Nappy rash in the genital area: what to know

The rash may look red, sore, shiny or dry on the skin covered by the nappy, including the outer genital skin and folds. Nappy rash is inflammation of the skin barrier. Wetness, rubbing, diarrhoea, frequent stools and fragranced products can make it worse. A yeast-related rash may be more vivid red and involve skin folds, but appearance alone cannot confirm the cause.

Keep the distinction between external skin and internal genital tissue in mind. Do not insert creams, wipes or cotton buds into the vagina or penis opening. In an uncircumcised baby, never force the foreskin back; clean only what moves naturally.

Change the nappy promptly after wetting or soiling. Rinse with lukewarm water or use fragrance-free products, then pat the skin dry. Give short periods without a nappy when practical, and fasten the replacement nappy loosely enough to reduce rubbing. A thin layer of a bland barrier product on external skin can protect it from moisture.

Avoid talcum powder, fragranced wipes, antiseptics and scrubbing. If the rash is not settling, a clinician can recommend a suitable emollient; see [Emollient Therapy](/treatments/medical-dermatology/emollient-therapy/). A suspected yeast rash may need a prescribed or pharmacist-recommended product, so read about [Topical Antifungal Treatment](/treatments/medical-dermatology/topical-antifungal-therapy/) without treating an uncertain rash yourself.

Arrange prompt medical advice if the rash is spreading, very painful, blistered, bleeding, weeping, crusted, or accompanied by fever. Seek urgent help if your baby is unusually drowsy, difficult to wake, feeding poorly, passing much less urine, or appears seriously unwell.

A clinician should review a rash that does not improve after careful nappy care, repeatedly returns, affects the urinary opening, or causes pain when passing urine. Get advice sooner for a newborn or for any baby with broken skin, because infection can develop through damaged skin.

Ask whether the rash is irritant, yeast-related or another condition; which products are safe on external genital skin; how often to apply them; and how quickly improvement should begin. Mention recent diarrhoea, antibiotics, new wipes, changes in feeding, or pain during urination.