Nappy rash caused by thrush: what to know

Thrush is a yeast infection. In the nappy area, the rash may look vivid red and feel sore, with involvement of the creases rather than only the surfaces that contact the nappy. Tiny red spots can appear just beyond the main rash. These clues are not a diagnosis, because irritant dermatitis and other skin problems can look similar. Thrush in the mouth or a recent course of antibiotics may be useful information for the clinician.

Change nappies often, clean gently with lukewarm water, and pat dry. Allow air to reach the area briefly when possible. Avoid fragranced wipes, bubble bath, talc and rubbing. Use only products suitable for the child's age and avoid sharing creams between family members. If a clinician confirms thrush, follow the prescribed course and directions; topical antifungal treatment may be recommended. A plain barrier can reduce contact with urine and stool, while emollient therapy may help support the skin barrier.

Contact a clinician if the rash reaches the folds, has satellite spots, keeps returning, or does not settle with gentle care. Seek urgent advice for fever in a very young baby, marked lethargy, poor feeding, dehydration, rapidly worsening pain, blisters, pus or widespread skin peeling. Do not apply steroid, antibiotic or antifungal creams unless a healthcare professional has advised that product for this child.

Does the appearance fit thrush? How long should treatment continue? Should anyone check for oral thrush, and which barrier product can be used alongside the treatment?