Nappy Rash: Causes, Home Care and When to See a Doctor
Nappy rash is common and usually clears with simple care at home. This guide covers what it looks like, what causes it, what to do at each nappy change, and the signs that mean your baby should see a doctor.
The short answer
- Change wet or dirty nappies as soon as you can. This matters most.
- Clean gently with water, or with wipes that have no fragrance and no alcohol.
- Pat dry and give your baby some nappy-free time.
- A pharmacist can recommend a barrier cream if the rash bothers your baby.
- See a doctor if the rash does not improve, spreads, or comes with a fever.
What nappy rash looks like
- Red or raw patches on the bottom or across the whole nappy area.
- Spots, pimples or blisters. They may look red or brown, and can be harder to see on brown or black skin.
- Dry, scaly skin.
- A bottom that looks itchy or sore, and a baby who seems uncomfortable.
What causes it
The most common cause is skin staying in contact with wee or poo for too long. Other causes include:
Rubbing
The nappy rubbing against the skin, or a nappy that is fastened too tightly.
Irritation
Soap, detergent or bubble bath, and wipes that contain fragrance or alcohol.
Tummy upsets and medicine
Diarrhoea, and some medicines such as antibiotics.
Infection
Thrush, a fungal infection, can cause or worsen a rash. This needs a doctor.
What to do at every nappy change
- Change the nappy as soon as it is wet or dirty. Less time against wet skin means less rash.
- Clean gently. Use water and a soft cloth, or wipes that are free of fragrance and alcohol.
- Pat the skin dry. Do not rub hard.
- Leave the nappy off for a while when you can. Let the skin air dry.
- Put on a nappy that fits, not too tight. Extra-absorbent nappies help keep skin dry.
Bathe your baby once a day, and not more than twice a day. If you use cloth nappies, use dry liners and change them often.
What to avoid while the skin is sore
- Soap, bubble bath and baby lotion on the rash. They can irritate it.
- Talcum powder and antiseptic creams.
- Fastening the nappy too tightly.
- Plastic pants or covers over the nappy.
This applies to skin that already has a rash.
Do you need a cream?
A mild rash often clears with the steps above. If the rash is making your baby uncomfortable, speak to a pharmacist. They can recommend a cream or medicine, and may suggest a thin layer of barrier cream at each nappy change.
A barrier cream sits on top of the skin and keeps wee and poo away from it. Follow the directions on the pack, and ask the pharmacist if you are not sure which one suits your baby.
When to see a doctor
Take your baby to a doctor or clinic if:
- The rash does not go away, gets worse or spreads.
- Your baby has a fever.
- You see blisters, or pus coming from the rash.
- Your baby seems to be in pain, very uncomfortable or hard to settle.
A doctor can check for thrush or a bacterial infection, which need their own treatment.
Nappy rash: common questions
This guide is general information from the Pureen team. It does not replace advice from your own doctor or pharmacist.