SymptomChildren's health
Baby Has a Diaper Rash: What Type Is It?
A diaper rash is redness, soreness or spots on the skin covered by a diaper. Most are simple irritant rashes from wetness and stool, which affect the skin that touches the diaper and spare the folds. A bright red rash in the creases with small red spots around the edge suggests yeast. Blisters, crusts, pus or fever suggest a bacterial infection. Most rashes clear in 2 to 3 days with frequent changes and a barrier cream.
Also called: Nappy rash, diaper dermatitis, red bottom
At a glance
- What it is
- Inflamed skin in the diaper area, most common between 4 and 15 months.
- Most common type
- Irritant rash from urine, stool and friction.
- Other types
- Yeast (candida), bacterial infection, seborrheic dermatitis, allergy.
- How serious
- Usually mild. Infection or a rash spreading beyond the diaper needs a doctor.
- Treatment
- Frequent changes, air time, thick zinc oxide or petroleum barrier cream, and antifungal cream for yeast.
When to get help
Call 911 or go to the ER
- A baby under 3 months with a fever of 38 °C (100.4 °F) or higher
- A rash with purple or dark spots that do not fade when you press a glass on them
- A baby who is floppy, very sleepy, or refusing to feed
See a doctor within a day or two
- Blisters, pus-filled spots, yellow crusts or open sores
- Fever with the rash, or spreading redness beyond the diaper
- Fewer wet diapers or signs of dehydration with diarrhea
Book a routine appointment
- A rash that is not better after 2 to 3 days of home care
- Bright red rash in the skin folds with spots at the edges (possible yeast)
- A rash that keeps coming back or also appears on the face, scalp or elsewhere
Usually safe to manage at home
- Mild redness on the bottom or genitals with no blisters or fever
Types of diaper rash and how to recognize them
| Type | What it looks like | Typical clues |
|---|---|---|
| Irritant (most common) | Pink to red, shiny patches on the buttocks, genitals, upper thighs | Spares the skin folds. Worse with diarrhea |
| Yeast (candida) | Beefy red, raised, in the folds, with small red "satellite" spots at the edges | Lasts over 3 days, after antibiotics, with oral thrush |
| Bacterial (impetigo, strep) | Blisters, honey-colored crusts, pustules, or bright red ring around the anus | Fever, pain, spreading |
| Seborrheic dermatitis | Salmon-pink, greasy, well-defined, in the folds | Cradle cap on the scalp |
| Allergic contact | Red rash exactly where wipes, dyes or diaper elastic touch | Started after a new product |
| Eczema | Dry, itchy patches | Eczema elsewhere, usually spares diaper area |
| Psoriasis | Sharply outlined bright red patches, little scale | Family history, not helped by usual creams |
The detail on each type, why they happen and how to prevent them is on our diaper rash condition page.
What to do now
- Change diapers often: as soon as wet or soiled, and at least every 2 to 3 hours, including once overnight if the rash is bad.
- Clean gently: use lukewarm water and a soft cloth, or fragrance-free, alcohol-free wipes. Pat dry, do not rub.
- Air time: leave the diaper off for a few minutes several times a day on a towel.
- Barrier cream: apply a thick layer of zinc oxide paste or petroleum jelly at every change. You do not need to wipe it all off each time; just remove soiled cream.
- Loosen the fit: use a slightly larger diaper size, and avoid plastic pants over cloth diapers.
- Skip irritants: no talc (it can be breathed in), no cornstarch on a yeasty rash, no scented products.
If it looks like yeast
Yeast rash usually needs an antifungal cream such as clotrimazole or miconazole, which are available over the counter. Ask a pharmacist or doctor before using it on babies, and apply it under the barrier cream. Improvement takes 2 to 3 days. If your baby also has white patches in the mouth that do not wipe off (thrush), the mouth needs treatment too.
Steroid creams
Do not use strong steroid creams in the diaper area unless a doctor prescribes them, because the diaper increases absorption and thin skin is easily damaged. A doctor may suggest 1% hydrocortisone for a few days for very inflamed rashes.
What makes diaper rash worse
- diarrhea, including from teething, antibiotics or a stomach bug
- starting solid foods, which changes stool
- antibiotics, given to the baby or the breastfeeding parent, which encourage yeast
- infrequent changes overnight
- tight diapers that rub
When diaper rash is something else
A few rashes that start in the diaper area need medical attention:
- Impetigo: blisters and honey-colored crusts from staph or strep bacteria. Needs antibiotic cream or tablets.
- Perianal strep: a sharply defined, bright red, sore ring around the anus, sometimes with blood-streaked stool.
- Hand, foot and mouth disease: spots on the buttocks along with mouth sores and spots on hands and feet.
- Kawasaki disease (rare): peeling red skin in the diaper area with fever for 5 days, red eyes and red lips.
- Balanitis: red, swollen tip of the penis in boys.
Frequently asked questions
How can I tell if a diaper rash is yeast?
A yeast diaper rash is bright red, raised and often worst in the skin folds and creases, with small red dots or bumps spreading out from the edges. It usually does not improve with barrier cream alone after 2 to 3 days. An antifungal cream is needed.
How long does diaper rash last?
A simple irritant diaper rash usually improves within 2 to 3 days of frequent changes and barrier cream and clears within a week. Yeast rashes need antifungal treatment. See a doctor if there is no improvement after 3 days of care.
When should I worry about diaper rash?
Call a doctor for blisters, pus, crusts, open sores, bleeding, fever, a rash spreading beyond the diaper area, or a baby who seems unwell or is not feeding. Any fever in a baby under 3 months needs urgent medical care.
Is it okay to use wipes on diaper rash?
Water and a soft cloth are gentlest on a sore bottom. If you use wipes, choose fragrance-free and alcohol-free ones. Some wipes contain preservatives that cause allergic rashes, so switch to water if the rash is not settling.
Can teething cause diaper rash?
Teething does not cause rash directly, but many parents notice looser stools and more rash around the same time. Frequent changes and a thick barrier cream during these periods help prevent it.
Sources
This guide was written from current patient and clinical guidance, including:
- American Academy of Pediatrics (HealthyChildren.org): Diaper rash
- American Academy of Dermatology: How to treat diaper rash
- NHS: Nappy rash
- MedlinePlus: Diaper rash
- Mayo Clinic: Diaper rash