Information

Nappy rash is thought to affect up to a third of nappy-wearing babies at any given time. Your baby’s skin comes into contact with urine (wee) and faeces (poo) in their nappy and this can cause it to become sore and irritated and covered in pink or red spots or blotches.

How serious is it?

Most nappy rashes are mild and can be avoided or treated with the right skin care routine. Your baby will usually feel no pain or discomfort. However, some nappy rashes are more severe and can be caused by an underlying condition or
bacterial infection. A severe rash is painful and distressing for your baby and may need treatment with medication.

Mild nappy rash

If your child has mild nappy rash, a small part of their nappy area will be covered in a pink or red rash, usually made up of small spots or blotches. However, they should feel well and will only experience a stinging sensation when passing urine or faeces.

If your baby has a mild nappy rash, they will not normally need any medication or specialist treatment. Instead, there are steps you can take to safely treat the rash at home.

• Leave your baby’s nappy off as long as possible
• Not putting a nappy on your baby will help them to stay dry and avoid contact with faeces or urine. It is usually most convenient to leave your baby’s nappy off when they are asleep. You can lay them on an absorbent towel or somewhere where you can easily manage any soiling or wetting
• Avoid using soaps when cleaning your baby’s skin
• Only use water to clean your baby’s nappy area in between changes. Use a soft material, like cotton wool or a soft towel, when drying. Dab the affected area carefully and avoid rubbing their skin vigorously
• Avoid bathing your baby more than twice a day. Experts think this may dry out their skin and cause a more severe nappy rash
• Apply a barrier cream every time you change their nappy
• Using a barrier cream or ointment after each nappy change will reduce the contact that your baby’s skin has with urine and faeces. Zinc cream, zinc oxide ointment and petroleum jelly are all suitable barrier creams. Ask your pharmacist for advice about which cream is most suitable for your baby
• Change your baby’s nappy frequently
• To lower the risk of your baby getting nappy rash, change your baby’s nappy as soon as they wet or soil it. If your baby has nappy rash, make sure you change their nappy more frequently than you normally would
• Consider changing the type of nappy you are using
• If you are using disposable nappies, use one that is highly absorbent. However, these are often more expensive than other nappies. If you cannot use high-absorbency nappies, make sure you change the nappy frequently; ideally, as soon as your baby wets or soils it.

Severe nappy rash

If your baby’s nappy rash is severe, they may have more advanced and painful symptoms that make them distressed or
uncomfortable. Symptoms may include:

• Bright red spots
• Dry, cracked and broken skin
• Swellings, ulcers and blisters on the skin

The rash will cover a larger part of the nappy area and may spread down the legs or up to the abdomen (tummy). Your baby may cry more often than usual and be irritable.

If your baby has severe nappy rash, they usually need medication to treat the condition. Your GP will first check that you have been carrying out the skin care routines advised for a mild nappy rash (see above). Once your GP is satisfied that the correct skin care routines are being followed, they usually prescribe some topical medicines to treat the rash. ‘Topical’ means that the medicine is applied directly to the affected area (in this case, the nappy area).

Choose care at home if…

• Your baby has mild nappy rash. Follow the instructions above and the rash will usually clear up in a few days.

Choose your pharmacist, health visitor or GP if…

• Your baby has symptoms of severe nappy rash
• Your child develops severely inflamed (swollen and irritated) skin or a fever. This may be a sign of infection

Choose 999 A&E if…

• There are no reasons why you should need to go to A&E for problems with nappy rash
• A&E is for urgent, life-threatening illness and injury

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