Diarrhoea and nappy rash: what to do

Nappy rash is inflammation in the area covered by a nappy. Diarrhoea makes stools more liquid, so they can spread and stay in contact with the buttocks, genitals, and upper thighs. The skin may look bright red, tender, or shiny. Frequent wiping can worsen soreness, especially when the skin barrier is already damaged. Rash in the creases, satellite-like spots at the edge, or a rash that continues after the diarrhoea settles may point to yeast or another diagnosis and should be reviewed.

Change nappies promptly and rinse away stool with lukewarm water when possible. Use a soft touch, pat dry, and apply a generous protective barrier. Keep nappies loose and give short periods of supervised nappy-free time. Avoid perfumed wipes, soap, talc, and products that sting. Offer fluids as advised for the child’s age and illness, and monitor wet nappies. If the rash has unusual features or fails to improve, a clinician can advise whether an emollient approach or topical antifungal treatment is appropriate.

Seek medical advice for a rash with blisters, open sores, pus, bleeding, spreading redness, or significant swelling. Get urgent help for a child who is difficult to wake, cannot keep fluids down, has blood in the stool, severe abdominal pain, fever with a concerning rash, or much less urine than usual. Ask for advice if diarrhoea continues or the child is very young, because dehydration can develop quickly.

Is this typical irritation or could another cause be present? Which barrier is suitable, and how should I clean the area? What fluid plan and warning signs apply to my child?