quickly or rather gradually. Typically diaper rash will start off appearing as a bright red patch in the area the diaper covers. If this phase goes untreated, the diaper rash can progress and this results in an overgrowth of yeast and it becomes a red rash with smaller patches of red bumps and pustules.

What Causes Diaper Rash?

1. Irritation from stool and urine

• Your baby’s skin is more sensitive than adult skin, so prolonged exposure to pee and poop can irritate it. Infrequent wet diaper changes, tight diapers that are too small, or episodes of diarrhea are a few diaper rash causes.

2. Changes in the diet

• Diaper rash is most common when a baby starts to eat solid food.  A change in diet commonly results in stool changes, and this can be more irritating to a baby’s skin.

3. Use of antibiotics

• Antibiotics kill both good and bad bacteria, so when a baby is taking antibiotics, the amount of good bacteria in his gastrointestinal system changes.  This good bacteria has many functions, one of which is regulating yeast (or what doctors call Candida) growth. When the good bacteria is altered, thanks to antibiotics, diaper rash can occur.

4. Chafing

• Tightfitting diapers or clothing that rubs against the skin can lead to a rash just by irritation. A similar comparison would be that of a tight wet swimsuit

5. Candidiasis

• A secondary yeast (fungal) infection. When the diaper rash starts simply as a red, irritating inflammation (also known as dermatitis), you want to act quickly because untreated dermatitis is the perfect environment for secondary yeast to grow. Picture this — the area covered by a diaper is especially warm and moist.  Add in dermatitis and you have the perfect storm.  Secondary candidiasis is full blown diaper rash and it looks worse with more redness and dermatitis and patches of red bumps and pustules.

Symptoms of Diaper Rash

• Bright red patch in the area the diaper covers
• Can progress to a red rash with smaller patches of red bumps and pustules

How To Prevent Diaper Rash

Dr. Amy and the Baby Pibu team share the best ways to prevent diaper rash:

1. Change diapers frequently and air out the bottom if needed

• Did you know that your baby’s skin is more sensitive than adult skin? Prolonged exposure to pee and poop can irritate a baby’s skin. Infrequent wet diaper changes, tight diapers that are too small, or episodes of diarrhea can lead to diaper rash. Prevent diaper rash with frequent diaper changes.
• If you see the beginnings of a diaper rash or an irritated red bottom, consider letting your baby “air it out” and go diaperless around the house for short time periods. This allows for less friction and less chaffing to prevent diaper rash.

2. Protect the bottom

• Application of an ointment, such as Baby Pibu’s Hydrating Ointment, with every diaper change can provide a protective layer between baby’s sensitive skin and the pee and poop. For longer naps and overnight sleep, application of an ointment with zinc oxide is recommended as zinc oxide provides further barrier protection for baby’s skin. For this, Baby Pibu’s Bottom Balm can be used. If there are any initial signs of redness or irritation in the diaper area, begin using Baby Pibu’s Bottom Balm with every diaper change.

3. Use a medicated diaper rash cream or ointment

• To prevent diaper rash, application of an ointment will physically protect your baby’s skin. When you see early diaper rash appearing as a red patch in the diaper area, apply an ointment with zinc oxide, like Baby Pibu’s Intensive Bottom Relief, as the zinc oxide will further act as a barrier to protect the skin and allow the skin to heal. If the diaper rash progresses and becomes full-blown with satellite red bumps, then apply OTC clotrimazole cream to treat the secondary candidiasis (yeast) along with applying a diaper rash cream with zinc oxide.

How to Treat Diaper Rash

When red bumps or pustules appear along with the redness in the diaper area, your baby has developed full-blown diaper rash with secondary candidiasis. When this happens, take the following diaper rash treatment steps:

1. Increase the frequency of diaper changes and make sure the diapers aren’t too tight.
2. You may want to let your baby’s bottom breathe by letting your baby go diaperless for short periods of time for diaper rash treatment.
3. Use a warm washcloth instead of a wipe to be less irritating and more soothing.
4. Apply a thick diaper cream with zinc oxide at every diaper change. Baby Pibu’s Intensive Bottom Relief is a good formula for this. This diaper rash treatment ointment has thymol (a natural anti-bacterial and anti-fungal) and cornstarch to help relieve the rash.
5. You can also mix in over-the-counter topical Lotrimin AF cream with clotrimazole with the diaper cream if needed.

When to Call the Doctor

If the diaper rash doesn’t improve within two to three days, even after using diaper rash treatment products, consult your pediatrician or dermatologist.

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