Nappy Rash (Diaper Rash): Causes, Treatment and Prevention

You change the diaper and find red, shiny, angry skin on your baby’s bottom. Nappy rash (diaper rash) is one of the most common reasons young babies cry and fuss. It looks alarming, but in most cases it clears within a few days once you adjust the routine.

This guide explains why nappy rash happens, how to treat it step by step, which creams are worth keeping at home, and when it is time to call the paediatrician.

What does nappy rash look like?

Typical nappy rash shows as red, warm, slightly raised skin on the buttocks, thighs and around the genitals. The skin folds are often spared in simple rash. Your baby may cry when the area is wiped or touched, and the skin can look shiny or have small sore patches.

Why does it happen?

• Wetness: a wet or dirty diaper left on for too long breaks down the skin.
• Urine and stool: they irritate delicate skin, especially loose stool when a baby has diarrhoea.
• Friction: a tight diaper or rough wipes.
• Heat and sweat: common in the long Pakistani summer, when babies sweat inside a plastic-backed diaper.
• New products: a different diaper brand, wipes with perfume or alcohol, or a strong detergent on cloth nappies.
• New foods: starting solids can change the stool and trigger rash.
• Antibiotics, in baby or in a breastfeeding mother, which can upset skin yeast.
• Yeast (Candida) infection: a different type of rash that needs different treatment.

How to treat nappy rash

1. Change often. Newborns need a change every two to three hours and after every stool. Do not wait for the diaper to feel full.
2. Clean gently with plain lukewarm water and cotton wool, or a fragrance-free wipe such as Maq Premium Baby Wipes. Do not scrub.
3. Pat dry and give the skin some air time without a diaper for a few minutes, on a towel.
4. Apply a thick barrier cream at every change. Choose one with zinc oxide, which creates a protective layer. Good options include Zinc Oxide Paste (read about zinc oxide), Nexton Baby Diaper Care Cream, Nexton Baby Diaper Cream and Burnoff Nappy Rash Cream.
5. Size up if the diaper leaves red marks at the waist or thighs. A looser fit lets air in.

You can find more in our baby care and diapers and wipes sections.

Choosing diapers and wipes

• Pick the right size. Diapers that are too small rub, and ones that are too big leak.
• Look for soft, breathable diapers such as the Rainbow Diapers range, sold by baby weight.
• Avoid wipes with alcohol and strong perfume.
• If you use cloth nappies, wash them in mild detergent and rinse well.

What to avoid

• Talcum powder. It can be inhaled and may irritate your baby’s lungs.
• Adult creams, steroid creams and anti-fungal creams unless a doctor prescribes them.
• Tight plastic pants over the diaper.
• Baby oils or lotions on top of the barrier cream.
• Home pastes such as toothpaste, haldi, or Dettol.

When to see the paediatrician

• The rash has not improved after three to four days of good care.
• The rash is bright red with small red spots spreading beyond the diaper area, or it sits deep in the skin folds. This can be a yeast infection.
• You see blisters, open sores, pus or bleeding.
• Your baby has a fever or seems unwell.
• The rash returns again and again.
• Your baby is under six weeks old and has a rash.

If your baby has loose stools and a fever, our guide to waterborne diseases lists the signs of dehydration to watch for.

How to prevent nappy rash

• Change diapers quickly and regularly, even at night when possible.
• Use a barrier cream at every change if your baby is prone to rash.
• Give a few minutes of diaper-free time every day.
• Wash your hands before and after every change.
• In summer, keep the baby cool and dress them in light cotton.

Frequently asked questions

Is nappy rash a sign of poor hygiene?

No. Even carefully looked-after babies get it. It is mostly about moisture and skin sensitivity.

Should I stop using diapers while my baby has a rash?

You do not need to stop, but more diaper-free time speeds healing.

Can I use coconut oil?

A thin layer can soothe some babies, but a zinc oxide barrier cream is better for protecting broken skin.

How long does nappy rash take to clear?

Mild rash usually clears in two to four days with good care. Stubborn or yeast rash can take longer.

Khasmart delivers baby care essentials across Pakistan.

This article is for general information and is not a substitute for advice from your paediatrician or pharmacist. It does not include dosage; always follow the directions on the pack or from your doctor.