Nappy rash with open sores: what to know

Nappy rash, also called diaper dermatitis, is irritation in the area covered by a nappy. Moisture, contact with urine or stool, friction, and frequent wiping can weaken the skin barrier. Once the surface is raw or cracked, it may sting during cleaning and can ooze a small amount of clear fluid.

A yeast infection can sometimes occur alongside nappy rash, particularly when the rash is bright red, involves the skin folds, or has small spots around its edge. Bacterial infection is another possibility when pain, warmth, swelling, crusting, pus, or rapidly expanding redness develops. Appearance alone cannot confirm the cause, so a clinician may need to examine the area.

Change the nappy promptly after it is wet or soiled. Rinse the area with lukewarm water or use fragrance-free, alcohol-free wipes, then pat rather than rub. Give the skin short periods of air exposure when practical, and fasten the nappy loosely enough to reduce rubbing.

Apply a thin protective layer recommended for broken or irritated skin. Avoid talcum powder, fragranced products, harsh antiseptics, and home remedies that may further irritate the wound. Do not pick scabs or scrub away attached skin. Wash your hands before and after care, and use a separate clean cloth for the nappy area.

If the rash has features suggesting yeast, a healthcare professional may recommend a topical antifungal treatment. Emollient therapy may also help support the skin barrier; use products and directions suited to your baby’s age and the condition of the skin.

Arrange medical advice promptly if the sores are worsening, spreading beyond the nappy area, bleeding repeatedly, producing pus, or surrounded by increasing warmth, swelling, or tenderness. Seek urgent help if your baby has a fever, seems unusually sleepy or difficult to settle, is feeding poorly, or has fewer wet nappies.

A clinician should also assess a rash that does not start improving with gentle care, keeps returning, or causes substantial pain. Take note of when the sores began, recent changes in nappies or wipes, and any creams already used; these details can help guide treatment.

Ask whether the broken areas look like irritation, yeast, or another infection; which cleanser and barrier product are appropriate; how often to apply any medicine; and what changes should prompt a same-day review. Mention any allergies, recent antibiotics, or previous reactions to nappy creams.