What should you know about eczema nappy rash?

Nappy rash is a general term for inflammation beneath a nappy. Irritant dermatitis can follow prolonged contact with urine or stool, rubbing, heat, or fragranced products. Eczema may make the skin barrier more sensitive, so redness and dryness can extend beyond the areas in direct contact with the nappy.

Look for red or darker discoloured skin, dryness, scaling, soreness, or small cracks. A yeast infection can also affect a nappy rash, particularly when the rash is persistent, involves the skin folds, or has small nearby spots. These appearances overlap, so a clinician may need to examine the skin before recommending a medicated cream.

Change nappies promptly and rinse the area gently with lukewarm water or use a fragrance-free cleanser. Pat rather than rub, and allow the skin to air-dry before putting on a clean nappy. Avoid fragranced wipes, bubble bath, talcum powder, and products that sting.

Apply a simple protective barrier recommended for babies, especially after cleaning and before sleep. An emollient can support dry, eczema-prone skin; see the guidance on [Emollient Therapy](/treatments/medical-dermatology/emollient-therapy/). Do not use steroid, antibiotic, or antifungal creams unless a healthcare professional has advised which product and how to apply it.

Arrange medical advice if the rash is spreading, very sore, cracked, weeping, crusted, blistered, or not settling with gentle care. Seek prompt help if your child has a fever, seems unusually sleepy or unwell, is feeding poorly, or passes much less urine. A clinician can check for eczema, yeast, bacterial infection, or another cause and may recommend [Topical Antifungal Treatment](/treatments/medical-dermatology/topical-antifungal-therapy/) when appropriate.

Ask whether the pattern fits irritant dermatitis, eczema, yeast, or infection; which cleanser, barrier, or emollient is suitable; how often to apply it; and what changes should prompt a follow-up visit. Mention any recent antibiotics, new wipes, nappies, creams, or laundry products.