What causes Diaper Rash?

New parents have a big job with their new tiny human… but it doesn’t have to be hard when it comes to treating and preventing diaper rash! That red rash is like a flashing beacon telling us that we need to do something, but what? Understanding the cause of the rash you’ve found is a key first step to effective treatment and prevention. The more you know, the more successful you and your baby will be.

Most Common cause: Contact Diaper Dermatitis

Most diaper rash is a form of contact dermatitis (“dermatitis” means “inflammation of the skin”).  Contact dermatitis is a specific kind of skin inflammation caused by contact with irritating substances, such as urine and feces (especially diarrhea).  Skin with contact diaper dermatitis is often warm, puffy, red and shiny in the diaper area, but usually NOT in areas where there are skin folds.  Why is it less common in folds? Inside the diaper, skin fold areas are often not in contact with urine and feces as much as other diapered areas, and therefore are less likely to become inflamed by these irritating substances.

Treatment & prevention​: Contact Diaper Dermatitis 

1. Clean: Change diapers as soon as they become wet or soiled. Use a soft cloth and warm water to gently cleanse the skin. Avoid wipes or other products that contain alcohol.
2. Air dry: When possible, allow your child to roam without a diaper. It may sound silly, but it really helps.  Also, when changing diapers, fan the skin or even use a hair dryer on low or no heat to gently air dry the skin. If using towels to dry the skin, pat the skin dry instead of rubbing.​​
3. Diaper cream: Applying a high quality diaper cream like Pain in the Butt Diaper Rash Cream with zinc oxide in a thick layer (like icing on a cupcake!) to dry skin will protect against wetness and irritation. Zinc oxide manufactured with a water resistant cream base creates a protective barrier on the skin against wetness and irritating substances to immediately help soothe, protect and heal contact diaper dermatitis. 

Contact diaper dermatitis will rapidly improve if you follow the steps above. Continue to check the rash, and if you don’t see improvement within 2 or 3 days or if the rash worsens, please contact your physician.​

Other causes of Diaper Dermatitis

1. Candida diaper dermatitis: If your baby’s rash appears in the warm moist folds of the skin around the thigh area and genitalia, and not as much where the skin is more exposed beneath the diaper, then the cause may be yeast overgrowth. This form of rash is known as Candida diaper dermatitis, and can appear as bumps, blisters, or pus filled sores or ulcers.  Babies with Candida diaper dermatitis may also have oral thrush, which is also a yeast infection. If you suspect Candida diaper dermatitis, please contact your physician.

2. Bacterial diaper dermatitis: Skin which is already irritated, abraded or cut can become infected with bacteria. Sometimes abrasions occur from vigorous wiping, so remember to take it easy! Bacterial diaper dermatitis can appear as crusty blisters filled with pus, or as a well-defined ring-shaped rash around the anus extending between the legs.  If you suspect bacterial diaper dermatitis, please contact your physician right away for next steps.

3. Irritant diaper dermatitis: Sometimes the physical shape of the diaper rubs against the skin in certain areas, causing inflammation. Securing the diaper less tightly may help relieve the irritation and also have the side benefit of increased airflow which helps prevent other causes of rash.  Choosing a different diaper design or a larger size may also be helpful.

4. Allergic diaper dermatitis: Fragrances, dyes and other allergens found in wipes, lotions, soaps, detergents and other products can cause irritation.  Identifying the source of allergic dermatitis is often challenging. In general, it's helpful to select products that use no fragrances or dyes when possible.