Nappy Rash

What causes nappy rash?

Nappy rash is a skin inflammation. Most cases are due to a reaction of the skin to urine and motions (faeces). In addition, a germ called Candida commonly thrives on the inflamed skin. (This is the germ that causes thrush.) Candida can cause a more inflamed rash which may include darker red spots spreading around the nappy area ('nappy thrush').

Most nappy rashes are mild and are not serious. Occasionally, skin conditions such as eczema, psoriasis and some other rare skin conditions cause unusual nappy rashes.

What can I do to help prevent or clear nappy rash?

• Fresh air. Leave the nappy off as much as possible to let fresh air get to the skin. Obviously, you cannot leave the nappy off all the time. But, the more fresh air, the better. Try lying the baby without a nappy on a towel or disposable absorbent sheet for a while each day. (But change the towl or sheet as soon as it become wet.)
• Nappies. Change the nappy often. Ideally, change the nappy as soon as it is wet or soiled. The aim is to prevent urine and motions from being in contact with the skin for long periods. If you use washable nappies, wash with a small amount of detergent. Rinse thoroughly, and do not use fabric softeners.
• Washing. Wash the baby's bottom with water only. Soaps may irritate the skin, so water alone is best.
• Drying. After washing, make sure the bottom is properly dry before putting on a new nappy. Dry by patting, not by rubbing, with a towel.
• Powders such as talcum powder may be irritating to the skin, so are best avoided.
• Barrier creams or ointments may help to protect the skin from moisture. If you use liberal amounts of barrier cream or ointment at the first sign of redness or inflammation, it may prevent a mild rash from getting worse. Apply just before putting on each nappy.
• Don't use tight fitting plastic pants over nappies. They keep in moisture and may make things worse.

Treatments

The above tips are likely to clear a mild rash. It the rash becomes worse, a doctor or health visitor may advise a treatment cream or ointment in addition to the above measures. If a cream or ointment is prescribed, apply it sparingly after each nappy change, and before using any barrier cream. Stop using it once the rash is gone.

The cream or ointment usually contains an anti-thrush medicine. This is often combined with a mild steroid. The anti-thrush part will clear Candida germs, or prevent them from infecting the inflamed skin. The steroid part reduces inflammation.

Sometimes a nappy rash becomes infected with bacteria (other types of germs). This may be suspected if the rash becomes worse, despite using a cream or ointment which contains an anti-thrush medicine and a steroid. In these cases an antibiotic medicine may be prescribed.

© EMIS and PIP 2004   Updated: March 2004   Review Date: April 2005   CHIQ Accredited   PRODIGY Validated

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