Nappy rash: how to help prevent and treat it

Although unpleasant for you and your baby, nappy rash is very common, and you shouldn’t panic if your baby develops it. Nappy rash may look severe, but it’s easy to treat and prevent with the right care.  

We know your baby’s health is important, so we’ve put this guide together on what nappy rash is, what causes it, how to prevent it and how to treat it. 

Nappy rash: what is it?

Nappy rash is when your baby’s skin becomes inflamed around their nappy area. It can occur at any time during your child’s nappy-wearing stage. All babies and toddlers who are in nappies can develop nappy rash.

Nappy rash can look like red rash patches across your baby’s bottom, or the whole area may be red with scattered pimples, swellings, spots and blisters. The skin may be hot to the touch, look sore and be painful or itchy for your child.  

The risk of nappy rash will change as your baby grows. During the first twelve months, your baby’s skin is more permeable and has a higher pH level compared to adult skin, which means they may be vulnerable to developing nappy rash. 

The causes of nappy rash

As nappy rash is very common, it’s important to think about what causes it. Most commonly nappy rash is caused by contact dermatitis. A candida infection (also known as a yeast infection) is another common cause.  

Contact dermatitis is when your baby’s skin becomes inflamed from coming into contact with irritating substances. There are several things that can trigger contact dermatitis in your baby, and it often occurs when your baby’s delicate skin comes into contact with wee and poo, especially for a prolonged period of time.

Nappy rash may also be caused by the kind of bubble bath, soap or washing detergent you are using, which can irritate your baby’s sensitive skin or cause an allergic reaction. It can also be caused by certain kinds of baby wipes – for example, you should avoid using alcohol-based wipes or those with fragrances.

A candida infection occurs when candida, a type of naturally occurring yeast, overgrows on the skin. This is the same yeast that can cause thrush, and it typically thrives in warm, moist conditions – just like inside a wet nappy!

Symptoms of nappy rash

Symptoms of nappy rash caused by candida can be slightly different to those caused by contact dermatitis. The skin may be red and pimply, with a rash that doesn’t respond to normal nappy cream occuring in the folds of skin between the legs and buttocks. You may also notice a thrush infection in your baby’s mouth.

Any kind of nappy rash can be made worse by a tight nappy rubbing against the skin and preventing air from circulating. Some medicines, including antibiotics or laxatives (taken to help babies poo more regularly), can also cause nappy rash.

Some babies may be more likely to develop nappy rash than others. If your baby has eczema, which can also be triggered or made worse by a rubbing nappy, they may have more sensitive skin and therefore be more likely to develop contact dermatitis and nappy rash.

How to help prevent nappy rash

There are a number of ways you can prevent nappy rash from occurring. Here are some easy tips you can follow to reduce the risk.

• Make sure you change the baby’s nappy regularly and as soon as possible if wet or dirty, to keep them fresh and clean. If a baby sits in a dirty nappy for long, they’ll be more likely to develop nappy rash. 
• Use water wipes that are free from fragrances and alcohol.  
• Gently clean your baby’s skin and bottom while bathing with warm water. Do not use soap or bubble bath. 
• Apply a layer of barrier cream like Bepanthen Nappy Care Ointment after every nappy change to prevent your baby’s skin coming into contact with irritants. 
• Avoid using talcum powder, as it can irritate your baby’s skin. 
• Ensure that your baby’s nappy fits properly. If it’s too tight, it can rub and irritate your baby’s skin. 

How to treat nappy rash

If your baby has a nappy rash, it’s important to care for their skin to prevent further discomfort. You should keep their skin clean and gently pat dry, avoiding rubbing it as this can cause more irritation. If the nappy rash has been caused by contact dermatitis, removing the irritant is a key step towards treating the rash (for example, certain kinds of soaps).

Typically, nappy rash will clear up with proper hygiene after around three days. If the rash doesn’t go away or becomes moist with red or white pimples in the folds of their skin, they may have developed an infection.  

If the nappy rash has been caused by candida, it’s important to try to heal the skin and reduce exposure. Make sure the area stays dry and clean, changing your baby more often than usual, and ensure you wash your hands and anything your baby lies on (like a changing mat or towel) after every change. You should make sure you change your baby’s nappy quickly if it’s wet, as yeast thrives in damp places.

Whatever sort of nappy rash your baby has, it’s important to have some time without the nappy. This helps to dry out the area and ensure good air flow, but be warned – it can get a bit messy, so it might be worth having play time or tummy time on a mat or towel!

You can also treat your baby’s skin with over-the-counter creams, and keep it protected using a barrier cream like Bepanthen. Bepanthen Nappy Care Ointment is suitable from birth to help care for your baby’s skin, keeping them protected from nappy rash. It creates a barrier against the harmful effects of urine, faeces and rubbing nappies.

If you’re worried that your baby’s nappy rash is severe or has become infected, you can talk to your doctor, health visitor or other healthcare professional for more advice. If it’s infected – for example, with a yeast or bacterial infection – your family doctor may prescribe a cream or medicine to help clear up the infection.

There are many different kinds of rashes that babies can get, and if your baby’s rash is spread over their whole body you should speak to your doctor or health visitor for more advice.