
Nappy rash is common and may occur despite the most careful attention to your baby. Almost all children wearing nappies get nappy rash at some stage.
Take your child to the doctor if:
In cultures where nappies are not worn, nappy rash is unheard of. Cloth nappies tend to cause fewer problems than disposables, which do not let air circulate as much. If possible plastic overpants should not be used for the same reason.
Various factors combine to cause nappy rash. The main cause is prolonged contact of a wet or dirty nappy with the baby’s skin. Ammonia may be released from the urine and this further irritates the skin. The use of plastic pants may make the rash worse because air cannot reach the skin and, as a result, moisture is retained. Associated conditions such as eczema or thrush may make the rash worse.
The skin in the nappy region looks red and sore. Some areas of skin may be raised or swollen and there may even be ulcers present. Skin folds are usually not involved because they are protected from exposure to urine. The rash may cause discomfort or pain, which may make the baby irritable and cry more often.
Simple measures will usually work and the rash will improve or disappear in a few days. A good course of action will include:
Secondary infection can sometimes occur, especially thrush (fungus or yeast). These bugs are normally present on the skin, but are real opportunists and multiply when the chemical balance has been disrupted in their favour. Thrush appears as bright red and shiny areas in the napkin area; they have clearly defined borders and also affect the skin folds. Numerous red dots (satellite lesions) may be studded beyond the outer edge of the rash.
Treat with an antifungal cream which will be prescribed by your doctor. As opposed to a simple nappy rash, which clears up quickly, thrush can take longer to clear, and has a tendency to recur. Treatment can be prolonged, and sometimes very frustrating.
If used consistently, the simple measures outlined above should help prevent nappy rash. Keep the nappy area clean and dry, and use protective sorbolene creams (often containing a zinc oxide base).