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Nappy Rash

By Dr Evelyn Lewin

Nappy rash is a common skin reaction that occurs in the area covered by a baby’s nappy. It can occur in babies who use cloth or disposable nappies. Nappy rash is more likely to occur when a baby has been in a wet, or soiled, nappy for a prolonged time. Classified by intense redness, peeling, raised bumps (papules) and a few fluid-containing bumps (pustules). You should contact your pediatrician if your baby is experiencing a severe rash.


Babies with nappy rash have a red, sore-looking looking rash in their nappy area. Sometimes, the skin may blister or ulcerate. Babies with nappy rash may be grizzly or miserable. Thrush looks similar to nappy rash. The rash is red and spotty, and skin looks shiny.


To prevent nappy rash, apply a thick layer of barrier cream at every nappy change. Barrier creams protect skin from direct contact with urine or faeces. Zinc creams offers good protection. When bathing, use a mild soap, or soap-free wash. Pat baby’s nappy area dry, rather than rubbing it. Then apply a generous slather of barrier cream. If possible, wipe baby’s bottom with cotton wool moistened with luke-warm water instead of baby wipes. Changing your baby’s nappy frequently, especially after she has soiled it, can help prevent nappy rash. Try to give your baby as much ‘nappy free’ time as possible. Place her on a towel or open nappy. The air helps prevent, and allow healing, of nappy rash. If you use cloth nappies, rinse them properly after use. Only reuse when completely dry. Avoid using plastic pants over nappies as they prevent air ‘breathing’, which can worsen the rash. If possible, swap to disposable nappies while your baby has nappy rash. Thrush requires treatment with antifungal cream. If you suspect your baby has thrush, see your GP. Also see your doctor if your baby has an unexplained fever while she has nappy rash, if the rash is not improving, if it is spreading to other areas, getting worse (blisters or ulcers appear), or if you are concerned.

Reviewed by Dr Evelyn Lewin 25 February 2015 references
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This document has been developed and peer reviewed by a KIDS HEALTH Advisory Board Representative and is based on expert opinion and the available published literature at the time of review. Information contained in this document is not intended to replace medical advice and any questions regarding a medical diagnosis or treatment should be directed to a medical practitioner.

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