Diaper rash: the basics
No, its not a failing. Diaper rash is a normal part of parenting, and infancy/ toddlerhood. Every parent will deal with this at some point.
PC: Canva
This article goes over how to identify a diaper rash, and my best tips for identification, causes, and when to call your doctor! To prevent this post from becoming overwhelming, I’m putting treatment suggestions into a separate post
I also have a NEW diaper rash cheat sheet on the guide page that provides a quick overview for you to keep in the medicine cabinet, and here are my favorite diapering products (affiliate rec)!
What it is:
Diaper rashes occur because skin irritation is more likely in warm, moist areas. Almost every parent deals with them at some point.
Causes of diaper rash
Irritation: This is the most common cause of rashes in the genital area. Skin (and baby skin in particular) is easily irritated when it is left in a moist, warm environment. Stool and urine can also be irritants.
What it looks like: Irritation (or contact) dermatitis looks like pink or red skin changes in the diaper area. They can be flat or progress to bumps and even open sores.
Jacquets Erosive Diaper Dermatitis: This is an especially severe form of diaper rash often seen in young infants with “punched-out” appearing larger ulcers and skin breakdown. It is thought to be due to the frequency of pooping in those first few weeks. See here for a pic. When my son had this, we ended up working with a wound care specialist, which is how I know about some of those second line treatments listed below!
Infection: Many different types of infection can cause skin lesions in the genital area.
Bacterial infections include things like Strep or Staph (yes, it is possible for a child with strep throat to get peri-anal strep).
What it looks like: These often look like open sores or raw skin, You may see either pus or honey-colored crusting on top. They will need antibiotic treatment.
Viral infections can include a range of typical rash-causing pathogens, such as Coxsackievirus. In general, the only treatment for many of these causes is time and supportive care.
What it looks like: These will vary based on the cause of the rash itself. For example, with Hand/Foot/Mouth syndrome, you will typically see the same lesions you see in the rest of the body. Monkeypox can also cause rashes in the genital area.
Fungal rashes are those caused by yeast such as Candida. These actually naturally occur on our skin but can cause irritation and discomfort in infants or those who are immune-compromised. It is not unusual to see these in the aftermath of skin irritation from other causes or after a course of antibiotics. These need to be treated with an anti-fungal medication and can take up to 2 weeks to go away.
What it looks like: The red bumps usually are more noticeably red with well-defined borders. Fungus particularly likes warm/moist areas, so these rashes classically cluster within skin folds. You can also see “satellite” lesions (which means smaller clusters of red bumps near to a larger rash area).
Allergic reactions: Some infants develop sensitivity to wipes, diaper types, or even products like soaps and lotions - and this can happen even if you’ve been using a product regularly. If you suspect this, think back to make sure you have not recently changed brands or products.
Treating diaper rashes
Stay tuned for a post on this soon!
When to call the pediatrician
This is not a comprehensive list. In general, always err on the side of calling your pediatrician if you have any concerns about your child. There is a lot to be said for a parent’s gut instinct, and I promise: your pediatrician would rather you called!
If your child is not improving within a few days, or if they seem to be getting worse, call your pediatrician. Other concerning symptoms include:
pus or drainage
severe pain
bleeding or many open areas/sores
systemic symptoms (such as fever, vomiting, diarrhea)
frequent or recurrent infections
you notice oral thrush (white patches in mouth)
if anything else is tickling your spidey sense
FAQs
What are your favorite products for diaper care?
I have put together a list of some of the products we use under “Faves” - or here is a direct (affiliate) link. I also have a separate post detailing them.
Do I need to use diaper ointment with every diaper change from the start?
No. If you begin to see any early redness, it is worth adding the barrier cream to prevent it from snowballing out of control.
Do I need to wipe down the skin after both pee and poop diapers?
Wipe away poop. No need to wipe down after simple pee diapers — just air dry + new diaper.
Do food allergies causing diaper rashes?
Diaper rash is not a sign of an IgE mediated true food allergy. However, with certain food sensitivities the stool can change. When my kids were young, if they had a particularly acidic food day, for example (lots of tomatoes, strawberries & citrus), they were more likely to develop a diaper rash.
Can diaper rashes be seen in older/potty trained children?
Certainly. Especially before kids are good at taking care of their own hygiene, if they do not wipe well (or if they wipe too vigorously!) we commonly see skin irritation. The good news is that treatment is the same: air out their bottoms, gentle wiping or washing, and diaper ointment is often the key.
PC:Canva
Hopefully this article covers some of what you need to know - don’t forget to check out the post on diaper rash treatment, so you have everything you need to keep that baby booty rash-free!
As always, call your pediatrician if you’re concerned!
