A pediatric dermatologist explains how and why babies get diaper rash—and how to stop it before it starts.
Diapering: it’s a dirty job, but hey, someone’s gotta do it (and that someone is…you.) But how can you keep your baby’s skin as safe and irritation-free as possible? And what’s the deal with diaper rashes, anyway? We asked Peter Lio, MD, Clinical Assistant Professor of Dermatology and Pediatrics at Northwestern University Feinberg School of Medicine, how to keep your kiddo’s most delicate skin clean and cared for.
Q: Why are babies prone to diaper rash?
A: Diaper rash has everything to do with—you guessed it—diapering: “Diapers unnaturally keep stool and urine right up against skin,” explains Lio. “Rashes can also be related to certain types of wipes which can be harsh on baby skin. Sometimes the culprit is the chemical in the wipes, other times it can be the paper of the wipes themselves—and it can be irritant or truly allergic in some cases.” (All the more reason to make sure your wipes are water-based, fragrance-free, and free of suspect chemicals). But try as you might, there will likely come a time when your little one has some sort of irritation down there. “It’s incredibly common, and the majority of children will experience it at some point,” says Lio. “The key is trying to prevent it and, if it occurs, promptly addressing it so it doesn’t cause any issues.”
Q: What does diaper rash look like, and how does it feel to babies?
A: Yikes, those poor little babies can have it rough—and it’s definitely not pretty: “Diaper rash tends to start as red, irritated skin, but can progress to true skin breakdown (open, oozing) and even become infected with yeast or bacteria,” says Lio. “It is likely very uncomfortable for babies, especially when more severe.”
Q: How often should I change my baby’s diaper to avoid irritation?
A: “Changing diapers frequently, but most importantly quickly after urine or stool seems to really help prevent and minimize irritation,” says Dr. Lio.
Q: What is cream to powder best for?
A: In a word: wetness, especially when it comes to those little folds, creases, and baby rolls. “A cream to powder formulation can be wonderful for absorbing excess moisture,” says Lio; use it in folds and creases (where chafing can be an issue) to help minimize irritation.
Q: How can I reduce the chances of getting diaper rash before it starts?
A: “There was a study a number of years ago that showed that babies in Greece very rarely got diaper rash,” notes Lio. “One big difference was that instead of wiping with diaper changes, they would gently wash the area in the sink and pat dry. This is much less irritating to the skin and can help prevent chafing.” If washing your baby in the sink at every diaper change just isn’t in the cards for you, don’t worry—that’s where baby skincare comes in. “Applying a thick, protective diaper paste or balm with each diaper change is also very helpful,” says Lio. These types of ultra-nourishing formulas help support the natural moisture barrier of baby’s skin, the first line of defense against irritation.
Q: How do I deal with diaper rash and discomfort when it does show up?
A: “At the first sign of diaper rash, it’s important to take action to prevent it from getting worse,” says Lio. He recommends this course of action:
- Pay extra attention to your baby so diaper changes can happen fast after a dirty diaper materializes.
- Do as the Greeks do: gently wash the area at each diaper change, then pat dry (no rubbing); it may help prevent additional irritation and trauma.
- Applying a thick, protective coat of diaper paste or balm after each diaper change helps support the skin, Lio says: “We often council to not remove all of the diaper balm. Just gently remove the top soiled layer until you see clean balm, then apply more. This way the skin stays protected.”
Q: How long does diaper rash generally last?
A: “If treated, usually just a few days,” says Lio. “However, more severe cases can persist for weeks or even months.”
Q: When does a diaper rash require a doctor’s visit?
A: “If things are worsening despite taking basic measures, if there are open sores or pustules, or if the baby appears very uncomfortable or has a fever, all of those warrant an expedited doctor visit,” says Lio.
Q: Any other diaper skin conditions I should watch out for?
A: Candida yeast infections are a form of diaper rash, and can exist on their own or as a complication of more irritant-type rashes, explains Lio. “Rarely, certain nutritional deficiencies (particularly zinc) can cause a rash that mimics diaper rash,” says Lio. “Because it’s often due to poor absorption of zinc, this requires evaluation by an experienced doctor.” There are other even rarer skin conditions, so if things aren’t improving, it’s always important to get your baby evaluated by a pediatrician or dermatologist.
The information provided by Pipette is intended solely for educational purposes. The information is not to be used for medical diagnostic purposes and is not intended to serve as a recommendation for treatment and/or management of any medical/surgical condition. Most of all, this information should not be used in place of a physician or other qualified health provider. If you believe you or your child have a medical condition, please contact your physician immediately.