What should you know about rash in nappy area?

Wetness held against the skin, rubbing from the nappy and contact with urine or stool can weaken the skin barrier. Fragrance, cleansers, wipes or a newly introduced product may trigger contact dermatitis. A rash that extends into skin folds, has small nearby spots or keeps returning may need assessment for yeast or another cause. Eczema can make the area more reactive. Similar-looking conditions include [Atopic Dermatitis](/conditions/atopic-dermatitis/), [Contact Dermatitis](/conditions/contact-dermatitis/) and [Intertrigo](/conditions/intertrigo/). Do not assume the appearance alone identifies the cause.

Change the nappy promptly after wetting or soiling. Rinse with lukewarm water or use a gentle, fragrance-free cleanser, then pat rather than rub. Allow the skin to dry fully and give short nappy-free periods when practical. A thin protective barrier can reduce contact with moisture. Avoid talc, fragranced products and vigorous scrubbing. Do not use steroid, antifungal or antibiotic cream on a baby’s skin unless a clinician has advised it for this rash.

Arrange medical advice if the rash is worsening, very painful, blistered, raw, oozing or not settling with gentle care. Seek prompt help if the child has fever, seems unusually sleepy, is feeding poorly, or the redness is spreading quickly. A clinician can inspect the folds and surrounding skin and choose treatment suited to the child’s age and the likely cause.

Could this be irritation, eczema, yeast or another infection? Which barrier product and cleaning routine should we use? Should any current cream or wipe be stopped? What changes would mean we need a same-day review?