Painful diaper rash: what parents should know

Moisture and contact with urine or stool can weaken the skin barrier, causing redness, soreness and small areas of raw skin. Friction from a nappy can add to the discomfort. A rash that is bright red, involves the skin folds and has small spots around its edge may need evaluation for a yeast infection. Other possibilities include irritation from wipes, allergy to a product or a different childhood skin condition.

Change the nappy promptly after wetting or soiling. Rinse with lukewarm water or use a fragrance-free cleanser, then pat rather than rub. Leave the area open to air briefly when practical and apply a generous protective emollient or barrier product at each change. Use loose-fitting nappies and avoid fragranced wipes, talc, antiseptics and scrubbing. If the rash has features of yeast infection, a clinician can advise whether topical antifungal treatment is suitable.

Contact a clinician if the rash is very painful, blistered, ulcerated, spreading, weeping or not improving with gentle care. Seek urgent help if the baby seems seriously unwell, has fever, is unusually sleepy, feeds poorly or has rapidly worsening skin changes. A newborn or a child with recurrent episodes should be assessed rather than treated repeatedly without advice.

Does the pattern suggest irritation, yeast or another rash? Which barrier product is appropriate? How should treatment be applied, and when should the child be reviewed if the skin remains sore?