What should you know about terrible nappy rash?

Irritant nappy rash often causes red, sore skin on areas covered by the nappy. Frequent wetness, loose stool, diarrhoea, rubbing, and fragranced wipes can weaken the skin barrier. A yeast-related rash may be bright red, involve skin folds, or have small spots beyond the main irritated area; it cannot be diagnosed reliably from a description alone.

Open skin, blisters, crusting, unusual bruising, or a rash outside the nappy area deserves medical assessment. Babies may also show discomfort through crying during changes or reluctance to sit.

Change nappies promptly, rinse with lukewarm water or use gentle fragrance-free products, and pat rather than rub. Give the skin short periods of air exposure when practical. Apply a protective barrier recommended for infants and avoid talcum powder, fragranced products, and vigorous scrubbing. [Emollient Therapy](/treatments/medical-dermatology/emollient-therapy/) may help protect irritated skin when suitable. If yeast is suspected, a clinician may recommend [Topical Antifungal Treatment](/treatments/medical-dermatology/topical-antifungal-therapy/); do not use leftover medicine or steroid combinations without advice.

Contact a clinician if the rash is not improving with gentle nappy care, keeps returning, affects the folds, or has blisters, pus, crusts, bleeding, or open sores. Seek urgent advice for fever, marked swelling, rapidly spreading redness, severe pain, poor feeding, unusual sleepiness, or fewer wet nappies. Very young babies with a significant rash should be assessed promptly.

Does this look like irritant rash, yeast, allergy, or another skin condition? Which barrier product is suitable? Should I change wipes, nappies, or washing habits, and what signs mean the treatment is not working?