Psoriasis and nappy rash: what to know

Psoriasis in a nappy area may look sharply red and smooth because moisture changes the usual scale. Irritant nappy rash is often linked with wetness, rubbing or contact with stool and urine. Yeast infection may involve nearby folds and small spots beyond the main rash. These patterns overlap, so colour alone cannot identify the cause. The child may also have psoriasis elsewhere, but a nappy rash does not by itself establish that diagnosis.

Change nappies promptly, rinse with lukewarm water or a fragrance-free cleanser and pat the skin dry. Give short periods without a nappy when practical, and apply a bland barrier or moisturising ointment to protect the skin. [Emollient Therapy](/treatments/medical-dermatology/emollient-therapy/) may be discussed for dry or irritated skin. Avoid fragranced wipes, scrubbing, powders and borrowed medicated creams. Use an antifungal only when a clinician or pharmacist considers yeast likely; [Topical Antifungal Treatment](/treatments/medical-dermatology/topical-antifungal-therapy/) is not suitable for every rash.

Arrange a medical review if the rash is persistent, recurrent, spreading beyond the nappy area or not improving with gentle care. Seek prompt care for blisters, open sores, pus, marked swelling, severe discomfort, fever or a child who seems unusually unwell. Babies with rapidly worsening skin should be assessed without delay.

Ask whether the rash looks irritant, psoriatic or fungal, whether a skin test is needed, and which barrier product is appropriate. Ask how to apply any medicated treatment and when the child should be reviewed.