What should you know about bumpy nappy rash?

Irritant nappy dermatitis often causes red, sore, uneven skin on areas exposed to wetness and rubbing. Yeast can be more likely when the rash involves skin folds and has small nearby spots, though appearance alone cannot confirm the cause. New wipes, creams, detergents, or foods may coincide with irritation. A rash outside the nappy area, blisters, crusting, or marked tenderness needs a clinician to consider other diagnoses.

Change nappies promptly, rinse with lukewarm water or use a gentle fragrance-free cleanser, and pat the skin dry. Give short periods without a nappy when practical, and apply a protective barrier recommended for infants. Avoid talc, fragranced wipes, harsh soap, and scrubbing. If a clinician suspects yeast, a topical antifungal may be advised; use it exactly as directed and do not share creams between children.

Arrange a review if the rash is worsening, very painful, cracked, bleeding, crusted, or not improving with careful nappy changes. Seek prompt help for fever, lethargy, blisters, pus, rapidly spreading redness, or a baby who is feeding poorly. A newborn or a child who seems unwell should be assessed sooner rather than treated repeatedly at home.

Does this look like irritation or yeast? Which barrier product is suitable? Should I change wipes, nappies, or detergent? How long should treatment continue, and what changes require a review?