Getting to the "Bottom" of Diaper Rash

Published: February 08, 2024
Ashleigh Neese
By Ashleigh Neese, PharmD Candidate
Melody Berg
By Melody Berg, PharmD, MPH, BCPS

Diaper rash is a common skin condition that can happen to anyone who wears diapers. The skin on the bottom may look red, inflamed, or even scaly along with the person being fussy, crying, or showing discomfort that worsens when having their diaper changed.

What causes diaper rash?
Diaper rash can happen when a moist environment has been created by diapers getting too wet, not being changed soon enough, or when skin is extra sensitive. Some things that may increase the risk of diaper rash include:

  • Leaving soiled diapers on for too long
  • Having diarrhea
  • Rubbing from too tight of clothing or diapers
  • Diet changes that affect the content of stools and may cause skin to react
  • Use of antibiotics

How can you treat diaper rash at home?
Using “ABCDE”:
Air  -  Leave the diaper off for a while to keep the skin dry
Barrier  -  Use skin protectants to keep the diapering area from being irritated
Cleansing  -  Cleaning the bottom during diaper changes with a wipe or rinsing the bottom with warm water before drying.
Diaper  -  Choosing the right diaper. Disposable diapers may already have a skin protectant in them and can be changed frequently which may prevent diaper rash.
Education  -  Changing the diaper as soon as possible when it is soiled or at least six times per day.

Skin Protectants:
Good skin protectants typically include ingredients such as Zinc oxide, petrolatum, lanolin, or simethicone. Look for the following brands: Desitin, A + D, Balmex, and Aquaphor Baby Diaper Rash Cream.

Some foods can make diaper rash worse by making the stool more acidic. It may be helpful to avoid some of these during a diaper rash flare-up:

  • Citrus fruits and juices
  • Tomatoes or spaghetti sauce
  • Strawberries
  • Grapes/Raisins

Following The “BRAT” Diet can help add bulk to the stool and is easy to digest:

  • Bananas
  • Rice
  • Apple sauce
  • Toast

How can you prevent diaper rash?
Continue to follow ABCDE after the diaper rash clears up and consistently use skin protectants.

What products should you avoid?
Products with talc, cornstarch, or other fine powders should be avoided, as they can be inhaled, or breathed in, and irritate the lungs.

When should you consult a doctor?
While diaper rash can sometimes be treated at home, a doctor should be seen instead if any of these happen:

  • No improvement within 7 days
  • Rash spreads outside of the diapering area
  • Oozing, blood, or pus coming from the rash or in the bottom area
  • Broken or peeling skin
  • Frequent diaper rash

Diaper rash is a common skin rash that causes discomfort, and when left untreated, can become a bigger problem. Fortunately, it is both preventable and treatable by ensuring that the diaper-wearer is frequently having their diaper changed, ensuring appropriate care and cleaning of the bottom is performed, and the diapering area is protected.

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