Learn the causes and types of rashes that could be troubling baby.

Think about not having diapers. Understandably, diapers were a hugely popular invention, allowing parents to conveniently manage babies’ waste products. But ever since children began to wear diapers, diaper rash has been one of their most common skin problems.

Here are a few tips for knowing the signs of diaper rash and some ways to keep baby rash-free.

Who gets diaper rash?

Children in diapers! Sometimes even if the parents are careful. Diaper rashes are most common between 8 and 12 months old, when kids are taking antibiotics, having loose stools or just starting solid foods. Breast-fed babies tend to have fewer cases of diaper rash. Anytime a child sits too long in a wet diaper or a stool-soaked diaper, though, a rash can result.

What is diaper rash?

A surprising number of rashes get lumped together and placed in the diaper rash category, including rashes caused by friction, irritants, allergies, infections, bacterial infections, seborrhea, psoriasis and a long list of illnesses that extend beyond the diaper.

Whatever the underlying cause, skin wetness is a common factor. Urine wetness increases skin friction, raises skin pH and makes skin more permeable. This intensifies the action of irritants, such as stool enzymes. And with any diaper rash, the outermost layer of skin can be temporarily damaged, making it easy for yeast or bacteria to settle in.

Managing diaper rash

Think ABC: Air out the skin; Barrier ointment or paste at each diaper change; Change diapers frequently.

What’s your best bet? Choose topical barriers without added fragrances, preservatives or irritating chemicals. Powders may work but can cause problems if inhaled.

If a rash lasts more than three days or looks like a yeast rash, an anti- fungal cream may be needed three times a day until the rash is gone. If the rash isn’t clearing up, check in with a pediatrician for other specific treatments.

Preventing diaper rash

Reduce skin exposure to urine and stool. Change dirty diapers promptly, cleaning the diaper area gently. If you use baby wipes, consider alcohol-free, fragrance-free wipes. Breast-feeding, diaper-free periods, avoiding unnecessary antibiotics and using probiotics when giving antibiotics can help prevent diaper rashes.

Diaper Clues

Friction rash
These common rashes show up most where friction is most, such as the inner thighs or under the elastic of diapers. They come and go quickly.

 

Irritant rash
Look for a rash on the most exposed areas, such as the round part of baby’s bottom, genitals or belly. Often, these don’t occur in skin folds and creases but do show up in places that come in contact with stool enzymes or irritants such as harsh soaps, baby wipes, detergents or medicines.

 

Allergic rash
These are also more common in exposed areas, but look more like poison oak.

 

Intertrigo
Moist heat causes this common diaper rash deep in the skin folds. The skin looks thin.

 

Yeast
Suspect yeast in any diaper rash treatment. Antibiotic use makes a yeast infection even more likely. A yeast rash is beefy red with raised borders and white scales. Small satellite rashes surround the main rash. But even without the classic pattern, yeast is often present.

 

Rare diseases can cause characteristic diaper rashes and should be considered in prolonged, severe rashes.

Alan Greene, M.D., is a leading authority on child health and wellness. He is the founder of the pioneering website DrGreene.com and the author of several books, including Raising Baby Green and Feeding Baby Green.