Medicines for Nappy rash

What it is

Nappy rash is a very common skin irritation in the area covered by a baby's nappy, and most babies get it at some point. It usually appears as red or discoloured, sore-looking skin over the nappy area — the bottom, genitals, and the folds of the thighs — and the skin may look inflamed, feel warm, and be uncomfortable, making the baby unsettled, particularly during nappy changes. The main cause is the skin being in prolonged contact with wee and poo, which irritate the delicate skin, made worse by friction from the nappy, and by not changing nappies often enough or the skin being left damp. Most nappy rash is mild and clears up quickly with simple nappy care. However, if the rash is more severe or persistent, it can become complicated by a fungal (thrush/candida) infection — which tends to be a brighter red, often affects the skin folds, and may have small red spots (satellite lesions) spreading beyond the main rash — and, less commonly, a bacterial infection. Some other skin conditions (such as eczema) can also affect the nappy area. Nappy rash is usually easy to treat and prevent, and understanding good nappy care is the key.

How it is treated

Most nappy rash is managed with simple measures and good nappy care, which both treat and prevent it. Key steps include: changing nappies frequently and promptly (as soon as they are wet or soiled), so the skin is not in prolonged contact with wee and poo; cleaning the area gently at each change (with water or fragrance-free wipes) and drying it gently but thoroughly; and giving the baby some nappy-free time to let the skin air and dry. A thin layer of a barrier cream or ointment (such as those designed to protect against nappy rash) helps protect the skin. Avoiding soap, bubble bath and fragranced products on the area, and not using talcum powder, helps too. For mild rash, these measures usually clear it within a few days. If the rash is severe, painful, or not improving, or looks like it may be infected — for example a fungal infection (bright red, in the folds, with spreading spots), which is common — a doctor or pharmacist may recommend a treatment such as an antifungal cream, and, occasionally, a mild steroid or antibiotic treatment for more inflamed or bacterially infected rashes. If a baby seems unwell, or the rash is severe or spreading, it should be checked. The reassuring message is that nappy rash is common and usually mild, and clears quickly with good nappy care — frequent changes, gentle cleaning and drying, barrier cream, and nappy-free time — with simple treatments available for infected or persistent cases.