Chemical burn or nappy rash: what to do

Irritant dermatitis can follow contact with wipes, soaps, detergents, creams or other substances. The skin may look red, raw, shiny or tender where the product touched. Ordinary nappy rash is also promoted by moisture, friction and contact with urine or stool, and the two patterns can overlap. A rash in the folds, satellite spots, blisters or marked peeling may need a clinician to check for another cause.

Stop the suspected product and rinse away residue with lukewarm water; pat dry without rubbing. Change nappies promptly, allow short periods of air exposure when practical and use a plain protective barrier that the child has tolerated before. Avoid fragranced wipes, antiseptics, powders, scrubbing and repeated product experiments while the skin is raw.

If yeast is suspected, a clinician may recommend a topical antifungal treatment. Do not use leftover medicines or combine treatments without advice, especially on a baby’s delicate skin.

Arrange prompt assessment for severe pain, open sores, blisters, bleeding, spreading redness, pus, fever, poor feeding or unusual sleepiness. Contact a clinician when the rash involves the folds, keeps returning or is not improving after the trigger is removed and gentle care begins. Chemical exposure to the eyes or mouth needs urgent advice.

Ask which product should be stopped, whether the rash is irritant or could involve yeast, which barrier is suitable, and how often nappies should be changed during healing. Mention the child’s age and when the exposure occurred.