What causes nappy rash?

Nappy or diaper rash generally refers to any skin irritation in the nappy area. The rash is common and the irritation is naturally associated with prolonged exposure to urine and faeces. Causes include leaving a nappy on too long, inadequate drying of the skin after bathing, allergy to lotions or soaps and chemical additives in laundry washing powders. Sensitivities may also occur with baby wipes and fabric softeners. Another cause is thrush, a yeast infection.

What happens with nappy rash?

Babies naturally cry when they are hungry and uncomfortable. They also cry when they have a sore bottom.

A nappy rash can be mild to severe (bright red skin to sores). In most cases the nappy rash begins around the anus and then spreads to the genital area and the folds in the skin plus the buttocks. The skin is bright red, sometimes spotty red, usually sensitive to touch, sore and irritating.

In more severe cases the skin may weep and have a scaly appearance.

Traditional Pharmacy

The obvious major goal is to keep the area as dry as possible in order the help the rash heal. Usual treatment is to protect the area with a layer of protective cream (usually containing zinc oxide). In most cases, nappy rash responds well to at home treatment.

If the infection is thrush (a candidal infection), suitable over-the-counter medications are available, including an antifungal cream containing clotrimazole. Bifonazole is also available in an antifungal cream as a once a day treatment. Consult your pharmacist for advice.

Natural Pharmacy

Calendula cream applied to the area helps the healing process, as well as aloe vera gel. The application of a Vitamin E cream may be of benefit.

What else to do

• At the first sign of a rash, wash the area and apply a barrier cream (sorbolene) or protective cream (zinc oxide).
• Check the skin often during hot or humid weather.
• Avoid using plastic overpants.

Prevention and Cautions

• Keep the baby dry and clean, changing the nappy frequently or as soon as it is soiled.
• Choose mild detergents to wash cloth nappies.
• Leave the nappy off as long as possible, allowing the area to dry naturally for 10 minutes or so.
• Avoid chafing and rubbing.

Seek professional advice if:

• If you suspect bacterial infection.
• If the rash appears worse.
• If your treatment does not improve after a few days.
• If the area is scaly or has yellow coloured blisters.
• If the baby's penis is red or swollen.

References

• The Merck Manual, 17th Edit. 1999
• The Encyclopaedia of Natural Medicine 2nd Edition. 1998