What should you know about red spotty nappy rash?

Nappy skin is exposed to urine, stool, rubbing and trapped warmth. Irritant dermatitis often looks red and sore across the covered skin. A yeast rash may be a brighter red, involve skin folds and have small spots just beyond the main rash. These patterns can overlap, so appearance alone cannot confirm the cause.

Change nappies promptly, rinse with lukewarm water or use a fragrance-free cleanser, and pat rather than rub. Give the area short periods of air exposure when practical. Apply a plain protective barrier to clean, dry skin. Avoid fragranced wipes, talcum powder and scrubbing. If a clinician identifies yeast, follow the recommended course of [Topical Antifungal Treatment](/treatments/medical-dermatology/topical-antifungal-therapy/). An unscented moisturising approach such as [Emollient Therapy](/treatments/medical-dermatology/emollient-therapy/) may support the skin barrier.

Arrange medical advice if the rash is worsening, spreading outside the nappy area, blistering, oozing or associated with fever. Seek prompt help if the child seems unusually sleepy, feeds poorly, or has marked pain. A rash that does not begin settling with careful nappy care also deserves assessment, especially in a young baby.

Ask whether the pattern suggests irritation, yeast or another skin problem; whether folds are involved; which products should be stopped; and how long to use any prescribed cream.