'Nappy Rashes'

How to treat, prevent and when to seek medical advice

First Line of Treatment

Ensure the nappy fits properly (too tight increases skin occlusion; too loose minimizes absorption of fluids).
‘Air time’. Leave nappies off for as long as possible to help skin drying of the nappy area.
Clean the skin and change the nappy every 3–4 hours, or as soon as possible after wetting or soiling, to reduce skin exposure to urine and faeces.
Use water, or fragrance-free and alcohol-free baby wipes.
Bath your Baby daily — avoid excessive bathing (such as more than twice a day) which may dry the skin excessively.
do not use soaps, baby lotion or bubble bath as they can irritate the skin
do not use talcum powder or antiseptics on nappy rash
do not put nappies on too tightly as it can irritate the skin

Nappy rash usually clears up after about 3 days if you follow these hygiene tips

If it does not clear

Your local Health Visitor or Pharmacist can recommend a nappy rash cream to treat it.
You should apply the cream first and wait a few minutes before you apply the barrier cream.

When to seek medical advice

If the rash doesn't go away or your baby develops a persistent bright red, moist rash with white or red pimples that spreads into the folds of their skin, they may have an infection.
Follow your Prescriber, Health Visitor or GP's instructions on whether and when to apply barrier cream as well as the prescribed cream.

[CHC 2.3.2023 National Health Service: Choices https://www.nhs.uk/conditions/baby/caring-for-a-newborn/nappy-rash/

The recommendations on management are largely based on a Cochrane systematic review Disposable nappies for preventing napkin dermatitis in infants [Baer et al, 2006], and expert opinion in review articles on nappy rash [Lund, 1999; Visscher, 2009; Ravanfar et al, 2012; Ness, 2013; Coughlin, 2014; Stamatas, 2014; Merrill, 2015; Atherton, 2016; Van Gysel, 2016; Cohen, 2017].

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