A diaper rash is any rash that affects the area of skin a diaper would cover. Different types of diaper rash can include irritant contact dermatitis, infections, eczema, intertrigo, and psoriatic diaper rash.

These rashes usually occur due to moisture and irritation from the diaper itself. However, some diaper rashes can indicate an underlying medical condition.

Most diaper rashes are relatively mild, but some can be quite severe, causing painful welts and sometimes cracking.

This article will cover the causes, symptoms, and treatments associated with several types of diaper rash.

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Types of diaper rash

There are many different types of diaper rash. The sections below will look at each of these in more detail.

Contact dermatitis

Irritant contact dermatitis is the most common cause of diaper rash. It develops when something irritates the skin.

This type of dermatitis tends to get worse when a baby sits in a wet or dirty diaper for a long period of time. In some cases, babies may also have allergies to the diaper itself.

Irritant contact dermatitis can cause bumps or spots to appear in the area. If it gets severe enough, there may also be welts that can crack open and bleed. Open sores make it easier for fungi and bacteria to get into the skin, increasing the risk of a secondary infection.

Changing the baby’s diaper more frequently and using a diaper rash cream until the rash clears up can help treat irritant contact dermatitis.

Candidiasis, or yeast, infections

A group of fungi called Candida naturally live on the skin and in the diaper area. When they grow in excess, though, they can cause a painful diaper rash known as candidiasis, or a yeast infection.

The rash may look inflamed, and it may include white, fluid filled blisters or swollen spots with a scaly outer layer.

Sometimes, a child gets a yeast infection following another type of diaper rash that cracks open and bleeds.

Applying a diaper rash cream can help treat some yeast infection rashes. It is also important to keep the area clean and dry.

If symptoms get worse or do not improve, a doctor may recommend using an antifungal cream.

Eczema

Eczema, or atopic dermatitis, causes itchy, dry patches to develop on the skin. Usually, atopic dermatitis does not affect the diaper area, but it might in some cases.

A parent or caregiver might notice that the baby’s skin looks inflamed or irritated. There may also be hard, scaly areas. The condition often appears at around 3 to 12 months old, and often appears in parts of the body that fold or bend, such as the backs of the knees.

Washing eczema gently with water and, depending on the age of the baby, a mild or eczema-friendly cleanser is important. Keeping the skin moisturized and using emollients can also help create a barrier to protect it.

A doctor may recommend a steroid cream or another treatment, depending on the severity of the eczema.

Bacterial skin infections

Bacterial infections of the diaper area can cause swollen and inflamed skin.

Babies with bacterial infections may develop a fever or seem sick. However, some may show no other symptoms besides the diaper rash.

Without treatment, these infections could also spread to other areas of the body and become life threatening.

In most cases, a doctor will prescribe antibiotics. Because bacterial infections can enter the body if diaper rash becomes severe and causes open wounds, preventing diaper rash may also prevent secondary infections.

Intertrigo

Intertrigo is a type of inflammatory skin condition that is more severe in skin folds and warm, wet places, such as the folds of the thighs or a baby’s buttocks.

Intertrigo sometimes gets secondary yeast or bacterial infections that require additional treatment. Babies who get intertrigo diaper rashes may also get other inflammatory rashes as adults.

In most cases, it is possible to manage intertrigo by removing the source of the irritation. For babies, this usually means more frequent diaper changes.

Psoriatic diaper rash

Psoriatic diaper rash is a type of psoriasis. Psoriasis is a chronic skin condition that causes the body to attack healthy cells, leading to thick, scaly patches of skin.

These scales may itch, and they may look pink or gray. Children may also have psoriatic patches elsewhere on the body, particularly the scalp.

Psoriasis does not get better with diaper rash treatment. However, some people may notice that certain irritants, such as a wet diaper, can trigger flares of psoriasis. Therefore, preventing diaper rash from developing is still important when a baby has psoriasis.

Numerous remedies can help treat psoriasis, including steroid creams and prescription drugs. Some people may also find relief from phototherapy.

»Learn more: Does my baby have psoriasis?

Treatment and prevention 

To help treat and prevent diaper rash, a person can:

Most cases of diaper rash occur due to irritant contact dermatitis and will go away on their own or with home treatment.

If these steps do not help, a doctor can prescribe medication and offer advice.

»Read more: How to get rid of diaper rash

Diagnosis

Parents and caregivers can see a doctor about severe diaper rash that cracks open and bleeds or does not get better with home treatment.

A doctor should be able to diagnose the cause of the diaper rash by examining the baby. If they suspect an underlying medical condition, they may recommend blood work or other tests.

If the diaper rash has a bacterial infection, a doctor may prescribe broad-spectrum antibiotics or take a culture to see which bacteria are present.

Summary 

Diaper rash can cause discomfort in babies. Severe diaper rash may even cause dangerous infections. However, trying a few simple management strategies can reduce the risk of a baby experiencing severe diaper rash.

Even with these interventions, some children continue to get diaper rash. A doctor or pediatrician can help with assessing the cause and make recommendations for preventing diaper-related pain and irritation.