- Home
- Advice Hub
- Newborn
- Essential Newborn Care
- What Causes Nappy Rash And How To Prevent It
What causes nappy rash and how to prevent it
Wondering what causes nappy rash? There’s a lot you can do to prevent it or stop it in its tracks. The key to prevention is following the “ABCDE rule.
Your baby’s skin is super sensitive, and it doesn’t take much to throw it out of balance. Add in the fact that they spend 95% of their days in nappies, and you can see why most babies will get nappy rash at some point. Recognising the signs, identifying potential causes and knowing about treatments for nappy rash can help you head it off before it gets too painful, so in this article, we’re going to run through the causes, preventive measures and remedies.
What is a nappy rash?
Nappy rash can creep up on you or appear as if from nowhere – so here are some things to look out for when you’re changing your baby’s nappy:
- Red, raw or sore skin
- Skin that feels hot to the touch
- Signs of discomfort when you touch your little one’s skin, or a wriggliness that suggests itching or pain
- Scaly or dry skin
- Spots or blisters in the nappy area – these might even be weeping.
If any of these symptoms are in play, it’s time to start treating your baby’s skin. Nappy rash can escalate quite quickly and become very painful for your little one, so don’t hesitate to take action. A pharmacist will be able to advise on appropriate treatment or refer you to a GP if needed.
How to prevent nappy rash?
Nappy rash will happen, but you can reduce the frequency and intensity of nappy rash by taking preventive measures. One of the main reasons nappy rash occurs is because babies are all wrapped up in their nappies, and even the most proactive nappy changes can’t prevent skin from coming into contact with their wee and poo – both of which can be quite stringent. That’s why it’s recommended that you follow the ABCDE rule…
Helpful tips – the ABCDE rule
Air
Trapped moisture irritates your baby’s delicate skin and encourages germs to grow, so make sure your baby’s nappy area is thoroughly dry before putting on a clean nappy and give your little one some nappy-free time whenever you can.
Barriers
Even the best nappies can’t whisk away all the wee and poo from your baby’s skin, so coating delicate areas with a layer of barrier cream containing zinc will give an extra bit of protection.
Cleansing
This one’s particularly important, because the longer your baby’s wee and poo are in contact with the skin, the more likely it is to become irritated. Check your baby’s nappy frequently (and we do mean frequently - newborns can wee up to 20 times a day!) and be thorough with the wipes or cotton wool, especially in skin folds where residues can hide. Use alcohol- and fragrance-free wipes (or reusable cloths) to avoid further irritation. Gently pat or blow the skin dry before putting on a clean nappy.
Diapers
(Well, nappies, really.) Choose nappies that have a high absorbency rate, and make sure they fit correctly – you should be able to fit a finger between your baby’s belly and the top of the nappy.
Education
Knowing what causes nappy rash is the first step to preventing it – so congratulations, you’ve already ticked this box!
Nappy rash: what to avoid
When you’ve got sensitive skin, the last thing you’d do is pour perfume on it – and the same goes for baby’s bottoms! Use fragrance-free and alcohol-free wipes every time – even when nappy rash isn’t a problem – to protect the delicate balance of your baby’s skin. If you’re using reusable wipes, make sure the fabric is soft and gentle and avoid scrubbing at sore skin as much as possible. If your little one is in a real mess, you might be better off putting them in the baby bath for a proper wash, rather than rubbing at tender skin. However, when bathing your baby, don’t use soaps or bubble bath that might cause further discomfort and only use creams specifically developed for nappy rash on the area – not regular antiseptics, body lotions or talcum powder.
Another common mistake is putting nappies on too tightly, which prevents any air from reaching the area and can exacerbate the rash.
When to ask a pharmacist for advice
Pharmacists are well qualified to offer advice and over-the-counter treatments for mild to moderate cases of nappy rash – with no need to wait on the phone or fill out a form to make an appointment! If your little one’s nappy rash isn’t clearing up or you’re concerned, the pharmacist should be your first port of call.
When to speak to a health visitor or GP
If the nappy rash is particularly painful, or if you notice signs of infection – such as a high temperature – it is time to take your little one to the GP for advice. They can prescribe medicated creams and will also be able to tell if there’s anything else going on, such as thrush (fungal nappy rash), which thrives in warm, moist areas and needs to be treated with anti-fungal medication, or bacterial infection, for which you will need a topical antibiotic.
Common treatments for nappy rash
At home, you can treat (and help prevent) nappy rash with a barrier cream from your local supermarket or pharmacy. These are specially formulated for the nappy area and act – as the name suggests – as a barrier between your baby’s skin and the wee/poo and friction that’s making it sore. Using this cream at every nappy change will help you keep on top of the nappy rash and should stop it from spreading or worsening.
Prescription-based creams and ointments may incorporate steroids such as hydrocortisone in small amounts to reduce swelling, or anti-fungal or anti-bacterial treatments depending on the nature of the infection. These creams should be used according to your doctor’s advice.
What triggers nappy rash?
As mentioned, sensitive skin can become irritated through prolonged exposure to moisture – especially wee or poo – and friction from poorly fitting nappies. However, even fitting a nappy properly and keeping on top of nappy changes can’t wholly prevent nappy rash. Sometimes changes in your baby’s diet, illness, or teething can lead to changes in their poo and wee – or even just greater sensitivity overall – that result in nappy rash. Another trigger could be something in the baby’s bath water, soap or – if you’re using reusable nappies – the washing detergent or soaking solution.
If your baby is suffering, don’t beat yourself up – with the right nappy rash remedies, it will clear up and they’ll soon be back to normal.
Frequently asked questions about nappy rash
One of the best treatments for nappy rash is fresh air, so if your little one is suffering try to give them plenty of nappy free time. Of course, there might be accidents but if the weather’s warm consider letting them kick about outside (on a towel or blanket that’s easy to throw in the wash!) or do the same inside and try to cover surfaces with something washable. After fresh air, the next most important thing is to stay on top of nappy changes, use something gentle to clean them with and slather on that barrier cream to help soothe the rash and prevent it from getting worse.
If you’re not seeing any signs of improvement after a couple of days of this, go to the pharmacist or see your healthcare professional for advice. It might be your little one needs a topical ointment to improve their condition.
If the skin is broken, intensely red or very hot, or your baby’s bottom is covered in swelling blisters, or if you’re seeing no improvements after 2 – 3 days, it’s time to seek medical help. They will likely be very uncomfortable and may need medicated ointment to get rid of the infection. You can also give child-friendly paracetamol to babies over 2 months to help with pain.
Fungal nappy rash is caused by the fungus Candida albicans – the culprit behind yeast infections, otherwise known as thrush. A fungal nappy rash is usually indicated by the presence of blister-filled cysts in the skin folds in the nappy area and it will be uncomfortable. Your little one will need antifungal treatment, which you can get from the doctor or pharmacist.
A nappy rash is usually red and can be raised and swollen, but the presence of pustules (puss-filled blisters) usually indicates something more is going on. If in doubt, pop into the pharmacy with your baby and ask the pharmacist to have a look. They can recommend an appropriate nappy rash treatment.
