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A baby can develop a rash under the diaper for a number of reasons.  Diaper rash is usually a straightforward problem that can be cleared up easily, if the correct cause is found.

Round irritated erosions might be caused by skin bacteria.  Antibiotic ointment (triple antibiotic, bacitracin, or Neosporin® non-prescription) applied 3 times a day usually clears this up quickly;  you can safely try this as a home remedy.

Little red bumps in clusters might be a sign of a yeast infection.  Sometimes the larger bumps will seem to peel at the edges.  Both boys and girls can develop this, because yeast likes to live in wet, dark, warm areas.  Yeast infections are treated with a prescription cream, which I usually prescribe during an office visit.

If you have recently changed diaper brands, and a rash has developed within a few days, consider changing back to the old brand until the rash has cleared, then try another brand.  Hydrocortisone cream (0.5%, non-prescription, 3 times a day for 3-5 days) might also help clear it up more quickly.

For most cases of common diaper rash, try this procedure with every diaper change:

• Rinse well with plenty of warm water.  You might even consider putting the baby in the kitchen sink so that you can use the dish sprayer.
• Pat the groin dry gently with a clean towel.
• Air dry; you can use a hair dryer on the cool setting to get the area really dry.
• Apply white zinc oxide diaper cream (such as Balmex® or Desitin®), so thickly (like cake icing) that a barrier is formed.  The skin can heal under the layer of diaper cream, despite continued stooling and urination.

Feel free to try any of the above treatments; if the rash isn’t improving or you have concerns, we welcome you to schedule a visit.

Copyright © 2008, David M. Epstein