Diaper Rash: What Every Parent Should Know

As a pediatrician with over 15 years of experience, I’ve had countless conversations with concerned parents about diaper rash. It’s one of the most common skin conditions in infancy—and understandably so. Baby stool is soft, sticky, and full of digestive enzymes that can irritate delicate skin. But diaper rash isn’t caused by just one thing. Understanding the different types and their treatments can help you care for your baby with confidence.

Let’s break it down together.

When Something Is Touching the Skin

One of the most frequent causes of diaper rash is simple contact. Stool contains digestive enzymes that are great for breaking down food—but unfortunately, they also break down skin. This is especially true during bouts of diarrhea, when loose stool sits on the skin longer and causes red, blotchy irritation.

Here’s a helpful trick: a 1:1 mixture of an emollient and an antacid can soothe this type of rash. The emollient moisturizes and protects, while the antacid neutralizes the enzymes. It’s a powerful combination, and your local pharmacist can help prepare it safely.

Other irritants include disposable diapers, soaps, laundry detergents (especially with cloth diapers), and scented ointments. These can trigger contact dermatitis, a rash caused by direct irritation or an immune response. For this type of rash, I recommend:

• Hydrocortisone cream (twice daily)

• A thick layer of zinc oxide ointment with every diaper change—thick enough that you can’t see the skin underneath. This creates a protective barrier so irritants touch the ointment, not your baby’s skin.

When Something Is Growing on the Skin

Babies have fewer natural skin microbes than adults, which leaves room for yeast (fungus) to grow. One common culprit is Candida albicans, the same organism that causes thrush and cradle cap. In the diaper area, it often appears as redness in the skin folds, surrounded by small red “satellite” spots.

This type of rash requires an antifungal cream. It’s important to get the diagnosis right—using hydrocortisone alone can actually make a yeast rash worse. If you’re unsure, don’t guess. Reach out to your pediatrician for guidance.

When Bacteria Invade the Skin

Sometimes, diaper rash opens the door for bacterial infections like impetigo, cellulitis, or even abscesses. These occur when normal skin bacteria enter through broken or irritated skin. Signs include:

• Intense redness

• Swelling or tenderness

• Hardness under the skin

• Drainage or scabbing

These infections need prompt treatment with topical or oral antibiotics. If you notice these symptoms, contact your child’s doctor right away.

Prevention: Your Best Tool

While diaper rash is common, there are simple steps you can take to reduce the risk:

• Avoid known irritants like harsh soaps or fragrances.

• Use a barrier ointment (like zinc oxide or petroleum jelly) with every diaper change.

• Change diapers promptly after bowel movements.

• Air dry skin for 5-10 minutes.

Even with the best care, diaper rash can still happen. And when it does, knowing what kind of rash you’re dealing with—and how to treat it—makes all the difference.