Four types of nappy rash and how to treat it at home

It’s one of the few near universal truths that along with being tired as a parent, your baby will get some form of nappy rash.  
While we often associate nappy rash with not changing nappies frequently enough, that’s not the only cause of nappy rash. There are different types of nappy rash, and they don’t all have to leave you feeling like you’ve failed as a parent.  
While nappy rash can be caused by your baby’s skin being in contact with wee or poo for a long time, that’s not always the issue.
Baby’s skin is super delicate (you can read more about the way a baby’s skin is different to adult’s skin here) and any rubbing, friction or contact with even mildly irritating substances can cause a breakout of red patches, spots, pimples or blisters. 
While some of that skin contact is inevitable, there are ways to spot what the rash might be caused by. In this post we explore:

different types of nappy rash and how to treat them

Four different types of nappy rash

1. Irritant dermatitis

Irritant dermatitis is a the most common type of rash you’ll find on a baby’s skin.

It’s typically caused by skin being in contact with urine of poo for too long. We’ve all had those moments when you realise you got distracted and forgot to change your baby’s nappy for a few hours, or when you’re trying to help your little one sleep through the night, and they have to adjust to spending the whole night in their nappy.

This can range in severity, but is commonly just noticeable as red patches around legs and bum and the top of the nappy.

2. Candida dermatitis

Candida dermatitis is a yeast infection. Nappies are the perfect place for yeast infections to grow as they’re warm and moist environments. Unlike irritant dermatitis, it’s not just regular poos and wees in contact with the skin that will lead to this particular rash. Candida dermatitis points to upset tummies with diarrhoea and acidic stools a common cause. It’s also possible that the wrong bath time products – soaps, bubble bath or moisturiser – could also cause an overgrowth of yeast.

Candida dermatitis can be found around the creases of the legs, bum, testicles or vulva and can result in pimples, blistering, bumps and ulcers. It’s also worth looking out for small areas of rash near the main rash – sometimes called satellite lesions.

3. Allergic dermatitis

Allergic dermatitis is the result of a reaction to a substance or material that has come in contact with your baby’s skin. If it’s in the nappy area it can be hard to identify without some careful backtracking of what product or substance you might have used on their skin that has caused the reaction. The resultant red sore bottom is a big clue, but can be hard to distinguish from other standard irritant dermatitis.

It’s also important to check for other rash areas outside of the nappy area as other rashes might give a better clue as to whether it’s a product used or something consumed that is the cause of the rash.

4. Bacteria dermatitis

This is commonly caused by Staphylococcusaureus (Staph) and Group A Streptococcus (Strep). Bacteria dermatitis affects areas of the skin that are already sore or broken. So you might find instances where untreated irritant dermatitis that have led to sores or broken skin can lead to more concerning bacteria dermatitis. 

These types of bacterial rash can look more severe. Staph bacteria dermatitis can look pus-filled blisters or yellowing scabs and crusts. Strep bacteria 

Three ways to naturally treat nappy rash at home

The good news is that to get rid of nappy rash, you don’t necessarily need very much help. 

The best treatment is early intervention, stopping a sore bum getting worse makes things much simpler. A lot of preventative measures therefore can be used more regularly at the first signs of irritant dermatitis.

  • Get your baby spending more time without a nappy on and ensure groin and crotch area is cleaned thoroughly, but very gently - switch to boiled (and then cooled) water and cotton wool if affected area is particularly sensitive.
  • Start changing nappies more frequently – every couple of hours – rather than waiting until the nappy feels fuller. This way you limit the amount of time a baby’s skin is in contact with irritants.
  • Use a good, natural barrier cream at early signs of redness or soreness. It’s often better to give a baby dry time when you see these signs because more moisture in the nappy area can add to the problems, that’s not always practical.
Note that finding a sore bottom just before you’re putting your baby to bed doesn’t give room for dry time so the best option to avoid overnight urine being in contact with sore skin is a good layer of barrier cream around the bum or genitals.

    How to prevent nappy rash with 'dry time'

    Once you have a good understanding of different types of nappy rash it can be a major help in working out how to prevent it in the first place.
    What’s clear, is that changing nappies frequently is not the only measure you should be mindful of when ensuring your baby or toddlers skin health and hygiene.
    A sometimes-intimidating way to prevent nappy rash is to allow your little one to spend time without a nappy on at all. No one wants to be cleaning up accidents all the time (which is why you're using nappies in the first place!) but here are some ways to make ‘dry time’ more hassle free:
    • Try using dry time for half an hour to an hour directly after a nappy change – ideally when you know they’ve just done a wee.
    • Try dry time on hard floors with wipeable surfaces under neath them (for little babies that might just mean time without a nappy on a changing mat place on a hard floor).
    • Try and combine dry time with tummy time on a mat like this Heads Up sensory playmat that we have designed to keep babies engaged on their front for longer. which provides cushioning, but is also easy to disinfect. Tummy time can be a bit of a pain as well so combining it is a great way to cover both bases.
    • Try dry time on a set of towels or bedding that you already intend to put in a high heat wash so an accident doesn’t mean any ‘additional’ washing.
    The other key preventative measure is to be more ruthless with the products you bring into contact with baby’s skin.
    Most often this means checking the labels on bath time soaps, moisturiser and bubble bath liquids, as well the wipes you are using to clean up the nappy area.
    Opting for fragrance free formulas designed for more sensitive skin might be a great place to start. Check out our skincare essentials list for some good options. 

    When to ask your doctor about persistent nappy rash

    As a parent it’s always best to just trust your instinct before any blog you read - ours included.
    If something doesn’t seem right, and you’re concerned, always call a doctor. While our suggestions for dealing with mild nappy rash might work fine, don’t ever hesitate to talk to a doctor about even the most mild nappy rash if it's worrying you. You know your baby best!
    If your baby is experiencing persistent rashes despite your best efforts to address it, speak to a doctor about what to do. Persistent rashes might occur because at-home remedies just aren’t powerful enough to deal with bacteria dermatitis. Or persistent rashes might be the result of an allergic reaction that should also be checked. Persistent nappy rash is a good reason to consult a doctor.
    If you suspect a rash is anything other than irritant dermatitis, it's best to talk to a doctor in order to establish if there are any prescribed or specific over the counter medicines that should be used. Candida, allergic and bacteria dermatitis will not necessarily respond simply to preventative or at-remedial treatments.
    the best treatments and products to help prevent nappy rash

    The best products to help prevent nappy rash

    here are now a range of alternative wipes (plastic-free, biodegradable etc) that also use extremely mild ingredients to ensure they're as gentle on your baby's skin as possible.
    Choosing the right wipes is a great way to help prevent nappy rash in the first place. You can read our ultimate guide to the best alternative wet wipes here.
    Some of our other favourite products to help protect the skin around your baby's nappy area include:
    • Water wipes or other non-branded alcohol-free and parfum-free wipes ensure a higher degree of sensitivity when cleaning the nappy area
    • Bamboo nappies offer better wicking properties than cotton so can be better at removing moisture from the nappy area – try these nappies from Mama bamboo
    • Great barrier creams are essential at dealing with the first signs of soreness. We recommend Sudocrem as simple antiseptic solution, but you could also try nappy barrier creams from Bepanthen or Burts Bees.
    • Our own Mushi microfibre cleansing cloths for kids use just water and are machine washable 1000 times. It means they're eco-friendly, super soft on skin and clean up more effectively than regular wipes to ensure you don't leave traces of poo or urine behind that can cause skin irritation.

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