| Diaper rashes are usually caused by irritation of the skin by urine and/or stool. Irritant diaper rashes usually spare the creases or skin folds of the diaper area and should improve in 2-3 days with OTC diaper rash creams. If it is not clearing up or is bright red and surrounded by red dots, your baby may have a secondary yeast infection (Candida) and will require treatment with an antifungal cream in addition to the regular diaper creams to help clear it up.
Seborrheic dermatitis can also involve the diaper area, and usually causes redness in the creases of the skin with sparing of other skin surfaces in the diaper area. Children with diaper rashes caused by seborrheic dermatitis will usually have involvement of other areas of the body, such as the scalp (cradle cap), behind the ears, or in other skin folds (axilla).
Diaper rashes prevention is by minimizing wetness in the diaper area. You can do this by frequent diaper changes, using superabsorbent diapers, applying a barrier ointment after each diaper change, increasing air exposure by keeping the diaper off as much as possible. Also avoid excessively cleaning or scrubbing the skin in the diaper area. Instead, use a mild soap or skin cleanser only after bowel movements and rinse with just warm water at other times.
Severe diaper rashes may need to be treated with a mild 1/2% hydrocortizone cream twice a day for two or three days in addition to the above recommendations. Avoid using stronger steroid creams in the diaper area.
Warning: Don't use Lotrisone, a combination of clotrimazole (an antifungal) and a very strong steroid to treat your infant's diaper rash. The steroid is too strong and can lead to serious side effects, including skin atrophy and growth retardation.
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