Reasons for nappy rash

Irritant nappy rash often affects skin that stays in contact with a wet or soiled nappy and may look red, sore or rubbed. A yeast rash may involve the folds and have separate small spots around the main irritated area. New wipes, creams, detergents, medicines, diarrhoea or a change in feeding can alter the skin barrier or increase exposure to irritants. Other rashes can occur in the nappy area too, so appearance and response to care should be reviewed together.

Change nappies promptly, rinse with lukewarm water or use fragrance-free gentle cleaning, and pat rather than rub. Let the skin air briefly when practical, avoid talc and fragranced products, and apply a protective emollient therapy product as directed. If folds are involved or the rash has features of yeast, a clinician may recommend topical antifungal treatment. Do not use steroid or combination creams unless a clinician has advised them.

Seek medical advice if the rash is severe, spreading, blistered, bleeding, weeping, unusually painful, or not improving with gentle skin care. Prompt review is needed with fever, poor feeding, unusual sleepiness, pus, or sores outside the nappy area. A baby who seems seriously unwell needs urgent medical help.

Ask whether the pattern is irritant or yeast-related, which cleanser and barrier product to use, how often treatment should be applied, and what changes should prompt a return visit.