Nappy rash with dry skin: what to know

The nappy area can be both damp and dry-looking: moisture damages the outer barrier, while wiping and cleansing remove protective oils. This can leave rough, flaky, red or cracked skin that stings during cleaning. A dry rash on the nappy area is not always simple irritation. If it extends beyond the nappy, affects folds, or appears elsewhere on the body, eczema, contact dermatitis or thrush may need consideration.

Change nappies regularly and rinse with lukewarm water when possible. Pat dry, rather than rubbing, and leave the area uncovered briefly. Apply a bland fragrance-free emollient or barrier product to clean skin; reapply according to its directions. Avoid hot water, scented wipes, talc, alcohol-containing products and vigorous rubbing. If cracks are painful or the rash is not settling, a pharmacist or clinician can help choose a suitable product and check the diagnosis.

Have the rash assessed if cracks bleed, the skin becomes wet or crusted, pain is increasing, or redness is spreading. Seek prompt advice for fever, poor feeding, unusual sleepiness, blisters, pus or signs of dehydration. Arrange review when the rash persists despite gentle care, returns often, or appears in areas outside the nappy.

Is this irritant rash, eczema, contact dermatitis or thrush? Which emollient or barrier should I use on cracked skin? Could a wipe, soap or laundry product be contributing?